Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

(^70) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Strategy Examples Rationale
Examine the problem
critically, and make sure
that the final statement
defines the specific
problem.
Specific problem
Do patients understand their pain
management regimen?
Assumed problem
Are patients following the
prescribed pain management
regimen?
Gives the team time
to gather information,
observe, listen, and
probe to ensure a true
understanding of the
problem
Ask clarifying questions. Clarifying questions
When are these patients
experiencing pain?
What are the precipitating
factors?
How often are they taking their
pain medications?
Helps the team get to
the specific problem by
using question words
such as when, what,
how
Refrain from blaming the
problem on external forces
or focusing attention on
the wrong aspect of the
problem.
Attributing blame
The patients are noncompliant
with the prescribed pain-
medication therapy.
The nurses did not educate
the patient properly about
the importance of taking pain
medications as prescribed.
Keeps the team focused
on processes and
systems as the team
moves to define the
EBP question
State the problem in a
different way.
Restating problem
40% of patients with post
total knee replacement had
low patient satisfaction scores
related to pain management after
discharge.
Helps gain clarity by
using different verbs
Table 4.2 Strategies for Defining the EBP Problem (continued)