Research Chapters 13, 14

C

Use of research findings in clinical areas is slow because: a. institutions prohibit use of nursing research. b. little clinically relevant research is being done. c. nurses are not usually rewarded for using research findings in practice. d. there is no nursing research to guide clinical practice.

A

What costs would NOT be typically considered in a cost-benefit analysis to decide if an adult child quitting school and moving home so as to take care of an invalid parent would be cost effective? a. Household living b. Insurance c. Out-of-pocket d. Provider

A

What theorist proposed a theory of quality health care and the process of evaluating it? a. Donabedian b. Gambone c. Loegering d. Reiter

C

When creating samples for outcomes research, which of the following is NOT a generally accepted guideline to follow? a. All patients are represented. b. Heterogeneous samples are preferred. c. Random sampling is very desirable. d. Very large samples are needed.

D

According to the nursing role effectiveness model, which of the following would affect the nurse's ability to engage effectively in an activity, such as giving a patient a back rub to help promote sleep? a. Dependent role functions b. Execution of medical orders c. Nurse-physician relationship d. Patient acuity level

A

A model of research use, such as the Stetler model, has been designed to: a. provide a comprehensive framework to enhance the use of research evidence by nurses to facilitate an evidence-based practice. b. help nurses find perfect research studies for clinical application. c. promote implementation of detailed, structured protocols based on single studies in practice. d. validate use of current practices and minimize change in practice.

D

A researcher conducting outcomes research is focusing on what component of patient care? a. Assessment b. Care planning c. Interventions d. Evaluation

B

A researcher is looking particularly at the decision-making process within a health care institution. What specific aspect of quality health care would this address? a. Practice styles b. Process of care c. Quality of care d. Structure of care

C

A researcher is looking particularly at the financial management of a health care system. What specific aspect of quality health care would this address? a. Practice styles b. Process of care c. Quality of care d. Structure of care

D

A researcher is looking particularly at the organizational hierarchy of a health care system. What specific aspect of quality health care would this address? a. Practice styles b. Process of care c. Quality of care d. Structure of care

D

An organization that facilitates research use would be characterized by: a. a management style that supports nurses. b. committed use of acceptable nursing policies and practices. c. reluctance to change. d. support for new ideas and innovations.

A

As a nurse who identifies a need for improvement in patient care, what would you do first to establish a new evidence-based guideline for practice? a. Conduct a thorough literature review. b. Enlist the support of affiliating physicians. c. Institute a research use project. d. Write the National Guideline Clearinghouse for information.

A

Developing evidence-based guidelines involves which of the following? a. Meta-analyses of a topic of interest b. Panels of experts sharing their opinions on best practices c. Quasi-experimental studies d. Rigorous experimental studies

D

How do clinical guideline panels contribute to outcomes research? Clinical guidelines: a. conduct a review of the available literature on a condition and send it to the facility for adoption. b. create health care protocols that incorporate recommended clinical guidelines. c. critique evidence-based practice for funding purposes. d. incorporate evidence on health outcomes into recommendations concerning management strategies.

B

If a researcher wants to conduct outcomes research, what is a major difference between it and a typical quantitative study? a. A definite plan must be developed, including all steps of the research. b. Process and causal links must be justified. c. The study requires a large sample. d. There is a need for two groups—the subjects of care and the providers of care.

C

In developing an evidence-based practice, who should the nurse include in any plans to implement a new guideline? a. CEO of the facility because support from the top is always needed for change to be successful b. Patients because they must live with the treatment c. Physicians who may admit patients to the unit where the new practice will be instituted d. Researchers who provide the evidence

B

Perhaps the biggest obstacle to outcomes research is that: a. experimental research is much more interesting. b. it is extremely complex and difficult to plan and control. c. many researchers are simply not interested in it. d. very few people are capable of conducting an appropriate study.

B

Staffing patterns is one area of study related to quality health care outcomes. What are the most current findings? a. A policy change should be implemented in hospitals based on the findings. b. Low levels of RN staffing were associated with higher rates of serious complications. c. Student nurses could assume some of the duties of RNs to alleviate the staff shortage. d. The most important thing was to have enough personnel to give a good staff-to-patient ratio.

A

Stetler and Marram developed a model concerned with: a. research use. b. role progression from novice to expert. c. strategies for coping and change. d. system stability and adaptability.

C

The Agency for Healthcare Research and Quality (AHRQ) is noted for development of which of the following? a. A use model for the implementation of research findings in the provision of health care b. An international panel of experts to determine the areas requiring research to improve health care c. Clinical practice guidelines to direct health care practices d. Integrative reviews of nursing research to be shared with other health care providers

C

The American Nurses Association (ANA) launched a major initiative to identify data to support better nursing coverage in patient care areas. What was this called? The: a. American Academy of Nursing Expert Panel on Quality Health Care b. National Institute for Nursing Research c. Nursing's Safety and Quality Initiative d. Patient Outcomes Research Team projects

D

The addition of the patient, family, and community as providers of care as well as the recipients of care to the theory of quality health care was important because: a. evaluating total care is important. b. health has many different aspects. c. the theory is based on quality. d. they then align with nursing theories.

D

The best measure of successful evidence-based practice is: a. acceptance of the practice to the point of being included in the policy manual. b. agreement of the health care team, which leads to consistent care for the patient. c. dissemination of the practice in nursing journals. d. patient satisfaction and positive outcomes increasing.

D

The methodology of outcomes research makes use of all BUT which of the following? a. Economic theory b. Epidemiology c. Evaluation methods d. Health policy

D

Which of the following correctly indicates the amount of clinical control nursing has over the implementation and evaluation of an intervention? a. Dependent variables must be under nursing control. b. Experimental controls must be maintained in the clinical area when the intervention is implemented in daily practice. c. Nursing must have independent control over the intervention if it is to be implemented successfully. d. Valid clinical measures need to be available to clinical nurses to monitor outcomes from interventions

A

Which of the following define standards of care? a. Care maps b. Tradition c. Trial and error d. Practitioner preference

A

Which of the following is a correct statement regarding a change in practice based on research evidence? a. All members of the health care team need to be vigilant about monitoring the results of the implementation. b. Generally the physician takes over the responsibility for monitoring effectiveness of the change. c. It is not necessary to constantly monitor the results as with research use projects. d. Because nurses are with the patients all the time, they alone are responsible for monitoring change.

B

Which of the following is a key point relating to outcomes research? a. Outcomes research programs are simplistic and may consist of one or two studies. b. Strategies must be developed in nursing to disseminate the findings from outcomes studies to the various constituencies needing the information. c. The goal of outcomes research is to examine the most productive way to provide patient care. d. The theory on which outcomes research is based was developed by Heidegger.

A

Which of the following is a major component of the nursing role effectiveness model? a. Patient-health outcomes b. Patient interaction c. Physician understanding of the nurse role d. Staff-patient ratio

C

Which of the following is an accurate statement about the research use process? a. If nurses decide not to implement findings of a study or set of studies, they are resistant to change. b. Making a decision to delay use of research findings in practice indicates the process was not carried out properly. c. Support for change will be stronger when this type of process is used to introduce new ideas and treatments. d. This process is only appropriate for experienced researchers and not staff nurses.

B

Which of the following is one of the characteristics of an innovation that determines the probability and speed at which an idea will be adopted? a. Authenticity b. Compatibility c. Multiplicity d. Uniqueness

A

Which of the following is proposed as the BEST method to measure improvement in patients' conditions? a. An index of improvement b. Change scores c. Has not been a useful method suggested at this time d. Percentage of improvement

A

Which of the following is related to the feasibility of implementing a new nursing intervention? a. Degree of change people will need to make b. Relevance to health care practice c. Reliability and validity of the measures used d. Significance of scientific merit

A

Which of the following is the last stage in Stetler's research utilization model? a. Evaluation b. Comparative Evaluation c. Translation/Application d. Preparation

B

Which of the following is the specific problem in trying to conduct "true" outcomes research? a. Health care personnel are too busy. b. It would require more funding than is ordinarily available. c. Researchers have little interest in outcomes research. d. There is fear of what the study will discover about the health care facility.

D

Which of the following statements is true regarding costs of care? a. Certain savings come from cutting hospital personnel and shortening patient stays. b. Hospitals need to keep patients in the facility longer if they want to continue to make a profit. c. If an institution is going to provide quality care, it might as well accept that it will see a loss of profits. d. Providing quality care is costly, but total savings can be realized when one looks at the whole picture.

C

Which of the following strategies for use is most amenable to adoption by baccalaureate nursing students and new graduates? a. Making poster presentations at local and regional clinical nursing conferences b. Preparing integrative reviews of completed research for publication in clinical journals c. Reading professional journals critically and reporting the findings at staff meetings d. Replicating studies and publishing the results in refereed journal

A

Which of the following would new BSN graduates do if they wanted to develop an evidence-based practice? a. Review literature related to the types of patients they see each day. b. Subscribe to a specialty nursing journal that describes theoretical-based clinical concepts. c. Submit a grant proposal to try a new method of wound dressing. d. Write a report in which practices are evidence based on their unit.

A

Which situation describes the true meaning of dissemination of findings of outcomes research? a. A series of presentation and publications in many venues b. An open forum for exchange of the results and individuals' responses to them c. An oral presentation at an international conference d. Publication in scholarly, peer-reviewed journals

A

Which statement best reflects why nurse-sensitive quality indicators are extremely important to the profession? Nurse-sensitive quality indicators: a. are directly related to what nurses do for their patients. b. are used to determine salary increases in performance reviews. c. provide an opportunity to demonstrate a high level of expertise. d. provide the profession with a means to monitor ways to provide quality patient care.

B

Which strategy would best address the difficulty practicing nurses have with understanding research terminology? a. Authorization for a federally funded national program to educate all nurses regarding research terminology b. Increased publication of research articles targeted at the practicing nurse instead of nursing scientists c. Knowledge of the research process incorporated into the NCLEX d. Mandated entry level for nursing at the baccalaureate level