Evidence
A student in the RN-BSN program is taking a research course and finds they are having difficulty. The instructor asks "What are the components of evidence-based practice (EBP)"? How should the student reply? (Select all that apply.) a. EBP relies on practice and research. b. Research utilization occurs after evaluation of all available evidence. c. EBP assists the nurse in the decision-making process. d. Research utilization and EBP are the same concept. e. EPB is more like performing a meta-analysis than is EBP.
a, b, c Evidence-based practice relies on practice and research. Before the research can be utilized it is important to see what the evidence supports prior to implementation. When a nurse is uncertain of a practice question, the evidence can be used for best practices. Research utilization is using the evidence found in the research EPB occurs after the evaluation of all available evidence.
A new nurse on an orthopedic unit is assigned to a client on skeletal traction. The nurse asks a colleague, "Do other orthopedic units have higher infection rates with peroxide when performing orthopedic cleaning pin for patients in skeletal traction?" This question is an example of a: a. Hypothesis b. PICO question c. Problem focused-trigger d. Knowledge-focused trigger
b. This is a PICO Question. PICO stands for Population, Intervention, Comparison, and Outcomes. P=Orthopedic patients in skeletal traction I=peroxide, C= compared to those that do not use peroxide, O=infection rates. Option A is incorrect because a hypothesis seeks to understand relationships amongst variables. Option C is incorrect because a problem-focused trigger is an inquiry as to how to resolve a clinical practice issue. Option D. is incorrect because this option seeks to define a practice problem or solve an unknown.
Which of the following relationships and differences would one find when comparing evidence-based practice (EBP) and research utilization? (Select all that apply.) a. EBP relies totally on research evidence, as does research utilization. b. Research utilization occurs after evaluation of all available evidence. c. EBP implies internal decision making on the nurse's part. d. Research utilization cannot be imposed from above. e. EBP was a later historical development than was research utilization. f. EBP considers values before it mandates utilization. g. Research utilization is more like performing a meta-analysis than is EBP.
c, e, f, g Research utilization is seen as an organizational process rather than as a process to be implemented by an individual practitioner. Activities of research utilization include (1) identification and synthesis of multiple studies in a common conceptual area (research base), (2) transformation of the knowledge derived from a research base into a solution or clinical protocol, (3) transformation of the clinical protocol into specific nursing actions (innovations) that are administered to patients, and (4) clinical evaluation of the new practice to ascertain whether it produced the predicted result. Evidence-based practice requires synthesizing research evidence from randomized controlled trials, and these types of studies are limited in nursing. Extensive evidence has been generated through nursing research, but there is a need for more. A criticism of the EBP movement is that the development of evidence-based guidelines has led to a "cookbook" approach to health care. The benefits of EBP are improved outcomes for patients, providers, and health care agencies. The best research evidence has been synthesized in many areas by teams of expert researchers and clinicians and then used to develop strong evidence-based guidelines for practice.
Evidence-based practice is defined as: a. Nursing care based on tradition b. Scholarly inquiry embodied in the nursing and biomedical research literature c. A problem-solving approach to clinical practice based on best practices d. Quality nursing care provided in an efficient and economically sound manner
c. Evidence-based practice is a problem-solving approach to clinical practice that uses the best available evidence, along with the nurse's expertise and the client's preference and values, in making decisions about care. Option A is incorrect because tradition is not grounded in evidence and relies on how things have always been done. Option B is incorrect because this defines a literature review. Option D is incorrect because this option defines quality initiates.
Which of the following best describes terms relates to research that attempts to determine an association between or among variables? a. Qualitative research b. Outcomes research c. Intervention research d. Correlational
d. Correlational research attempts to determine an association between or among variables. Qualitative research studies the whole human's response, within an individual or a group framework. Outcomes research examines the results of care and measures the changes in the health status of patients. Intervention research investigates the effectiveness of an intervention.
The nurse describes to a student nurse how to use evidence-based practice guidelines when caring for patients. Which statement made by the nurse is the most accurate? a. Inferences from clinical research studies are used as a guide. b. Patient care is based on clinical judgment, experience, and traditions. c. Data are evaluated to show that the patient outcomes are consistently met. d. Recommendations are based on research, clinical expertise, and patient preferences.
d. evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise. Clinical judgment based on the nurse's clinical experience is part of EBP, but clinical decision making should also incorporate current research and research-based guidelines. Evaluation of patient outcomes is important, but interventions should be based on research from randomized control studies with a large number of subjects.
