Chapter 15

Which actions are suggested strategies for implementing evidence-based practice (EBP)? Select all that apply.

A chief nursing officer meeting with the hospital administration team to help them understand EBP and the benefits it offers., Updating clients and/or their families about current research studies they may qualify to take part in., Assembling a cross-disciplinary committee to refine research-based policies and procedures.

Which groups set professional standards for nursing practice? (Select all that apply.)

American Nurses Association, The National Council of State Boards of Nursing

What is the initiating event that starts the evidence-based practice process?

Clinically relevant question

A medical nursing unit in a large metropolitan hospital is participating in a double-blind randomized clinical trial. What might the role of the RN be in this clinical trial?

Collecting data

The identification of an independent and a dependent variable is a characteristic of which step of the scientific/nursing research process?

Defining variables

The use of informed consent and protecting the patient from harm are characteristics of what step in the scientific/nursing research process?

Ensuring an ethical process

A nurse uses data from a nursing research study regarding nasogastric tube care when caring for her patient. This nurse has demonstrated the use of:

Evidence-based practice

Nurses and physicians are expected to select health care interventions that are supported by research and other credible forms of evidence. They may also be expected to provide evidence to demonstrate that the care they deliver is not only clinically effective but also cost-effective and satisfying to patients. This best describes which concepts?

Evidence-based practice

True or false: Only nurses who work in hospitals that conduct research can contribute to research.

False

Which of these is not a challenge technology has created in health care?

Fewer health care professionals

In regards to the changing of colostomy pouches, a nurse has noticed that patients on the unit who use a specific product do better with wound healing than those who do not. She is curious about why this is. Which step in the research process does this represent?

Focusing on a clinical problem area

A nurse who is individually consuming research to improve her evidence-based practice would participate in which activities? Select all that apply.

Join a journal club, Search journal articles and literature, Practice using scholarly language

Anita has been an operating room nurse for nearly 15 years. She is always up for learning new things but finds reviewing research to be intimidating, and that it is often hard to implement changes and apply new knowledge. Which of the following act as barriers to learning? Select all that apply.

Lack of authority to make changes in practice, Lack of training in research or evidence-based practice, Lack of organizational support

The most rigorous level of nursing research is:

Level 1: systematic review of randomized or nonrandomized clinical trials

Which of the following support the need for evidence-based practice?

Logical reasoning, Clinical experience, Patient satisfaction

As a disaster response nurse near the site of a car bombing, you encounter a 25-year-old male who is unable to walk. He is breathing, and his respirations are 35. Using START triage, how would you triage this victim?

Red

When assembling a scientific study for research, in which step do researchers examine previous studies?

Reviewing the literature

What does the acronym START stand for?

Simple triage and rapid treatment

Why is it important for nurses to be familiar with the steps of the research process?

So they can critique research studies effectively

A research nurse knows part of her job is protecting a patient's rights. Which of the following constitute the patient's rights? Select all that apply.

The right to confidentiality, The right to consent to participate in a study without coercion, The right to refuse to participate without jeopardizing the care he or she will receive, The right to be protected from harm

What purpose in a research study does the initial review of the literature hold for the reviewer? Select all that apply.

To refine the research question being asked, To find out what related studies have been conducted, To help the researcher develop a strong knowledge base

Technology has directly improved which of the following in health care recently? Select all that apply.

Training, Access to information, Access to health care

True or false: Easier access to confidential information is both an advantage and a challenge of technology in health care.

True

True or false: Evidence-based practice (EBP) is defined as practice based on the best available evidence that also incorporates patient values and preferences along with clinician judgment and expertise.

True

True or false: Evidence-based practice use includes all interprofessional team members, not just nurses

True

True or false: Nurses have the ability to formulate hypotheses in their daily nursing practice.

True

True or false: The ultimate goal of research is to develop, refine, and expand knowledge.

True

True or false: The use of text messaging, pagers, and cellphones in the health care setting has allowed for better rest and less disruption of the client.

True

Technological changes that influence nursing practice and health care include which of the following? Select all that apply.

Use of robots to deliver meal trays, make rounds, and take vital signs, Tailoring treatment plans for malignant tumors from genetic-testing results

In the analyzing data step of the research process, when would statistical analysis be required?

When inferring some characteristics about a population

A nurse is a member of the research council at her hospital. Which type of research engagement is this?

Working on a team to review research to improve practice

The purpose of evidence-based practice is to:

establish best practice guidelines for various clinical problems.

Common barriers to using EBP and research in nursing include:

lack of education on how to read and critique research.

Which of the following is true about START triage?

This technique is commonly used in the United States but is also used worldwide.

The scientific method and nursing research process are composed of many steps. The first step in the research process is:

focusing on the clinical problem area.

True or false: Ideally, technology should replace the human element of health care in every way possible to remove the possibility of human error.

False

Which factor leads the nurse to take the first step in identifying possible research questions?

Focusing on a clinical problem area

As a disaster response nurse, you encounter a 38-year-old female with a head laceration at the site of a train crash. She walks up to you. Her respirations are 24, capillary refill is 2 seconds and mental status is intact. Using START triage, how would you triage this victim?

Green

A preterm labor patient is being transferred to a regional medical center because her newborn will require NICU services. The nurse must print off the patient's electronic health record for the referral hospital. The patient must sign a consent for release of medical information prior to printing the EHR. This must occur because of:

Health Information Portability and Accountability Act (HIPAA)

An adult victim at an accident scene is not breathing. When performing START triage, which action would you take?

Position airway

Integration of EBP research into clinical practice will be accepted more readily if organizations take which actions? Select all that apply.

Provide necessary resources for implementing EBP, Display commitment to developing EBP care pathways, Provide health care teams with time to implement EBP

In START triage, tag colors include which of the following?

Red = Immediate (critical), Green = Minor (those who can walk), Black = Expectant (those without respirations)

A nurse has questions regarding diabetic foot care. The nurse conducts a search and identifies a lack of research on diabetic foot care. The nurse has contributed to nursing research by:

identifying a gap in nursing research theory.

An example of how technology has positively influenced the nursing profession includes:

importing patient data into the electronic medical record using a handheld device.

A nurse is asking a patient to sign an informed consent form. Which of the following does informed consent require? (Select all that apply.)

That the patient consents to having the procedure performed, That the patient is competent, That the patient agrees to the procedure without coercion, That the patient understands the treatment/test and its potential adverse effects, That the patient has had other treatment options explained to him or her

To successfully implement EBP into nursing practice, what key stakeholders must be on board with the change? Select all that apply.

The health care organization, The individual health team members

The nurse's preceptor says, "When I painted the heels of a patient with betadine, the wound healed. I don't know about all this evidence-based practice - I know what works." The nurse knows which of the following is true of this statement?

The nurse will look for more evidence to support the intervention and ask for patient preferences.

A nurse is trying to convince a hospital administrator that they should be encouraging the use of evidence-based practice. Which characteristics could the nurse cite as a benefit? Select all that apply.

Control of health care costs, Provision of highest quality patient care, Increased patient satisfaction

True or false: While evidence-based practice improves the patient experience and outcomes, it also benefits the nurses involved by improving their self-confidence and enhancing job satisfaction.

True

A nurse manager tasks an RN with updating their unit-specific nursing policies and procedures. The manager states that the policies must be updated through an evidence-based practice process. The RN understands that she will need to:

perform a literature review to identify current evidence-based practice guidelines.

An alarm is sounding in a patient's ICU room. The nurse enters the room, silences the alarm, and reviews the monitor data. The nurse then leaves the room. This is an example of:

treating the monitor and not the patient

A nurse shares a nursing research article with her peers during a monthly staff meeting. The nurse outlines the steps taken in the research process and how the findings apply to the nursing care they provide. The nurse has contributed to nursing research by:

using relevant research.

A nursing student who is currently completing a clinical rotation on the medical-surgical unit has been reading research articles on medical management of myocardial infarction patients. The student is not sure whether she should share this information with the nurse on the unit, who seems to be effectively managing her patient assignment. Does the nurse have to incorporate research findings into practice?

yes

Proponents of evidence-based practice integration believe that systematic review of all research on specific health topics leads to:

the best form of evidence for clinical practice.