EBP Test #1 - Ch. 1 & 2

confidence

The strength of the evidence is also called what?

5

How many types of foreground questions are there? (answer with the numerical value only).

F

Is the following statement true or false? (T/F) A single randomized controlled trial (RCT) constitutes the highest level of evidence and is the most reliable guide to nursing practice.

T

Is the following statement true or false? (T/F) A well-formulated PICOT question should specify the measurable patient outcomes that need to addressed.

T

Is the following statement true or false? (T/F) Finding a quasi-experimental study in a peer-reviewed nursing journal article that tests a protocol for the frequency of turning for immobile patients is an example of external evidence.

F

Is the following statement true or false? (T/F) Foreground questions can often be answered by consulting an up-to-date nursing or science textbook.

intervention, prognosis, diagnosis, etiology, meaning

List the 5 types of foreground questions (typically asked in PICOT template format), separate answers with a comma, & use all lowercase.

VI

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "Single descriptive or qualitative studies."

V

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "Systematic reviews of descriptive and qualitative studies."

I

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "Systematic reviews or meta-analyses of RCTs."

PCORI

State the abbreviation of the title of the described research institute (<-- hint). "Authorized by Congress to produce and promote high-integrity, research-based information to help patients and their healthcare providers make more informed decisions."

a

A group of nurses have successfully implemented a new evidence-based protocol related to postoperative patient assessment. What is the next step for this project? a) Tell others about the results of their project b) Elicit feedback from patients and other stakeholders c) Evaluate the costs of the change in practice d) Search the literature for research that relates to the practice change

c

An obstetrical nurse wants to implement a body of evidence related to fetal monitoring practices on the unit. What is the first step that this nurse should take? a) Review the literature about fetal monitoring practices b) Consult with the expert nurses on the unit c) Begin to foster an attitude of curiosity in the OB staff d) Evaluate the outcomes of current practices

external evidence

Evidence generated through rigorous research (e.g., RCTs and cohort studies) that is intended to be generalized to and used in other settings. (answer in lowercase, two words).

internal evidence

Evidence typically generated through practice initiatives such as outcomes management or quality improvement projects that are not intended to be generalized to other clinical settings. (answer in lowercase, two words).

triple aim

Fill in the blank (in lowercase). The focus of healthcare reform in the United States encompasses what is known as the Institute of Healthcare Improvement's "________ ______" which includes: 1) Enhancing the experience of care for those served. 2) Improving the health of populations throughout the nation. 3) Reducing per capita costs of national health care. - EBP has been shown to be useful in reaching these aims.

Cochrane

Fill in the blank: "The concept of EBP began when Dr. Archie _____________ published a report in 1972 for the Nuffield Provincial Hospitals Trust that demonstrated how slow the medical profession was in using published evidence to change practice."

quality of evidence

Fill in the blanks. Level of evidence + _______ ___ _____________ = stength of evidence. (answer w/all lowercase)

strength of evidence

Fill in the blanks. Level of evidence + quality of evidence = __________ ___ _____________. (answer w/all lowercase)

level of evidence

Fill in the blanks. _________ ____ ____________ + quality of evidence = stength of evidence. (answer w/all lowercase)

Cochrane Center Collaboration

Fill in the blanks: "_______________ ___________ _________________ was established in 1992 in Dr. Archie's name to assist healthcare professionals in making clinical decisions based on the best external evidence. This led to one of the best known sources of systematic reviews (website/database)."

c

In performing a rapid critical appraisal of a research study as evidence, which three factors are the most important to be evaluated? a) Study validity, study veracity, study strength b) Study validity, study reliability, study confidence c) Study validity, study reliability, study applicability d) Study validity, study strength, study reproducibility

ANCC

State (in all caps) the abbreviated title of the credentialing center (<-- hint) that started the Magnet recognition program. "The program fosters EBP, as conducting research and using EBP are critical for attaining Magnet status."

III

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "CT's without randomization."

IV

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "Case-control and cohort studies."

VII

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "Opinion of authorities and/or reports of expert committees/panels."

II

State the Hierarchy of Evidence level in EBP described below. (State the level using ONLY the appropriate ROMAN NUMERAL--uppercase). "Single RCTs."

barriers

The following are common examples of what (in EBP)? (Answer w/one-word in lowercase) - Lack of administrative/management support & mentors - Resistance to change - Misperceptions or negative attitudes about EBP - Lack of EBP knowledge & skills - Lack of autonomy over practice and lack of incentives

barriers

The following are strategies used to elminate what (in EBP)? (Answer w/one-word in lowercase) - Establishing a clear philosophy & organizational vision in which EBP is valued & expected - Developing a strategic plan to create a culture and environment that fosters EBP - Dispelling misperceptions about EBP - Teaching the basics of EBP - Encouraging questions about currently used clinical practices

background

The following is an example of which type of question? "How does the drug acetaminophen work to affect fever?" (one-word answer, all lowercase)

foreground

The following is an example of which type of question? "In children aged 3 to 8 years, how does acetaminophen compare with ibuprofen in lowering a fever?" (one-word answer, all lowercase).

position of evidence in hierarchy

The level of evidence is also referred to as the what? (5 words, all lowercase)

validity, reliability, applicability

The quality of the evidence comprises which 3 important factors (that must be evaluated)? (Answer in all lowercase, separated by commas).

background question

This type of question: - Asks for general info. about a clinical issue - Usually has two components: 1. The starting place of the question (e.g., what, where, when, why, and how) 2. The outcome of interest - Broader in scope than PICOT questions (two word answer, all lowercase)

foreground question

This type of question: - Asks for specific scientific evidence about diagnosing, treating, or educating patients - The focus is on specific knowledge - Use of PICOT format is recommended for a focused literature search (two word answer, all lowercase)

d

Which of the following components of a PICOT question is absent from the following clinical question? "Among patients with dementia, how does the use of reorientation therapy compared with regular, supervised mobility affect patient agitation?" a) P (Population) b) I (Intervention) c) O (Outcome) d) T (Time)

step 1

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Ask the Burning Clinical Question in PICOT format (Patient population, Intervention/issue of interest, Comparison intervention of control & experimental groups, Outcome, & Time frame)."

step 3

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Critically appraise the external evidence (i.e., rapid critical appraisal, evaluation, and synthesis) including 3 areas of evaluation: validity, reliability, and applicability."

step 0

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Cultivate a spirit of inquiry within the EBP environment." Key elements of EBP include: - A spirit of inquiry; A philosophy, mission, clinical promotion system, & evaluation process that incorporates EBP - Knowledgeable EBP mentors - An infrastructure that provides support in using EBP; Administration and leadership that supports, values, & models EBP - Consistent recognition of individuals & groups who implement EBP

step 6

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Disseminate the outcomes of the evidence-based change." - For change to be sustainable, outcomes need to be shared with project stakeholders - Internal communication strategies can include e-mail messages, reports at unit/department meetings, dashboards, and scorecards - External communication strategies include podium or poster presentations at conferences and professional publications

step 5

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Evaluate outcomes of the change or practice decision based on evidence." - Outcomes measurement determines whether the evidence-based change resulted in the expected outcome in the clinical practice setting

step 4

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Integrate the best evidence with one's clinical expertise and patient preferences & values in making a practice decision or change." - This step is the synthesis of the external and internal evidence, the practitioner expertise, and the patient/family preferences that produces the implementation of a practice change - Patients' histories and circumstances have a significant bearing on the choice of practice changes - Availability of resources must also be considered

step 2

Which step of the EBP process is defined below? (answer in lowercase w/step and #). "Search for and collect the most relevant best evidence--following the hierarchy of evidence (Levels I-VII)."

etiology

Which type of PICOT template is the following? (one-word answer in lowercase). Are ________________(P) who have _________(I) compared to those without _________________(C) at ______________ risk for/of ___________ (O) over ____________(T)?

meaning

Which type of PICOT template is the following? (one-word answer in lowercase). How do ________________(P) with _________(I) perceive _________________(O) during ____________(T)?

prognosis

Which type of PICOT template is the following? (one-word answer in lowercase). In ________________(P) how does___________(I) compared to _____(C) influence/predict _______(O) over (T)____________?

intervention

Which type of PICOT template is the following? (one-word answer in lowercase). In ________________(P) how does___________(I) compared to __________(C) affect ___________(O) within (T)____________?

diagnosis

Which type of PICOT template is the following? (one-word answer in lowercase). In ________________(P) is ___________(I) compared to _____(C) more accurate in diagnosing (O) ____________?