Question Development Tool Practice Problem

QUESTION DEVELOPMENT TOOL

Nursing Evidence-Based Practice

Appendix B: Question Development Tool

1. What is the problem and why is it important?

The problem is the high incidence of medication errors at the practice setting. The hospital’s policy is zero incidents of medication errors. Over the past two years, however, there has been a notable increase in such incidents, with the past year recording at least one error in every ten medication administration events. The most common medication errors involved administering the wrong medication, administering medication to the right patients in wrong doses, and administering medication at the wrong time. Unfortunately, medication errors can cause severe physical injury and preventable death in severe cases (Tariq et al., 2022). Further, such errors place the institution at risk of reputational issues, legal settlements, and costs associated with prolonged patient hospitalization

2. What is the current practice?

The hospital operates a decentralized alarm system that notifies nurses whenever a patient is due for medication as a means to ensure that drugs are administered at the right time, to the right patients, and in the right doses.

3. What is the focus of the problem?

? Clinical

? Educational

? Administrative

4. How was the problem identified? (Check all that apply)

??Safety/risk management concerns

? Quality concerns (efficiency, effectiveness, ? timeliness, equity, patient-centeredness)

? Unsatisfactory patient, staff, or organizational outcomes

??Variations in practice within the setting

??Variations in practice compared with external organizations

???Evidence validation for current practice

???Financial concerns

5. What is the scope of the problem?

? Individual ? Population ?Institution/system

6.What are the PICO components?

P – (Patient, population, problem): admitted patients at the practice setting

I – (Intervention): medication safety education program for medical professionals (Abukhader & Abukhader, 2020)

C – (Comparison with other interventions, if applicable): An alarm notification system

O – (Outcomes that include metrics for evaluating results): A 20 percent reduction in the incidence of medication errors at the facility

7. Initial EBP question

How effective is a medication safety education program for medical staff as compared to an alarm notification system in reducing the incidence of medication errors among hospitalized patients?

8. List possible search terms, databases to search, and search strategies:

Search terms: medication safety education, alarm notification, reduced medication errors

Databases to search: Cochrane Open Access Library, Plos, PubMed, and The Digital Commons Network

Search strategies: brainstorm terms that studies could use in describing the topic, develop a list of relevant terminology and key words to govern the search, use of keywords rather than sentences or statements to search the selected databases, searching databases for controlled vocabulary such as MeSH terms in PubMed, and using Boolean operators to combine search terms

9. What evidence must be gathered (Check all that apply)

? Literature search

? Patient/family preferences

? Standards (regulatory, professional, community)

? Clinical expertise

? Guidelines

?Organizational data

? Expert opinion

Johns Hopkins Nursing Evidence-Based Practice

Appendix B: Question Development Tool

Directions for Use of the Question Development Tool

Purpose: This form is used to develop an answerable question and to guide the team in the evidence search process. The question, search terms and strategy, and sources of evidence can be revised as the EBP team refines the EBP project focus.

What is the problem and why is it important? Indicate why the project was undertaken. What led the team to seek evidence? Make sure the problem statement defines the actual problem and does not include a solution statement.

What is the current practice? Define the current practice as it relates to the problem.

What is the focus of the problem? Is the problem a clinical concern (e.g., preventing blood stream infections); an educational concern (e.g., discharge teaching for patients); or an administrative concern (e.g., safety of 12-hour nursing shifts)?

How was the problem identified? Check the statements that describe how the problem was identified.

What is the scope of the problem? Does the problem look at an individual (e.g., clinician, patient, family member); a population (e.g., adult cardiac patients, recovery room nurses); or an institution/system (e.g., patient transportation, patient or staff satisfaction)?

What are the PICO components?

· P (patient, population, problem) e.g., age, sex, setting, ethnicity, condition, disease, type of patient, or population

· I (intervention) e.g., treatment, medications, education, diagnostic tests or best practice(s)