What’s your Q? Empowering nurses to answer clinical questions through the evidence-based practice process

Background/Rationale The research-to-practice gap of approximately 15 years is due to many factors, one lacking clinician’s evidence-based practice (EBP) knowledge, skills, and competency. Evidence-Based Practice is a problem-solving process incorporating external evidence, clinical expertise, and patient preferences, guiding clinicians to integrate evidence into practice. Fostering a spirit of inquiry empowers nurses to engage in the EBP process to solve clinical practice problems and improve patient outcomes. A system-wide practice change for filtering IV fluids led to a wondering question about the best practice for filtering intravenous parenteral nutrition in the neonatal population. Purpose To engage clinical nurses in the EBP process by asking a wondering question about the best practice for filtering parenteral nutrition and to synthesize the evidence. Implementation plan The seven-step EBP process was the model guiding this inquiry. Neonatal nurses were invited to critically appraise the literature, guided by EBP mentors, to ascertain the best practice for filtering parenteral nutrition. The nurses were educated on the EBP process, assigned an article, and associated rapid critical appraisal tool to critically appraise together with a team of EBP mentors. Outcomes Nine neonatal nurses participated in the EBP process to evaluate and synthesize the evidence using the newly implemented, seven-step EBP process to identify best practice for filtering parenteral nutrition administered to neonates in the neonatal ICU. Upon evaluation and synthesis of the literature, the inquiry team recommended a 0.2-micron positively charged filter for administration of parenteral nutrition and a 1.2-micron filter for intralipid administration for all pediatric and neonatal patients. Implications for Practice Engaging clinical nurses in the EBP process to evaluate and synthesize literature, guided by EBP mentors knowledgeable and skilled in the EBP process, is necessary for hospitals and healthcare organizations to implement and sustain evidence-based practices. Upon critically appraising the evidence and incorporating clinical expertise, the inquiry team recommends an evidence-based practice change