Nurs305: Exam 1 - Ch. 5 Evidence-Based Practice

Front 1

In caring for patients, it is important for the nurse to realize that evidence-based practice is

a. the only valid source of knowledge that should be used

b. secondary to traditional or standard care knowledge

c. dependent on patient values and expectations

d. not shown to provide better patient outcomes

Back 1

C. Dependent on patient values and expectations

Front 2

What are the three components of evidence-based practice (EBP)?

Back 2

Patient values, clinical expertise, best research evidence

Front 3

What are the steps of EBP?

Back 3

1. Ask a clinical question.

2. Collect the most relevant and best evidence.

3. Critically appraise the evidence you gather.

4. Integrate all evidence utilizing clinical expertise, patient preferences and values in making a practice decision of change.

5. Evaluate the practice decision or change.

6. Share the outcomes of EBP changes with others.

Front 4

What does PICOT stand for?

Back 4

Patient population

Intervention of interest

Comparison (between what?)

Outcomes

Time frame

Front 5

The first step in EBP is to ask a clinical question. In doing so, the nurse needs to realize that in researching interventions, the question

a. is more important than its format

b. will lead you to hundreds of articles that must be read

c. may be easier if in PICOT format

d. may be more useful the more general it is

Back 5

C. May be easier if in PICOT format

Front 6

Who is Xan Goodman?

Back 6

UNLV Health sciences
librarian

Front 7

What does RCT stand for? Why is it significant to the research process?

Back 7

RCT stands for Randomized Control Trials. These are considered the best resources because there is a decreased chance for skewed data.

Front 8

Define meta-analysis.

Back 8

lots of different sources

Front 9

True or false: the lower on the hierarchy of evidence, the more "basic" and credible it is.

Back 9

False! If it is closer to the bottom of the hierarchy of evidence, it is less credible.

Front 10

What is the most credible source according to the hierarchy of evidence?

Back 10

Systematic reviews and meta-analysis of RCT's

Front 11

What is the least credible source according to the hierarchy of evidence?

Back 11

Opinion of authorities or expert committees

Front 12

Give an example of study limitations that would be included in the Results and Conclusions section of a research article.

Back 12

Small sample size, inaccurate/inefficient equipment, variations/inconsistencies in test subjects, etc.

***Only sample size was included in Karen's lecture, the rest were found via Google

Front 13

Who would be the major stakeholders when integrating a change in the hospital (i.e.: the emergency room)?

Back 13

The people implementing the changes: nurses, housekeeping, lab, etc.

Front 14

What questions would you ask yourself while evaluating the practice decision/change?

Back 14

How is the clinical practice change working? How effective was the change? Do modifications need to be made? Will this change be sustainable?

Front 15

True or false: sustainability of EBP changes is more likely when value is seen by the change.

Back 15

True! If stakeholders see a benefit to the change, it will improve their cooperation.

Front 16

Who is the main focus of Outcome Management Research?

Back 16

The recipient of care (typically the patient but could be the nurse too)

Front 17

True or false: Properly implementing the scientific method minimizes bias or opinion by the researcher.

Back 17

True!

Front 18

Quantitative research focuses on...

Back 18

Numerical data, statistical analysis, controls to eliminate bias in findings

Front 19

True or false: quantitative research is subjective.

Back 19

False! Quantitative research is objective (i.e.: numbers).

Front 20

What are the four type of quantitative research?

Back 20

Experimental research, non-experimental research, surveys, evaluation research

Front 21

True or false: experimental research includes case controlled studies.

Back 21

False! Experimental research includes RCT's (randomly assign control group and treatment group).

Front 22

Which type of quantitative research may be conducted retrospectively?

Back 22

Non-experimental research

Front 23

Which type of quantitative research relates to Outcomes Management Research?

Back 23

Evaluation research

Front 24

Which type of quantitative research requires gathering a large amount of data to describe the population and topic of study?

Back 24

Surveys

Front 25

Why are large population samples essential when performing quantitative research using surveys?

Back 25

Large population samples minimize sampling error.

Front 26

Define qualitative research.

Back 26

Study of phenomena that are difficult to quantify or categorize.

Front 27

True or false: patient perception of illness is an example of qualitative research.

Back 27

True!

Front 28

How would you obtain qualitative data?

Back 28

Written transcripts, interviews, story-telling

Front 29

Define ethnography.

Back 29

Explores cultural phenomena

Front 30

Define phenomenology
.

Back 30

explores structures of subjective experiences and consciousness

Front 31

Define grounded theory

Back 31

discovery of theory through analysis of data

Front 32

Qualitative research methods include ______________, _________________, and ___________.

Back 32

Ethnography, phenomenology, grounded theory

Front 33

In conducting a research study, the researcher must guarantee that any information the subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. This concept is known as

a. anonymity

b. confidentiality

c. informed consent

d. the research process

Back 33

B. confidentiality

Front 34

Give an example of a vulnerable population.

Back 34

Elderly, mentally ill, prisoners, children, poor (poverty)

Front 35

What is Respect for Persons?

Back 35

Subjects are given full and complete information including potential harm, benefits, & alternative methods of treatment.

Front 36

True or false: subjects have the power of free choice to voluntarily consent or decline participation in a study.

Back 36

True! This is called autonomy.

Front 37

True or false: non-maleficence can be defined as the patient's benefit from participating in a study.

Back 37

False! Non-maleficence means do no harm.

Front 38

What does HEW stand for?

Back 38

Health Education and Welfare

Front 39

The hospital policy stats that when starting an intravenous (IV) catheter, the nurse must first prepare the potential IV site with alcohol and dress it using a gauze dressing. The nurse has done a literature review and believes that EBP dictates the use of a transparent dressing to prevent catheter dislodgment. What should the nurse do?

Back 39

Bring findings to the policy and procedure committee

Front 40

What is the focus of outcomes management?

Back 40

Increase patient safety and decrease medical errors.

Front 41

What is an example of high-risk/low-volume?

Back 41

Restraints, cardiac arrest

Front 42

What is an example of high-risk/high-volume?

Back 42

Catheters, medications

Front 43

Define sentinel event.

Back 43

Incident involving death or serious physical or psychological injury

Front 44

True or false: the National Patient Safety Goals was published by the World Health Organization (WHO)?

Back 44

False! The National Patient Safety Goals was published by The Joint Commission.

Front 45

What is the "bottom up approach"?

Back 45

All members of the health care team are responsible for developing and integrating changes.

Ultimate goal is to reduce costs, enhance quality and improve teamwork

Front 46

What is rapid cycle improvement?

Back 46

A response to a serious problem; radical changes made in a short period of time

Front 47

Why is it important to revisit interventions after they've been implemented by major stakeholders?

Back 47

To analyze successes and potentials for improvement

Front 48

The nurse has used her PICOT question to develop an EBP change in protocol for a certain nursing procedure. However, to make these changes throughout the entire institution would require more support staff than is available at this time. What is the nurse's best option?

Back 48

Conduct a pilot study to develop evidence to support the change.