NUR351- Quiz 2 Modules 5.01-5.06

Disciplined research is considered to be the best method of obtaining reliable knowledge for clinical practice. TRUE FALSE

True Rationale: Research utilization must be based on research-based findings from peer-reviewed sources, not authority or personal experience. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 310-311

Arrange the answers into the correct order. Mouse users arrange by clicking and dragging each answer to the desired location. Keyboard users can arrange though drop down by selecting the right order. A nurse researcher plans for dissemination of a completed study. Rank order the following list of steps in the dissemination process from beginning (top) to end (bottom). 1. Develop effective writing skills. 2. Develop a plan. 3. Know the audience. 4. Select a communication outlet

4, 3, 2, 1 1)Select a communication outlet. 2)Know the audience. 3)Develop a plan. 4)Develop effective writing skills. Rationale: Dissemination of research steps is completed in chronological order: (1) select a communication outlet, (2) know the audience, (3) develop a plan, and (4) develop effective writing skills. This process has been developed to help get research findings out to nurses in practice. Remediation:Polit and Beck: Essentials of Nursing Research, 10th edition, p. 36

Evidence-based practice models have been developed to help nurses move evidence into practice. Rank order the list of steps in the EBP process from beginning (top) to end (bottom): 1) Searching for relevant research-based evidence 2) Integrating evidence with other factors 3) Assessing effectiveness 4) Appraising and synthesizing the evidence 5) Framing an answerable clinical question

5, 1, 4, 2, 3 1)Framing an answerable clinical question 2)Searching for relevant research-based evidence 3)Appraising and synthesizing the evidence 4)Integrating evidence with other factors 5)Assessing effectiveness Rationale: Moving evidence into practice involves a logical step-wise process: (1) framing an answerable clinical question, (2) searching for relevant research-based evidence, (3) appraising and synthesizing the evidence, (4) integrating evidence with other factors, and (5) assessing effectiveness. Remediation:Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 315-318

A nurse researcher is developing search strategy to locate relevant studies for her research review. He will be using citations from relevant studies to find previous research on which the previous studies were based. Which approach is the research using? A) Ancestry B) Descendancy C) Primary sourcing D) Bibliographic

A) Ancestry Rationale: The ancestry approach, also known as footnote chasing, uses information gathered from citations from relevant studies to find earlier research on which the studies were based. This will provide research articles that can be evaluated for usefulness in supporting a research study. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 92

A nurse searches for systematic reviews that summarize the results of several studies in one research article. Which database would be most likely to provide this information? A) COCHRANE B) Google Scholar C) PubMed D) PsycINFO

A) COCHRANE Rationale: COCHRANE is the database that is most likely to provide access to systematic reviews, which combine and analyze multiple relevant studies. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 290-291 Polit and Beck: Essentials of Nursing Research, 10th edition, p. 311.

Which method of dissemination is likely to reach the widest audience? A) Journal publication B) Grand rounds C) Journal club D) Round table

A) Journal publication Rationale: A journal publication provides a medium for communicating study findings to a world-wide audience. Other researchers may build on this research or apply the findings to clinical practice. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 43-44

One approach to a bibliographic database search is a feature that allows the researcher to enter his or her own key words into the search field instead of the exact subject heading used in the database. This feature is known as: A) Mapping B) Wildcard C) Text word search D) Subject codes

A) Mapping Rationale: Mapping allows researchers to enter their own words into the search field instead of the exact subject heading used by the database. This key word is then translated into probable subject headings within the database resulting in citations that relate to the subject heading. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 93

The first step in disseminating research findings is selecting an outlet for the information. The most effective method to informally share results with a small group of people is: A) Roundtable presentation B) Journal club C) Journal publication D) Podcast

A) Roundtable presentation Rationale: A roundtable presentation is the most effective way to share results with a small group of people. This method allows for group discussion and sharing experiences. The presentation is prepared the same way as a lecture; however, the size of the audience is generally smaller.

Models of EBP guide practice in large organizations. Which models are directly related to EBP? (Select all that apply.) -A-GAME Model -Transcultural Model -Iowa Model -Stress and Coping Model -Stetler Model

A-GAME Model, Iowa Model, Stetler Model Rationale: The A-GAME Model, Iowa Model, and Stetler Model can be used to promote EBP at both practitioner and organizational levels. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 313

A nurse studies the history of research utilization in nursing practice. Which organization was most influential in influencing this process? A) American Nurses Association (ANA) B) Conduct and Utilization of Research in Nursing (CURN) C) Sigma Theta Tau International (STTI) D) National Institute of Nursing Research (NINR)

B) Conduct and Utilization of Research in Nursing (CURN) Rationale: The best known early research utilization project is CURN: Conduct and Utilization of Research in Nursing.

Which step of the research utilization process requires careful scrutiny of all available evidence for its applicability to clinical practice? A) Search B) Examine C) Apply D) Decide

B) Examine Rationale: The examination step requires scrutiny of all evidence to assure credibility and applicability to a clinical problem and determine the best research studies to use as a basis for improving clinical practice. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 310-311

Which approach is most likely to have a positive influence on the adoption of a new evidence-based practice (EBP)? A) Posting names of staff who do not comply with the new guideline B) Having staff pilot the practice and give feedback before implementation C) Surprising the staff with the new practice D) Requiring mandatory auditing of compliance with the new practice

B) Having staff pilot the practice and give feedback before implementation Rationale: Having staff pilot test the practice change not only provides valuable information about effective implementation strategies, but also motivates staff to be part of the change. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 318

To facilitate EBP in a hospital setting, which activity would provide recognition for staff who recently completed EBP projects as part of a nurse residency program? A) Provide online training on EBP for staff. B) Hold a poster presentation session in the lobby featuring staff's EBP projects. C) Solicit input from staff about recent changes and listen to concerns. D) Offer continuing education credits for workshops on special EBP topics.

B) Hold a poster presentation session in the lobby featuring staff's EBP projects. Rationale: A poster presentation in the hospital lobby provides recognition to graduates of the nurse residency program, and educates other staff as well. This type of session can be a positive motivator for staff in implementing EBP.

Which method of dissemination would allow a researcher to share information with a small group of approximately 6 to 12 individuals? A) Poster presentation B) Roundtable presentation C) Grand rounds D) Journal publication

B) Roundtable presentation Rationale: A roundtable presentation is an informal way to share information with a small group. This method allows the group to discuss information and relate it to experiences and practice.

A nurse considers both supports and challenges to an EBP approach in the nurse's institution. Which factors would be supportive of EBP? A) Minimal financial support to conduct studies B) Staff receive release time to participate in journal clubs C) Scarcity of strong research evidence on a topic of interest D) Lack of access to nursing and medical electronic databases

B) Staff receive release time to participate in journal clubs Rationale: Release time to participate in journal clubs is an incentive for nurses to review the most recent research. This contributes to an EBP environment.

A nurse reviews examples of evidence-based practice (EBP). A practice that is considered evidence-based would: A) occur at a large medical center. B) consider client preferences when planning care. C) involve good communication. D) involve several different disciplines.

B) consider client preferences when planning care. Rationale: EBP includes consideration of client preferences and values, which is one of the three primary components of EBP. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 13-14

What is a facilitator, rather than a barrier, to implementation of EBP? A) Lack of time and money B) Resistance to change C) Adequate access to resources D) Poor attitudes toward EBP

C) Adequate access to resources Rationale: Having adequate access to the appropriate resources is a facilitator of EBP implementation. The remaining options are barriers.

A nurse considers presenting results of a pilot study as a poster presentation at a local conference. What is the advantage of a poster presentation? A) Provides the basis for evidence-based clinical rounds. B) Allow the speaker to reach a wider audience, such as grand rounds. C) Allow the presenter more time to speak directly with others about his or her work. D) Encourage group members to voice many different opinions and beliefs.

C) Allow the presenter more time to speak directly with others about his or her work. Rationale: Poster sessions give the presenter maximum interaction with interested colleagues, allowing time for questions and answers. Poster sessions usually involve one-on-one discussion, rather than groups, in an informal setting. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 43-44

Explaining a clinical problem a nurse is trying to solve or the policy a nurse is trying to revise is an example of which step in the nursing research utilization process? A) Decide B) Apply C) Clarify D) Search

C) Clarify Rationale: Clarify is the correct step. Explaining a clinical problem you're trying to solve or the policy you're trying to revise is an example of the clarifying step in the nursing research process.

A nurse studies the research utilization process. Which is the correct order of the six key steps involved in using nursing research in practice? A) Clarify, search, examine, apply, decide, and evaluate. B) Clarify, examine, search, decide, apply, and evaluate. C) Clarify, search, examine, decide, apply, and evaluate. D) Clarify, examine, decide, apply, evaluate, and search.

C) Clarify, search, examine, decide, apply, and evaluate. Rationale: There are six key steps involved in utilizing nursing research in practice: clarify, search, examine, decide, apply, and evaluate.

An evaluation plan to determine the effectiveness of a new practice change would focus on what activity? A) Determine the amount of research available on a topic. B) Train staff to use the new policy or procedure. C) Collect information on client outcomes. D) Form a team to review the literature.

C) Collect information on client outcomes. Rationale: Collecting information on client outcomes is the primary activity of an evaluation plan. Other tasks on this list are part of planning and implementation stages. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 318

In which step of the research utilization process does the nurse determine the outcomes of any interventions used with clients? A) Search B) Apply C) Evaluate D) Examine

C) Evaluate Rationale: Evaluation is the correct step. Evaluation of client outcomes is critical to determine if the interventions used with participants are successful.

A nurse researcher plans to publish research findings on pneumonia in children with tracheostomies. Which audience would be most appropriate as an outlet for dissemination? A) Medical-surgical specialists B) Nurse educators C) General pediatric nurses D) Pediatric oncology nurses

C) General pediatric nurses Rationale: From the list, pediatric nurses (in general) would be the audience most likely to read about these study findings. These nurses are the usual nursing caregivers for children with tracheostomies in all settings. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 43-44

A nurse learns to conduct an effective search using search tools, such as Boolean operators. Which search term(s) is likely to gather the most information? A) Diabetes B) Obesity C) Obesity or diabetes D) Obesity and diabetes

C) Obesity or diabetes Rationale: "Obesity or diabetes" using the Boolean operator "or" instructs the computer to retrieve any of the terms listed, even if only one of the terms is found in the text. Other options on this list are more restrictive. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 93

A nursing team doesn't have enough funding to properly implement evidence-based practice (EBP). What would be an appropriate way to address this barrier? A) Conduct a test-pilot program before completely rolling out the implementation of EBP. B) Put up flyers around the nursing station to promote EBP and remind nurses of the benefits. C) Seek out funding sources through local organizations and specialty organizations. D) Host a webinar for all nurses to teach them more about EBP.

C) Seek out funding sources through local organizations and specialty organizations. Rationale: Seeking out funding from external sources could decrease the impact of the funding barrier. Local organizations, including both general and specialty groups, may provide small grants for this process.

Why are journal clubs especially practical as facilitators of EBP? A) Only BSN educated nurses can participate in sessions B) They are usually required by nursing management C) They are participatory, actively involving all levels of staff in discussion. D) They require a higher degree and advanced understanding of the research process.

C) They are participatory, actively involving all levels of staff in discussion. Rationale: Journal clubs are usually optional activities, open to all interested staff. The focus can include topics of interest to a select group, making them especially relevant and meaningful for learning. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 3

In defining evidence-based practice, three distinct components are integrated. Which factors reflect these three components? (Select all that apply.) - The practitioner's clinical expertise - The interdisciplinary nature of care - The setting where practice takes place - Synthesis of the most relevant research - Client preferences and values

Client preferences and values, Synthesis of the most relevant research, The practitioner's clinical expertise Rationale: Evidenced-based practice integrates clinical expertise, client preferences, and research. These are the three essential elements of EBP. Additional factors in this list are supportive in nature. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 13-14

A nurse considers how to apply EBP in the nurse's practice setting. Which activity would be a valid application of the EBP process? A) Apply an intervention from one research study with clients on the unit. B) Complete a trial and error process to determine best outcomes. C) Change practice on the unit after clarifying a new idea and trying it out. D) Develop policies and procedures for client care based on compiled research.

D) Develop policies and procedures for client care based on compiled research Rationale: Of these descriptions, developing policies and procedures based on compiled research evidence best fits the description of EBP. Trial and error or applying a single study to practice do not fall within this description. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 14-17

Learning to analyze research studies to determine if they are methodologically sound is an example of which step in the nursing research utilization process? A) Evaluate B) Decide C) Apply D) Examine

D) Examine Rationale: Examine is the correct step. Learning to critically examine research studies for credibility and methodological soundness is the third step of the research utilization process.

A charge nurse and team of nurses lack the motivation required to implement EBP. Which solution may help to address this barrier? A) Host a webinar for hospital clerical staff to make them aware of what EBP is and how it impacts the clinical staff, and therefore the entire office. B) Seek out funding sources through local organizations, specialty organizations, or federal organizations. C) Explore stakeholder resistance early and address concerns with an implementation plan. D) Gain authorization to offer continuing education credits for attending training workshops and include staff use of EBP in the annual evaluation.

D) Gain authorization to offer continuing education credits for attending training workshops and include staff use of EBP in the annual evaluation. Rationale: Offering continuing education credits and including EBP use in the annual evaluation would motivate staff to implement EBP.

A group of nurses identifies a change needed in care of clients with urinary catheters. Which factor would facilitate changing practice? A) Administrators are focused on improving care in another area. B) Unit manager is unable to change the vendor for urinary catheter supplies. C) Staff nurses believe that current care is adequate for these clients. D) Journal club members have reviewed evidence-based guidelines on urinary care.

D) Journal club members have reviewed evidence-based guidelines on urinary care. Rationale: Change would begin with a review of the evidence, in this case the work of the journal club members in reviewing the latest research. In order for change to occur, there needs to be buy-in by all staff and administrators. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 314 Polit and Beck: Essentials of Nursing Research, 10th edition, p. 318

Which would be the best option for the nurse who is seeking out sources of information specific to the fields of psychology, behavioral sciences, and mental health? A) PubMed B) COCHRANE C) Google D) PsycINFO

D) PsycINFO Rationale: PsycINFO is the best choice. PsycINFO is a large bibliographic database that contains information specifically regarding psychology, behavioral sciences, and mental health.

A nurse wants information on a new subject area. Which research source is considered the most reliable of the options provided? A) Looking an answer up in a nursing school textbook. B) Asking an experienced health care professional for answers. C) Searching Google for answers. D) Seeking out literature in an electronic database, such as CINAHL or MEDLINE.

D) Seeking out literature in an electronic database, such as CINAHL or MEDLINE. Rationale: An electronic database such as CINAHL or MEDLINE is likely to provide the most up-to-date and comprehensive information. Other resources may have outdated or unreliable information. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 92-98

When considering best evidence for clinical decision making, evidence hierarchies provide sources based on the strength of the evidence they provide. Which of the following provides the strongest level of evidence for clinical decision making? A) Descriptive study B) Quasi-experimental study C) In-depth qualitative study D) Systematic review

D) Systematic review Rationale: A systematic review is at the top of the evidence hierarchy. They provide the strongest evidence because they are derived from a synthesis of many studies and use a formal protocol. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 15

A nurse reviews a study for possible application. Which issue would be most important to consider for application to practice? A) The professional background of the author B) The geographical location where the study took place C) The journal that published the study D) The associated costs and risks of applying in a different setting

D) The associated costs and risks of applying in a different setting Rationale: The costs and risks of applying an intervention or approach from another study would be most important to consider. Other items on this list are of secondary importance. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 313-314

Which of the following assessments should be evaluated when appraising evidence for use in EBP? (Select all that apply.) -EBP model -Evidence quality -Clinical relevance -Author's academic affiliation -Financial costs

Evidence quality, Financial costs, Clinical relevance Rationale: When appraising evidence for EBP, the evidence quality needs to be evaluated. For each study, the extent to which the findings are valid must be determined. Financial costs of interventions and assessments need to be examined for feasibility. The relevance of the appraised evidence must be examined in terms of the clinical relevance for specific clinical situations. Academic affiliations of study authors and the EBP model do not impact validity of evidence. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 316-317

Evidence-based practice (EBP) consists of identifying the best evidence and integrating it with other factors to make clinical decisions. Components of EBP include which of the following? (Select all that apply.) -Financial resources -Level of education -Patient preferences -External evidence from research -Clinical expertise -Evidenced-based theories

Evidenced-based theories, Clinical expertise, Patient preferences, External evidence from research Rationale: EBP involves the use of the best evidence to make clinical decisions resulting in positive patient outcomes. Best evidence comes from external research evidence, evidence-based theory, internal evidence such as clinical expertise, and patient preferences and values. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 2

When searching for the best evidence for clinical practice, a randomized control trial is considered to be the most rigorous source of evidence. TRUE FALSE

FALSE Rationale: A systematic review is considered to be the highest level of evidence as a basis for clinical practice because it is a synthesis of multiple studies. Randomized control trials are considered to be Level II evidence. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 15

Health care organizations can show support for evidence-based practice by hiring external consultants to perform research and informing nurses within the organization about changes that will be made based on evidence. FALSE TRUE

FALSE Rationale: Health care organizations demonstrate support for evidence-based practice by providing release time and resources for their nurses to enable them to understand, value, and conduct research. Evidence-based changes in nursing practice must have buy-in from staff and they must be part of the change process. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 318

Historically, the EBP movement originated in the discipline of medicine in the United States. TRUE FALSE

FALSE Rationale: The EBP movement began in the United Kingdom based on the work of Archie Cochrane and in Canada with work pioneered by Dr. David Sackett. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 311

When applying the research utilization process, the clarification step occurs when the information gathered is put into practice and outcomes are evaluated. TRUE FALSE

FALSE Rationale: The clarification step occurs when the clinical problem and the need for evidence to solve the problem is clarified. The evaluation step occurs when outcomes are evaluated. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 310-311

Cost of access is one factor that affects nurses' ability to search for information. Which databases are available free of charge? (Select all that apply). - Google Scholar - PubMed - Cochran - CINAHL - MEDLINE

Google Scholar and MEDLINE Rationale: MEDLINE and Google Scholar are available free of charge, but CINAHL, Cochran, and PubMed all require subscriptions for full access. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 92-98

Which of the following statements are potential barriers for evidence-based practice? (Select all that apply.) -Nurses do not have the skills to access research evidence. -Nurses do not value research. -Nurses want to research topics from other disciplines. -Nurses want to be part of a research team. -Nurses do not understand research.

Nurses do not understand research., Nurses do not have the skills to access research evidence., Nurses do not value research Rationale: Nurses are often unfamiliar with research and do not have the background or education to access or understand evidence. The culture of their workplace may not value the research process, and therefore, research is not supported. Wanting to work in teams or research topics unrelated to nursing are not barriers to research.

Professional conferences are important venues for disseminating research findings. Methods for presenting research findings to a wide clinical audience include which of the following? (Select all that apply.) -Roundtable presentations -Oral presentations -Poster presentations -Published journal articles -Dialog with attendees

Oral presentations, Poster presentations, Dialog with attendees Rationale: Oral presentations allow for descriptions of important concepts of a research study to be presented to a clinical audience. Poster presentations provide visual displays of research findings to a large audience. Dialoging with conference attendees allows for the exchange of ideas and information and about study findings to increase understanding of the meaning of the findings. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 43-44

The first step in evidence-based practice (EBP) is to develop an answerable research question. A well-written clinical question contains which of the following components? (Select all that apply.) -Population -Intervention -Time frame -Location -Outcome

Population, Outcome, Intervention Rationale: EBP uses the acronym PIO to help develop researchable questions. The "P" stands for population and the characteristics of the people. "I" represents the intervention of interest in the study. "O" is the outcomes or consequences of interest in the study. Time frame and geographic location are not included in the template of a research question. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 315

Challenges to EBP include a lack of organizational support for research and implementation of evidence-based nursing. FALSE TRUE

TRUE Rationale: A barrier to EPB is a lack of organizational support. This lack of support can include the inability of the organization to provide release time for research and provision of resources needed to perform and implement EBP.

When searching electronic databases, identification of keywords is one of the first tasks the researcher must perform to begin the process of reviewing literature for a research study. TRUE FALSE

TRUE Rationale: A key word search is an essential first task in searching bibliographic databases. The key word captures the main concepts in the research question and is an important method in accessing relevant studies to begin the process of reviewing literature. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, pp. 92-93

The EBP movement has caused concern for some nurses and researchers who worry that qualitative research is not being given enough consideration in evidence hierarchy used to support clinical decision making. FALSE TRUE

TRUE Rationale: Critics of EBP are concerned that qualitative evidence is not being given the same level of consideration in the EBP movement and quantitative evidence. Although qualitative studies lack the scientific rigor of quantitative studies such as a randomized control trial, there can be significant evidence provided by qualitative studies that can be used to support clinical decisions.

Research evidence should be integrated with the nurse's clinical expertise and patient preferences before a decision is made to implement the evidence into practice. FALSE TRUE

TRUE Rationale: Once evidence has been appraised, the nurse's clinical expertise must be considered before implementing EBP. Nurses may be aware of factors that would make implementation of a particular practice unwise. Similarly, if patients have strong negative feelings toward a procedure or action, EBP should not be implemented. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 317

Although qualitative research findings are not at the top of the hierarchy of evidence, disseminating findings of a qualitative study is as valuable as disseminating findings from a quantitative study. FALSE TRUE

TRUE Rationale: Qualitative study findings offer essential insight into clinical problems and help influence nurses' perceptions of phenomena and clinical situations. They provide an understanding of experiences from multiple perspectives including the patient's perspective. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 317

All of the following statements represent nursing activities used in promoting evidence-based practice: participate in inter-disciplinary evidence-based projects, join a journal club, and attend professional conferences. FALSE TRUE

TRUE Rationale: Journal clubs review studies that have the potential to change clinical practice. Participation in EBP projects promote more positive attitudes about the research process and assist nurses in the development of research skills. Professional conferences provide a venue for interaction between nurses and researchers where implications of research studies can be explored for their relevance to clinical practice. Remediation: Polit and Beck: Essentials of Nursing Research, 10th edition, p. 324