Topic This article explores the use of 4 quality improvement tools and 2 evidence-based practice tools that, when used within the nursing process, encourage critical thinking about quality issues. Clinical Relevance Patients and families expect to receive patient-centered, high-quality, and cost-effective care. Caring for critically ill patients is challenging and requires nurses to engage in quality improvement efforts to ensure that they provide evidence-based care. Purpose of Paper To explore the use of critical thinking tools and evidence-based practice tools in assessing and diagnosing quality issues in the clinical setting. Content Covered The nursing process serves as the framework for problem solving. Some commonly used critical thinking tools for assessing and diagnosing quality issues are described, including the Spaghetti Diagram, the 5 Whys, the Cause and Effect Diagram, and the Pareto chart.

Evidence-based nursing care is informed by research findings, clinical expertise, and patients’ values, and its use can improve patients’ outcomes. Use of research evidence in clinical practice is an expected standard of practice for nurses and health care organizations, but numerous barriers exist that create a gap between new knowledge and implementation of that knowledge to improve patient care. To help close that gap, the American Association of Critical-Care Nurses has developed many resources for clinicians, including practice alerts and a hierarchal rating system for levels of evidence. Using the levels of evidence, nurses can determine the strength of research studies, assess the findings, and evaluate the evidence for potential implementation into best practice. Evidence-based nursing care is a lifelong approach to clinical decision making and excellence in practice.