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

4 The Practice Question 71

Strategy Examples Rationale

Challenge assumptions. Is the team’s assumption
correct?
The patient fills the pain-
medication prescription and is
taking pain medication in the way
that it was prescribed.

Helps the team avoid

conjecture and question

everyday processes and

practices that are taken

for granted

Expand and contract the
problem.

Expanded problem

Is dissatisfaction with post-

discharge pain management part

of a general dissatisfaction with

the hospital stay as a whole?

Contracted problem

Are there multiple reasons

for dissatisfaction with post-

discharge pain management,

such as inability to pay for pain

medications or fear of becoming

dependent on pain medications?

Helps the team

understand whether

the problem is part of

a larger problem or

is made up of many

smaller problems

Assume multiple
solutions.

Multiple solutions

What ARE best practices for

managing post-discharge pain

in patients following total knee

replacement?

Single solution

What IS the best practice for

managing post-discharge pain

in patients following total knee

replacement?

Helps the team identify

more than one possible

solution to determine

the best fit for the

population of interest