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Nursing: Evidence Based Practice

Resources for Highline Nursing Capstone's Evidence Based Practice Research

Background vs. Foreground Questions

What's the difference between background and foreground questions in Evidence Based Practice?

Background Questions Foreground Questions
  • More general and foundational
  • Asked when you don't know much about the topic, and need more information get started
  • Asked when you need more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc. to develop  an effective foreground question
  • Question may begin with what or when
  • Too general for an effective Nursing research topic
  • NOT good for a PubMed search
  • More specific question that will provide evidence for clinical decision making
  • Usually related to a specific patient, population, or treatment (Who/What/How)
  • Uses the PICO acronym to narrow and define the question
  • One of four content areas: treatment, diagnosis, etiology, and prognosis
  • Good for an effective Nursing research topic
  • Good for a PubMed search

Literature resources:

Literature resources:
Examples of Background Questions: Examples of Foreground Questions:
  • "What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes?"
  • "What are the measures of effective blood sugar control?"
  • "What is an effective 'telehealth' consultation?"
  • "What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers?"
  • "For adolescents with type II diabetes does the use of telehealth consultations compared to in-person consultations improve blood sugar control?"

Adapted from NYU Libraries. Capstone and PICO Project Toolkit

Adapted from Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110(3), 58–61. https://doi.org/10.1097/01.naj.0000368959.11129.79

Is Your Research Question Too Broad or Too Narrow?

Make sure your question isn’t too broad or too narrow. If you notice any of the following while searching for articles and books, you may need to refine your topic. 

Too Broad? Too Narrow?
can be summed up in one or two words  difficult to figure out where you would locate information (e.g., data may not exist)
difficult to come up with a thesis statement hard to research because there is so little current information (e.g., you only found 3 or 4 results in your searching)
hard to research because there is so much information (e.g., you found 1000s of hits in your searching)  

Examples of topics that might be too broad:

"Is Medical Nutrition Therapy effective?"

Strategies to improve a too broad topic:

Apply journalistic question words (Who | What | Where |When | Why | How) to your topic to narrow your focus. (e.g., “Bicycle Helmets” could be narrowed to “What is the impact of wearing bicycle helmets on patients in the United States younger than 18 years old on emergency room admittance statistics” = who, where)

Examples of topics that might be too narrow:

"Is a one-shot motivational interviewing session effective for reducing after-school soda consumption among teens?"

Strategies to improve a too narrow topic:

Remove one aspect of your topic 

What is Evidence Based Practice?

According to Melnyk et al. (2009): "Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values." 

According to the American Nursing Association (2023), Evidence Based Practice is defined as "providing holistic, quality care based on the most up-to-date research and knowledge rather than traditional methods, advice from colleagues, or personal beliefs."

References

American Nurses Association. (2023, May 5). What Is Evidence-Based Practice in Nursing? ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/#:~:text=Evidence%2Dbased%20practice%20in%20nursing%20involves%20providing%20holistic%2C%20quality%20care

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-Based Practice: Step by Step: Igniting a Spirit of Inquiry. AJN, American Journal of Nursing, 109(11), 49–52. https://doi.org/10.1097/01.naj.0000363354.53883.58