Nursing Research Quiz 2

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. Would McDonald need to pose a clinical background question OR a clinical foreground question to identify relevant evidence?

A clinical foreground question

Foreground or background question? What effect does altitude change on circadian physiology?

Background question

Foreground or background question? What is the pathophysiology of Lyme disease?

Background question

Foreground or background question? What is the risk of bronchopulmonary aspiration during enteral feeding?

Background question

Foreground or background question? When do complications of pneumonia usually occur?

Background question

What is the intervention, influence, or exposure of "What bedrest elevation for mechanically ventilated patients is maximally effective in reducing the risk of ventilator-associated pneumonia?"

Variation in bedrest elevation

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. In searching for evidence, McDonald would need to ask a clinical question that would include identifying the Population. What would that population be?

Women who have had a cesarean birth

A group of nurses working in a community health center were unsure of how to answer questions from patients about appropriate means of cleansing children's wounds in home settings. Most nurses felt that sterile saline should be recommended to minimize the risk of infection, but others believed that tap water was adequate for cleansing acute wounds. The nurses decided to examine the evidence and located a systematic review in the Cochrane database. Among the studies that had been conducted, the review concluded that there were no differences in rates of infection or healing between the use of tap water versus sterile saline in the cleansing of wounds. However, few of the studies that had been done involved the use of children, and most had been conducted in health care settings. The nurses decided to initiate a new study to gather more focused and informative evidence about the effects of saline solution versus tap water in cleansing children's wounds. Did the nurses use pre-appraised evidence?

Yes, a systematic review from the Cochrane database is an example of pre-appraised evidence

A group of nurses working in a community health center were unsure of how to answer questions from patients about appropriate means of cleansing children's wounds in home settings. Most nurses felt that sterile saline should be recommended to minimize the risk of infection, but others believed that tap water was adequate for cleansing acute wounds. The nurses decided to examine the evidence and located a systematic review in the Cochrane database. Among the studies that had been conducted, the review concluded that there were no differences in rates of infection or healing between the use of tap water versus sterile saline in the cleansing of wounds. However, few of the studies that had been done involved the use of children, and most had been conducted in health care settings. The nurses decided to initiate a new study to gather more focused and informative evidence about the effects of saline solution versus tap water in cleansing children's wounds. Does this summary describe an EBP effort?

Yes, the nurses wanted to determine best practices with regard to cleansing of children's wounds

What is the outcome of "What bedrest elevation for mechanically ventilated patients is maximally effective in reducing the risk of ventilator-associated pneumonia?"

Risk of ventilator-associated pneumonia

What is the population of "Does depression contribute to mortality among patients with heart failure?"

Patients with heart failure

What is the outcome of "Which large-volume enema solution--tap water, soap suds, or polyethylene glycol-electrolyte solution--results in the least mucosal irritation in patients with constipation?"

Amount of mucosal irritation

What is the outcome of "Do patients receiving an intradermal injection experience greater discomfort with bevel-up or bevel-down needle injection?"

Degree of comfort

What is the intervention, influence, or exposure of "Does depression contribute to mortality among patients with heart failure?"

Depression

T/F An evidence hierarchy for a meaning question ranks RCTs as level II evidence.

False

T/F In the PICO acronym, the "O" component of clinical questions stands for Observation.

False

T/F Problem-focused triggers in the Iowa Model are akin to research utilization.

False

T/F Quality improvement projects are essentially the same as EBP projects.

False

T/F Research utilization is essentially synonymous with evidence-based practice.

False

T/F Systematic reviews are always in the form of a meta-analysis.

False

T/F The evidence-based practice movement originated in the United States.

False

Foreground or background question? Do patients receiving an intradermal injection experience greater discomfort with bevel-up or bevel-down needle injection?

Foreground question

Foreground or background question? Does depression contribute to mortality among patients with heart failure?

Foreground question

Foreground or background question? What bedrest elevation for mechanically ventilated patients is maximally effective in reducing the risk of ventilator-associated pneumonia?

Foreground question

Foreground or background question? What is it like for patients with HIV or AIDS to adapt to changes in body weight and ensuing body image changes?

Foreground question

Foreground or background question? What is it like for people with a history of severe phobias to overcome their phobia?

Foreground question

Foreground or background question? Which large-volume enema solution--tap water, soap suds, or polyethylene glycol-electrolyte solution--results in the least mucosal irritation in patients with constipation?

Foreground question

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. McDonald's clinical question would identify an intervention, influence, or exposure--what would that be?

Having a vaginal birth after cesarean

What is the population of "What bedrest elevation for mechanically ventilated patients is maximally effective in reducing the risk of ventilator-associated pneumonia?"

Mechanically ventilated patients

What is the outcome of "Does depression contribute to mortality among patients with heart failure?"

Mortality

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. In appraising the evidence located in this injury, would McDonald likely apply the AGREE II instrument?

No, McDonald would not be evaluation a clinical practice guideline

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. Would McDonald likely find the answer to a question about future risks of birth complications from VBAC in a metasynthesis?

No, the question is not about meaning or process, it is about the effect of a certain exposure

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. Would McDonald need to assess implementation potential in this effort?

No, this is an individual EBP effort, not an institutional effort

What is the population of "Do patients receiving an intradermal injection experience greater discomfort with bevel-up or bevel-down needle injection?"

Patients receiving an intradermal injection

What is the population of "Which large-volume enema solution--tap water, soap suds, or polyethylene glycol-electrolyte solution--results in the least mucosal irritation in patients with constipation?"

Patients with constipation

What is the intervention, influence, or exposure of "Do patients receiving an intradermal injection experience greater discomfort with bevel-up or bevel-down needle injection?"

Positioning of the bevel during needle injection

A group of nurses working in a community health center were unsure of how to answer questions from patients about appropriate means of cleansing children's wounds in home settings. Most nurses felt that sterile saline should be recommended to minimize the risk of infection, but others believed that tap water was adequate for cleansing acute wounds. The nurses decided to examine the evidence and located a systematic review in the Cochrane database. Among the studies that had been conducted, the review concluded that there were no differences in rates of infection or healing between the use of tap water versus sterile saline in the cleansing of wounds. However, few of the studies that had been done involved the use of children, and most had been conducted in health care settings. The nurses decided to initiate a new study to gather more focused and informative evidence about the effects of saline solution versus tap water in cleansing children's wounds. Would the trigger be described as problem-focused or knowledge-focused?

Problem-focused

McDonald was caring for a 27-year-old woman who just delivered her first infant by emergency cesarean birth. The mother was upset because she believed the she would have to deliver any subsequent children by cesarean birth. She asked McDonald about the risks of birth complications with vaginal birth after cesarean (VBAC). McDonald decided to look for the best possible evidence to answer her question. Would the trigger in McDonald's effort be described as problem-focused or knowledge-focused?

Problem-focused

A group of nurses working in a community health center were unsure of how to answer questions from patients about appropriate means of cleansing children's wounds in home settings. Most nurses felt that sterile saline should be recommended to minimize the risk of infection, but others believed that tap water was adequate for cleansing acute wounds. The nurses decided to examine the evidence and located a systematic review in the Cochrane database. Among the studies that had been conducted, the review concluded that there were no differences in rates of infection or healing between the use of tap water versus sterile saline in the cleansing of wounds. However, few of the studies that had been done involved the use of children, and most had been conducted in health care settings. The nurses decided to initiate a new study to gather more focused and informative evidence about the effects of saline solution versus tap water in cleansing children's wounds. The nurses decided to initiate a new study because they deemed the evidence base inadequate. Would their new study be qualitative or quantitative study?

Quantitative

What is the intervention, influence, or exposure of "Which large-volume enema solution--tap water, soap suds, or polyethylene glycol-electrolyte solution--results in the least mucosal irritation in patients with constipation?"

Three alternative large-volume enema solutions

T/F A key step in an individual EBP effort is to integrate appraised research evidence with expertise and local contextual information.

True

T/F A metasynthesis integrates knowledge from multiple qualitative studies.

True

T/F A well-known early nursing research utilization project is the CURN project.

True

T/F In a meta-analysis, the unit of analysis is an individual study rather than an individual study participant.

True

T/F In asking clinical foreground questions, there is always a "P" component, regardless of question type.

True

T/F In organizational EBP projects, an important activity is pilot testing and evaluating an evidence-based innovation.

True

T/F In the PICO acronym, the "C" component is the comparator for the "I" component.

True