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

4 The Practice Question 69

Table 4.2 Strategies for Defining the EBP Problem

Strategy Examples Rationale

Phrase the problem

statement in terms of the

knowledge gap, not the

solution.

Knowledge gap

Staff lack knowledge of the best

strategies to manage patient pain

immediate post-discharge total

knee replacement

Solution

Patients need a better pain

management strategy for the

immediate post-discharge period.

Allows the team to see

other, potentially more

effective, solutions

State the problem rather

than symptoms of the

problem.

Problem

40% of patients discharged post

total knee replacement complain

that they were not able to

manage their pain.

Symptom

Patients with total knee

replacement were not satisfied

after discharge.

Allows the team to

determine the true

problem, and its size

and scope, without

being sidetracked by

outward signs that a

problem exists

Describe in precise terms

the perceived gap between

what one sees and what

one wants to see.

Current State

Patient satisfaction with pain

management post discharge is

36%.

Future State

This is compared to a national

benchmark of 85%.

Allows the team to

assess the current state

and envision a future

state in which broken

components are fixed,

risks are prevented,

new evidence is

accepted, and things

that were missing

elements are provided

continues