Why are comprehensive bibliographic databases (such as CINAHL, PubMed, and Scopus) more complicated to search than databases such as DynaMed and the Cochrane Database of Systematic Reviews? Given that gray literature is not peer reviewed, why would researchers want to use it.Describe the association among the need for change (background), aim of the project, and the purpose for undertaking an improvement change. Identify the tools and population necessary to determine the need for a project?