Clinical questions arise from various cues, problems, and/or observations from patient care, nursing practice, or broader changes in healthcare knowledge and delivery. The most important step in Evidence-Based Nursing (EBN) is to correctly identify a problem through patient assessment or practice assessment, processes that require reflection by the nurse on clinical practice, in conjunction with a knowledge of the patient's present circumstances. The ability to identify the problem is the foundation for evidence-based nursing; if a nurse fails to identify a problem correctly, then all the evidence she/he locates and the resulting decision-making will be irrelevant (Haddock, 2005).
The information below describes how to frame the question once the patient or practice assessment and the resulting problem identification have occurred.
An early step in framing the clinical question is to determine the type of question: background or foreground. The type of question helps to determine the resource to access to answer the question.
Clinical questions typically fall into one of four main categories:
* Knowing the type of clinical question is important later in the EBN process--once the nurse goes to look for studies that will answer his/her question.
Nursing Practice Questions:
In nursing, many other questions about practice will also arise, with some of the questions resulting from the nursing principle of working with rather than on the patient. These questions can be quantitative or qualitative in nature. Examples include: