Clinical Inquiry Skills in Nursing

Lesson Transcript
Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Clinical inquiry is the practice of asking about medical procedures and information to gain knowledge and improve patient care. Learn about the importance of clinical inquiry in nursing, and explore the PICO framework that is used in clinical inquiry. Updated: 01/21/2022

What Is Clinical Inquiry?

Melissa is a bachelor-prepared nurse working in the ICU. She is pursuing her master's degree and learning about clinical inquiry in nursing. Clinical inquiry is the practice of asking questions about clinical practice. Throughout nursing school, we learn many things. Once we move into clinical practice, we learn even more! Many times we are learning from experienced nurses that are teaching us from their training and experience. As knowledgeable as these nurses are, sometimes the things we're taught are not best practice, although they may very well be common practice.

In an effort to continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it's done this way or is it just because we've always done it this way?

There are three areas that clinical inquiry can extend into. Quality improvement projects are used to improve patient care. Research is done to generate new knowledge. And evidence-based practice is the practice of the knowledge gleaned by research. Evidence-based practice takes research and is implemented in patient care for the best outcomes.

Melissa is challenged to identify an area at work to practice her clinical inquiry.

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  • 0:04 What Is Clinical Inquiry?
  • 1:21 Formulating PICO
  • 2:32 Practice Investigation Steps
  • 3:55 Lesson Summary
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Formulating PICO

Melissa has worked in the ICU for two years now and she often cares for patients with a tracheostomy. All of her training for managing a tracheostomy came from working with the nurses and respiratory therapists on her unit. She was always taught to squirt normal saline into the tracheostomy prior to suctioning. She understood that this helped to thin the secretions to be suctioned out.

With her new homework assignment to practice clinical inquiry, she now thought more about this practice. Any substances entering the lungs is harmful, so why is it okay to squirt normal saline into them?

The PICO framework is used to guide clinical inquiry into further investigation. P is to identify the problem, population, or patient. I is for the intervention in question. C is for a comparative intervention and O is for the outcome that results from the intervention.

Melissa attempts to use the PICO framework to address her clinical inquiry. (P) In a patient with a tracheostomy, (I) is the use of normal saline, (C) safe versus not using normal saline during suctioning, (O) to remove secretions.

Practicing Investigation Steps

The next week in class, the professor continues her teaching on clinical inquiry. Now that the students have their questions, what do they do with that? She explains to the students that the next step is to review the current literature available on their question.

Research such as randomized control trials (RCTs) are the strongest evidence available. RCTs involve research with an experimental group and control group in which the only difference between the two groups is the outcome variable being studied. Not all topics have RCTs available so the students need to be creative in their search to find research that pertains to their questions.

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