Chap 24
The nurse understands the role of the National Institute of Nursing Research (NINR) in the American Recovery and Reinvestment Act of 2009 when stating: (Select all that apply.) a. "The NINR was not involved in the recovery act." b. "The act was created to assist with the economic recovery of the country." c. "The act includes measures to modernize our national infrastructure, including health care." d. "The act was created to take control away from Americans." e. "The act was created to modernize our national infrastructure excluding health care."
?? The NINR has several functions, including acting as a major source of federal funding for nursing research, supporting education in research methods and research career development, and establishing the National Nursing Research Agenda. Funding local hospitals is not a function of the NINR.
Which statement would indicate a unit nursing staff is entering the preutilization step of research utilization? a. "We've found two studies that have explored methods for reducing violent behavior on psych units." b. "We need a new approach to containing violence on the psych unit." c. "This is the plan for implementing the new antiviolence strategies." d. "This is a summary of the evaluation data we collected."
ANS: B The first step in using research in nursing practice is the recognition that some aspect of nursing practice could be done in a more efficient, a more beneficial, or simply a different way, so wanting a new approach to containing violence on a psych unit would be an example. Identifying studies about methods for reducing violent behavior would be step 2—assessing. Planning to implement new antiviolence strategies would be step 3 of the process. A summary of evaluation data would be included in the final step (step 5) of the process.
Which statement by the nursing professor shows understanding of the major function of the National Institute of Nursing Research? a. "Serves as a major source of federal grants to fund nursing research" b. "Provides direction to nurses interested in research utilization" c. "Collects data about the major nursing schools in the country" d. "Provides money to fund the education of nurses"
ANS: A Federal grants fund nursing research and also support education in research methods, research career development, and excellence in nursing science.
Which steps can the nurse take to apply evidence-based research into nursing practice? (Select all that apply.) a. Identify, review, and evaluate the data applicable to the problem. b. Define the problem. c. Design a practice change based on the data. d. Implement the change in nursing practice. e. Continue to work around the problem.
ANS: A, B, C, D The nurse should begin by defining the problem. Next, the nurse should identify, review, and evaluate the data applicable to the problem. The next steps are to design a practice changed based on the data and implement the change in nursing practice. The nurse should not continue to work around the problem.
A student asks the nurse manager, "When I was reading an article about research utilization, I ran across the phrase 'practice context.' What does that mean?" What is the best response? a. "It is made up of the factors and systems that contribute to delivery of nursing care in a particular setting." b. "It refers to the specific group of patients who are to receive care in a particular setting." c. "It describes the type of health care delivery system that is currently in place in a particular setting." d. "It refers to the policies, procedures, and staffing patterns of a nursing unit."
ANS: A Practice context determines to what degree you can use the findings from nursing research. It is a blending of all those factors and systems that contribute to the delivery of nursing care. This blend includes the health, social, and cultural characteristics of the patient population served; the type of practice setting; the economic resources of the setting; the type of health care delivery system; the existing policies and procedures; the staffing pattern; and the administrative structure. Each factor or system can be either enabling or inhibiting, but it is the practice context as a whole that is evaluated to determine the applicability of nursing research findings. The other options are components or part of the practice text. The answer includes all of the factors, not just the specific ones listed in the distracters.
Which action can the nurse expect in the preutilization step in nursing research utilization? a. Recognition that some aspect of nursing care could be done in a different way b. Recognizing that nurses need shortcuts in order to manage their workload c. Critical evaluation of published research d. Using electronic databases to search current literature
ANS: A The action that the nurse can expect in the preutilization step is the recognition that some aspect of nursing care could be done in a different way. This step is not meant to create shortcuts for nurses to manage their workload. Critical evaluation of published research and using electronic databases to search current literature occurs in the second step, assessing.
What is the correct sequence of activities in the research utilization process? a. Identification of practice problem, evaluation of related published research, planning, implementation, evaluation b. Planning, implementation, evaluation, review of published research, application to practice problem c. Evaluation of published research, decision to identify practice problem, planning, implementation, evaluation d. Determining question to be answered, determining data-gathering methods, data evaluation, plan for utilization, evaluation
ANS: A The proper sequence in the research utilization process must begin with the identification of a practice problem (preutilization), which in turn sets the stage for the step-by-step approach incorporating critical thinking and decision making, including evaluation of published research (assessing), planning, implementing, and evaluating.
How can nurses being to define their practice context? a. Identify characteristics that are specific to the group of people who will receive nursing care. b. Specify all types of settings that nursing occurs in. c. Determine all characteristics of the setting that contribute to nursing care. d. Determine all characteristics of the setting that inhibit nursing care.
ANS: A To define their practice context, nurses should do the following: identify characteristics that are specific to the group of people who will receive nursing care, specify the type of practice setting that the care will occur in, and determine characteristics of the setting that contribute to or inhibit nursing care.
The nurse has an adequate understanding of evidence-based practice when the nurse states which of the following? (Select all that apply.) a. "Evidence-based practice is similar to research utilization." b. "Evidence-based practice is becoming important in all areas of health care." c. "Evidence-based practice incorporates many additional sources of data that may contribute to improved nursing care." d. "Evidence-based practice is not accepted as best research evidence." e. "Evidence-based practice is not used in nursing care."
ANS: A, B, C Evidence-based practice is similar to research utilization, is becoming important in all areas of health care, and incorporates many additional sources of data that may contribute to improved nursing care. It is also accepted as best research evidence and used directly in nursing care.
A nurse is educating a coworker on the similarities between conducting research and research utilization. The nurse judges the teaching to be effective when the coworker states: (Select all that apply.) a. "Both are a step-by-step process." b. "Both involve critical thinking." c. "Decision making must occur in both processes." d. "Knowledge generation is essential in both processes." e. "Collecting new data occurs in both." f. "Reviewing published research studies is part of both processes."
ANS: A, B, C Using nursing research in practice is a step-by-step process incorporating critical thinking and decision making to ensure that a change in practice has a sound basis in nursing science. Collecting new data is primarily done in conducting research, and research findings can generate new knowledge. Reviewing published research studies is a component of research utilization.
The nurse understands the function of The National Institute of Nursing Research (NINR) when stating: (Select all that apply.) a. "The NINR is a major source of federal funding for nursing research." b. "The NINR supports education in research methods." c. "The NINR funds local hospitals." d. "The NINR supports education in research career development." e. "The NINR establishes National Nursing Research Agenda."
ANS: A, B, D, E The NINR has several functions, including acting as a major source of federal funding for nursing research, supporting education in research methods and research career development, and establishing the National Nursing Research Agenda. Funding local hospitals is not a function of the NINR.
Which statement by the nurse shows understanding of what would not be a barrier to research utilization? a. "Too few studies reported in the literature relating to the identified problem" b. "Obtaining consensus to implement a new approach to resolve the care problem" c. "Staff suggesting there is too little time to learn a new approach to the care problem" d. "Staff asking, 'Why fix it if it isn't broken?'"
ANS: B Consensus building constitutes a second phase of step 1 that is used to identify the specific practice to be changed. In this phase, the incorporation of the principles of change theory will increase the possibility of success. A change will be more acceptable if those affected are included in the decisions related to the change. Clear communication and teamwork are essential elements of this process. Group consensus is crucial for the successful application of research findings. Barriers include those who are resistant to the change, budgetary and personnel constraints, too few research studies related to the practice problem, the lack of replication of the findings, and the time lag from the completion of a research project until the project report is published may make the research findings obsolete.
How does evidence-based practice (EBP) differ from research utilization? a. EBP has similar steps to the nursing process, which differ from research utilization. b. EBP is a systematic method of applying research findings to nursing practice that incorporates many additional sources of data that may contribute to improved nursing care. c. Research utilization is a component of nursing practice that involves the collection of data to answer a specific research question and EBP uses the data to make protocols. d. EBP uses a nursing theoretical framework for implementation of practice guidelines, which is essential for the continued development of nursing theories
ANS: B Evidence-based practice is similar to research utilization in that it is a systematic method of applying research findings to nursing practice that incorporates many additional sources of data (not just nursing and nursing theory) that may contribute to improved nursing care. A brief definition of evidence-based practice that is generally accepted is the integration of the best research evidence with clinical expertise and patient values. EBP implies internal decision making on the nurse's part. The steps in applying evidence-based practice include defining the problem; identifying, reviewing, and evaluating the data applicable to the problem; designing a practice change based on the data; implementing the change in nursing practice; and evaluating the implementation. All three processes—research utilization, nursing research, and the nursing process—have the same five major steps. However, the specific tasks for each process are different. The collection of data to answer a research question is the research process, not research utilization.
A nursing professor has just joined the National Institute of Nursing Research (NINR). Which activities should the professor anticipate being a part of? a. Providing financial support for any worthy nursing research study b. Channeling federal money into nursing research related to the national nursing research agenda c. Publishing information detailing successful research utilization projects d. Arranging traineeships in development of research proposals
ANS: B One function of the NINR is to establish the National Nursing Research Agenda, which is composed of priority topics for nursing research. These topics may be related to a national health need, or they may be in an area that requires research for the development of nursing science. The NINR is a major source of federal funding for nursing research. The NINR also supports education in research methods, research career development, and excellence in nursing science. It does not arrange nursing research traineeships or publish information on the success of research utilization projects.
A nursing professor is educating students on barriers to incorporating nursing research into practice. The nurse professor judges the teaching to effective when a student states: (Select all that apply.) a. "Because of advances in research, there are no barriers." b. "A barrier is time lag from completion of research until the project report is published." c. "Resistance of individuals involved can cause a barrier." d. "Budget constraints are a barrier." e. "Personnel constraints are rarely a barrier."
ANS: B, C, D The teaching has been effective when the student lists the following as a barrier to incorporating nursing research into practice: Time lag from completion of research until the project report is published, resistance of individuals, and budget and personnel constraints.
A staff nurse recognizes the need for a change in practice regarding hand hygiene. How can the nurse implement a change in practice? (Select all that apply.) a. Ignore the problem until management enforces a change. b. Ask if the manager can hold a staff in-service. c. Implement the change on the unit. d. Monitor the change. e. Evaluate the effectiveness of the change.
ANS: B, C, D, E The fourth step of applying evidence-based practice is to implement the change in nursing practice. The nurse can accomplish this by asking if the manager can hold a staff in-service, implementing the change on the unit, monitoring the change, and evaluating the effectiveness of the change.
The nurse manager has an adequate understanding of research utilization when stating which of the following? a. "In the process of research utilization, the emphasis is on finding new data." b. "A major component of the process is reviewing current nursing practices." c. "The process involves transferring research findings into practice." d. "The process is solely based on critical thinking."
ANS: C Research utilization involves transferring research findings into practice. Emphasis is based on using existing data. A major component is reviewing completed nursing research studies and is based on critical thinking and decision making.
A nurse educator is teaching a nurse about research utilization. Which statement by the nurse indicates understanding? a. "Research utilization is the collection of data to answer a specific question." b. "Research utilization is the analysis of the practice context." c. "Research utilization is the process of integrating the findings of completed studies into practice." d. "Research utilization involves application of the findings of one research study."
ANS: C Research utilization is the process of systematically integrating the findings of completed nursing research studies into clinical nursing practice. The important aspect is using already existing research data and findings to modify nursing practice.
What does research utilization on an inpatient unit require? a. A nursing theoretical framework should be followed. b. Orem's theory of self-care requisites should be followed. c. Only the nurses should participate in the implementation. d. The implementation should be consistent with the nursing framework in the practice context.
ANS: D Implementation of a new approach should follow a specific plan. It is also important that evaluation data be collected at the same time as the implementation to clearly determine the effect of the new approach. A major component of the research utilization process is reviewing completed nursing research studies that have been published in the literature. In contrast, conducting new research involves the collection of new data to answer a specific clinical practice question. Nursing research utilization is a step-by-step process incorporating critical thinking and decision-making to ensure that a change in practice has a sound basis in nursing science.
Which of the following nursing activities are necessary to provide evidence-based nursing care? a. Maintaining self-directed practice and using the Internet to locate relevant research articles b. Having an advanced degree (CNS or FNP) and providing clinical supervision for peers c. Attending continuing education programs and working toward a graduate degree in nursing d. Systematically integrating nursing research findings and applying relevant evidence to practice
ANS: D Providing evidence-based practice involves searching the research literature, critically synthesizing research findings, and applying relevant evidence to practice. The other activities are myths about what makes effective practitioners.
A nursing instructor is educating a group of student on research utilization. The teaching has been effective when a student states: a. "Research utilization is using the results of a single study in nursing practice." b. "Research utilization is the collection of data to answer a research question." c. "Research utilization is a review of nursing practice." d. "Research utilization is the process of transferring research findings into clinical practice."
ANS: D Research utilization is the process of transferring research findings into clinical practice. It is not using results of a single study in nursing practice, the collection of data to answer a research question, or a review of nursing practice.
The nurse understands the process of research utilization when the nurse does not complete which of the following steps? a. Assessing patient care c. Implementing a plan of care b. Planning for the patient's needs d. Guessing the extent of care needed
ANS: D The steps included in using nursing research in practice are preutilization, assessing, planning, implementing, and evaluation. The nurse does not guess during the research utilization process.