Evidence Based Practice

Identify in order, the recommended steps for implementing evidence-based practice in the clinical setting.

Ask a clinical question in pico format Search for and collect the most relevant and best evidence Critically appraise the evidence validity and reliability Integrate evidence with one's clinical expertise and patient preferences Evaluation of change Present outcomes of the evidence-based intervetions

steps in the systematic review process

1.Identify the research/practice problem 2.Formulate the clinical questions 3.Database searches 4.Evaluation of the evidence 5.Interpretation and dissemination of the findings

Employees of XYZ Company were surveyed to determine how much they paid in out-of-pocket healthcare costs in a given year. The highest reported amount was $13,500, and the lowest reported amount was $425. For this data set, what is the range?

13,075

A study being conducted on older adults with stage 2 dementia on calming communication techniques as compared to sedative medications on the agitation level of clients. In a PICO format, the level of agitation would be the _______________.

Outcome

A widely used EBP model consisting of four components for identifying clinical questions for specific patient problems is known as the ____________ model.

PICO

A researcher is attempting to reduce error so nurses can have confidence in inferring findings to another practice setting by avoiding a type I error. What occurs in a type I error?

The null hypothesis is rejected when it should have been accepted.

Snowball sampling in qualitative research refers to

accumulation of participants based on word-of-mouth

A major portion of a research article is the methods section, which includes a discussion of the study design, the sample, and the ____________ collected.

data

The researcher conducting a qualitative study has interviewed 13 participants. As the researcher analyzes the last two interviews nurse notes that no new information has been obtained and information gathered is repetitive from the other interviews. This would be considered to be

data saturation

Midrange theories

deals with a protion of nursing's total cocern

Which type of statistics explains characteristics of variables found in a sample and describes, summarizes, and synthesizes collected data?

descriptive

In evaluating evidence, you should remember that the mean is the best measure of central tendency if there are no extreme values in the data set, and the ____________ is the best measure if there are extreme values.

median

Attrition rate is defined as the

percentage of participants not completing the study.

Theory which predicts cause and effect relationships, generated and tested by experimental research

predictive theory

Subjects were self-described underactive adults between the ages of 18 and 22 willing to address physical activity. Once recruited, participants were randomized to control and intervention groups. This is an example of

random assignment

A method of sampling in which all people in the population of interest have an equal chance of being selected to be included in the study is

random sampling

Nonprobability sampling carries more risk of selection bias than probability sampling because ____________ is not used.

randomization

elements of experimental design

requires manipulation of the IV, randomization of the sample, and control (control group)

Construct validity is the degree to which an instrument measures the ____________ it was intended to measure.

theoretical concept

In nursing, ____________ scales are often used to collect data about patient pain, fatigue, quality of life, and health status.

visual analog

purpose of evidence

•Optimize patient outcomes • Improve nursing competency •Advance nursing practice.

Environmental manipulation

Nightingale

Case-Control Studies

Compare two groups with and without a specific condition

Due to the potential for inappropriate disclosure of personal information in qualitative studies, protecting the ____________ of participants is especially important.

Confidentiality and anonymity

The difference between research utilizations and EBP is....

Research utilization involves changing practice based on findings of a single research study; EBP is the syntheses of findings from multiple studies to incorporate with practitioner skills and client preference to determine best care.

Many healthcare facilities are increasing their support for EBP because of ____________ that link payment to positive patient outcomes.

changing reimbursement policies

are interested in examining the effects of fluoride introduced into the water system on the oral health of children. In a multi-center study they plan to study children from age two to ten. Plans are to enroll children receiving care in community health care clinics in five major cities, New York City, San Francisco, Chicago, Miami, and Phoenix. Who is the accessible population of this study?

children living in New York City, San Fran, Chicago, Miami and Phoenix and are receiving care in community health care clinics

Core concepts of nursing such as person, environment, health, and the nurse are known as

metaparadigms

A distribution in which the peak of the data is not at the center but has a longer tail to the left indicates that the mean is less than the median and mode and the data are

negatively skewed

Which section of a research article identifies the problem being studied and includes a purpose statement and background information on the topic?

Introduction section

Coding is a data analysis method used by qualitative researchers that involves

attaching labels to each line of transcript

In health related experimental designs, the group of subjects receiving the standard of care but not the intervention is the

control group

Descriptive Studies

Non-experimental studies use to provide information about a phenomenon.

You are researching members of the military. You select the following as data to be measured: Private, Corporal, Sergeant and Lieutenant. You know that these data re:

Ordinal

Incorporates the idea that there is another self; nursing is the other self

Orem

Best definition of research

Planned and systematic activity that leads to new knowledge and/or the discovery of solutions to problems or questions.

quasi-experimental design

Quasi-experimental designs are like experimental designs, but because they lack randomization or a control group this makes claims of cause and effect weaker than in experimental designs.(P. 171).

Cohort Studies

Quasi-experimental designs using two or more groups.

You are involved in a study on your unit testing the effectiveness of differing amounts of medication given to patients intravenously. You know that the number of milliliters of fluid given is an example of which type of data?

Ratio

The difference between a conceptual model and a theory is that a conceptual model is more global and abstract while the theory is more detailed.

True

True or false: An conceptual definition of concepts in a theory establishes meaning and shows the relationship between a given concept and other theoretical terms.

True

Qualitative studies must be conducted with extreme rigor because of the potential for ____________ inherent in this form of research.

subjectivity

grand theories

theories that cover a broad range of nursing's concern

criteria for determining strength of intervention

•Number of studies •Design suitability •Quality of execution •Consistency •Sample size

In contrast to quantitative studies, qualitative studies are

exploratory and inductive

the research method based on documentation of sources used to retroactively study events or people is

historical

In attempting to minimize type I error, which of the following alpha levels can be interpreted as the most highly statistically significant result?

p = 0.0001

The research method used to study participants' lived experience is

phenomenology

To determine the minimal acceptable sample size, researchers would perform a statistical method called a ____________ so that the true effect in a quantitative study is detected.

power analysis

A qualitative study investigating the lived experience of women under the age of 25 who survived a liver transplant is an example of which sampling method?

purposive

difference between quantitative and qualitative

quantitative designs use numbers to give meaning to a phenomenon or an event, and qualitative designs rely on words.

method of sampling in which all subjects in the sample have an equal chance of being assigned to either the treatment group or the control group is

random assignment

In Contrast to quantitative methods, qualitative data analysis is completed ____________

simultaneously with data collection

5 Ss

1.Studies 2.Synthesis 3.Synopses 4.Summaries 5.Systems

Theory

A set of concepts linked through propositions to explain a phenomenon

Nonexperimental designs in which data is gathered from a group of subjects at only one point in time are known as ____________ studies.

Cross-sectional

Which section of a research article provides interpretation of the study's results?

Discussion

Randomized Control

Experimental studies with large samples

What provides essential foundation for nursing practice?

Theories and research

The difference between a population and a sample is

a sample is a representative group of a defined population.

The fact that urban settings are being used exclusively in the study introduces:

bias

When extraneous variables influence and distort the relationship between the independent variable (IV) and the dependent variable (DV) so that the findings do not reflect a true relationship between the IV and the DV, the result is

bias

Nationally, health care researchers are interested in examining the effects of fluoride introduced into the water system on the oral health of children. In a multi-center study they plan to study children from age two to ten. Plans are to enroll children receiving care in community health care clinics in five major cities, New York City, San Francisco, Chicago, Miami, and Phoenix. Who is the population of this study?

children who live in the united states

The research method based on making collective observations and that is used to study a particular culture is

ehtnography

sampling bias occurs when...

elements in the sample over or under present characteristics of the target population.

The more representative the sample, the more confidence there is ______________ the results of studies to the target population.

generalizing

Intergrative Review

gives a detailed report of a number of studies conducted on a particular topic.

Studies have shown that the reasons that nurses do not draw on research are related to_________________

individual and organizational factors.

The degree to which one can conclude that the independent variable, rather than extraneous variables, produced the change in the dependent variable is known as

internal validity

A nurse researcher participated in a qualitative study regarding perception of arthritic pain in relation to functional abilities required for the role of parent. Findings revealed the theme of planning activities at pain-limited times of the day as a coping strategy. Use of this information in practice is an example of the

interpretation of research findings.

Sytematic Review

is a rigorous process conducted to review the literature to answer practice questions. Articles all include the same clinical problem

study reports that the Chronbach's alpha coefficient for an instrument used is α = .45. You know that this means that the accuracy of this measure

is unsatisfactory and reveals a lack of internal consistency

Qualitative studies are deemed ____________ when strategies have been implemented to meet credibility, transferability, dependability, and confirmability criteria.

trustworthy

external validitiy refers to:

The degree to which the findings can be generalized to other subjects, settings, and times.

Schmidt and Brown (2012) delineate different roles and responsibilities in the development of evidence based practice. What is one step the individual staff nurse can take to advance EBP at the point of care?

Identify clinical questions related to current nursing practice

Which EBP model explain how organizations change practice?

Iowa Model

Which of the following designs would best be used to study the process of physical development among preterm infants?

Longitudinal

Meta-Analysis

Results of several studies are combined and summarized into a measurable format

What is the best definition of EBP?

Use of theory-derived, research-based information in making decisions about health care delivery, with consideration of individual needs and preferences and the clinical expertise of the provider.