(^72) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Developing Answerable EBP Questions .................................
Having agreed on the nature and scope of the practice problem, the EBP team
develops an answerable question that addresses a clinical, administrative, or
knowledge problem (see Appendix B).
EBP projects require time, availability of evidence, EBP skills, expert mentors,
and leadership support. Consequently, the EBP model and process may not be
practical for all questions. Choose questions that have a high return on quality
and safety outcomes as well as those that align with organizational priorities.
Before embarking on an EBP project and committing the necessary time and re-
sources, consider the following questions:
■■ Would the practice changes resulting from this project improve clinical
or staff outcomes, unit structures or processes, or patient or nurse
satisfaction?
■■ Would they reduce the cost of care?
■■ Can potential practice changes be implemented given the current culture,
practices, and organizational structure within the particular practice
setting?Choosing a Background or Foreground Question
There are two types of EBP questions: background and foreground (Sackett,
Rosenberg, Gray, Haynes, & Richardson, 1996; Sackett, Straus, Richardson,
Rosenberg, & Haynes, 2000). A background question is a best practice ques-
tion that is broad and produces a wide range of evidence for review. Background
questions are used to identify and understand what is known when the team has
little knowledge, experience, or expertise in the area of interest (e.g., concept,
treatment, intervention). For example, a background question intended to better
understand pain management for people with a history of substance abuse is as
follows: What are the best nursing interventions to manage pain for patients with
a history of substance abuse? This question would produce evidence related
to pharmacology, alternative therapies, behavioral contracting, and biases in