EBP Exam One
Based on the titles of the studies, which is most likely the strongest level of evidence?
"Systematic review of respiratory viral co-infections in children"
A keyword is (select all that apply):
used when an appropriate subject heading is not available., searchable in several different fields contained in the database., a general term that is commonly used within a discipline., a term that may vary from author to author
Before making a practice change, what should be considered?
Clinician expertise, Patient preferences and values, Both internal and external evidence
Which of the statements below describe an EBP project? Select all that apply.
Determining which dressing is most likely to decrease the occurrence of pressure ulcers, Determining the best standard of care for asthmatic pediatric clients
The nurse has gotten staff on board and created a team for the EBP project. What is the next step?
Develop the PICOT
Identify the O: Is a chest x-ray more effective than CT scan in identifying pneumonia in patients with emphysema?
Identifying pneumonia
Subject headings will do which of the following? Select all that apply.
Increase the amount of citations that can answer a nurse's PICOT question, Help decrease the amount of irrelevant citations the nurse finds
Please rank the following strength-of-evidence levels from strongest study results to weakest study results.
1)Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) 2)Evidence obtained from well-designed controlled trials without randomization 3)Evidence from systematic reviews of descriptive and qualitative studies 4)Evidence from the opinion of authorities and/or reports of expert committees
Please rank the following study types from highest (Level 1) to lowest (Level 7) in the evidence pyramid.
1)Randomized controlled trial 2)Cohort study 3)Qualitative study 4)Clinical practice guideline
How can a nurse manager best support staff nurses in their enthusiasm for evidence-based change?
Listen to the nurse, inquire about their EBP knowledge, and connect them with a resource on the unit.
How can the nurse determine a subject heading? Select all that apply.
Look them up in the database being searched., Ask the librarian., Look at the subject headings that were assigned to a study that will answer the PICOT question.
Which keywords could be used for the concept of a rapid response team? Select all that apply.
MEWS, PEWS, MRT, RRT, ENIT
How many types of templates are there to handle clinical questions?
5
When trying to improve catheter-associated urinary tract infection (CAUTI) rates on a unit, which type of project would the nurse want to utilize? Select all that apply.
A research project, An evidence-based practice project, A quality improvement project
What are the determinants of transitions to palliative care in acute patients under the age of 35? What is the P?
Acute patients < 35 years old
What is a facilitator to the implementation of EBP?
Adequate access to resources
Which of the following is a facilitator to EBP?
Adequate resources
Foreground or background: What are the clinical manifestations of menopause?
Background
Why are background questions useful before formulating a PICOT question? Select all that apply.
Background questions are broad and help lead to a PICOT question., Background questions serve as the foundation for asking a PICOT question
Identify all sources of internal evidence. Select all that apply.
Benchmarking data from other organizations., Data gathered from the EHR, Data a colleague presented from an EBP project., Your unit's quality improvement data.
Choose the highest level of evidence based on the title of the article
Bullying in the Digital Age: A Critical Review and Meta-Analysis
A client insists on having a wart treated by rubbing a cut potato on the wart rather than the injection that is currently being used in practice. The nurse realizes additional discussion is needed with the client to understand the request. The nurse speaks with the client and realizes the client has a needle phobia. Taking this into account, the nurse mentions that cryotherapy may be another option for wart removal, and that while it doesn't have as high a success rate as the injection being proposed, studies indicate that it is still fairly successful. The client is interested in this approach and wants to know how successful it is compared to the injection. In this scenario, what is being used to drive clinical decision making? Select all that apply.
Client preference, Clinical expertise, External evidence, Internal evidence
Clinical or research: Are mobile devices more effective in managing workflow among ER nurses?
Clinical
Which healthcare role is best trained to have the most expertise in the steps of EBP?
Clinical nurse specialist
An adult presenting with a high fever, dizziness and aching joints who has been on an Appalachian trek for a month asks whether Lyme disease is a possible cause of the symptoms they are now experiencing. The provider wonders if running an enzyme immunoassay would get the patient back on the trail sooner than running an immunofluorescence assay. Which question template would the provider use?
Diagnosis/diagnostic test PICOT template
Which statements are true about evidence-based practice (EBP)? Select all that apply.
EBP allows clinicians to translate evidence into clinical decision-making., EBP is the integration of best available evidence with clinical expertise and client preferences
Which statement is true regarding research and EBP?
EBP uses research to support and practice change
Consider the following clinical scenario: Are fair-skinned children who have prolonged unprotected UV exposure compared to darker-skinned children without prolonged unprotected UV exposure at increased risk of melanoma? Which question template would you use?
Etiology PICOT template
Choose the lowest/weakest level of evidence
Expert opinion
When given a choice of external evidence, which of the following would provide the weakest support for practice change?
Expert opinion editorial
Guidelines developed by the American College of Chest Physicians would be an example of:
External evidence
Health care organizations can best 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
What is the next step a nurse would take to move forward an EBP initiative after attending a professional conference and speaking with key stakeholders?
Formulate a PICOT question
What types of clinical issues might guide a prognosis question? Select all that apply.
Future outcomes regarding therapy, Patient choice concerning therapy
A charge nurse and team of nurses lack the motivation required to implement EBP. Which solution may help address this barrier?
Gain authorization to offer continuing education credits for attending training workshops and include staff use of EBP in the annual evaluation
Why is it important to generate a good PICOT question? Select all that apply.
Good PICOT questions will ensure the search is likely to be successful., Well-formulated PICOT questions ensure the clinical issue is well defined., PICOT questions avoid directing the search for evidence in one direction
What is the P in this PICOT: Does hand washing by healthcare providers reduce hospital-acquired infections?
Healthcare providers
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?
Hold a poster presentation session in the lobby featuring staff's EBP projects.
If there isn't a systematic review in the literature I've identified,
I'll try and locate a guideline that answers my clinical question., I'll need to read the studies from other levels of evidence I've found
Which of the following is NOT included in the steps of EBP?
Inquire about the preferences of nurses
A client's self-report of pain is considered to be:
Internal evidence
What other terms might a nurse use to express the concept of a subject heading? Select all that apply.
Lexicon, MeSH, Descriptors, Controlled vocabulary
After returning from a conference with an example of best evidence that is not current practice in one's organization, what is the first step toward making a change in that organization?
Meeting with a manager and continuing to read the literature.
Choose the highest level of evidence
Meta analysis
Which of the following is the strongest level of evidence?
Meta analysis
Which statements are potential barriers for evidence-based practice? Select all that apply.
Nurses do not understand research., Nurses do not have the skills to access research evidence., Nurses do not value research.
Which of the following is NOT a component of PICOT?
Organization
Which of the following would be considered as external evidence?
Outcome data from a published research study
Which studies use a control group? Select all that apply.
Randomized controlled trials, Controlled trials
Levels of evidence are used for which reasons? Select all that apply.
Ranking primary sources of evidence, Ranking websites, Ranking secondary sources of evidence, Ranking expert opinion
Which process produces results that are valid only in the setting in which it took place?
Quality improvement
Clinical or research: How is temporal arteritis managed in the elderly?
Research
Foreground or background: When do complications of appendicitis usually occur in children?
Research
Which statements are true about research? Select all that apply
Research is a systematic investigation that uses scientific methods to answer clinical questions., Research can be considered to be external evidence., Research creates new knowledge or validates existing knowledge
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?
Seek out funding sources through local organizations and specialty organizations.
Why are journal clubs especially practical as facilitators of EBP?
They are participatory, actively involving all levels of staff in discussion.
Levels of evidence are important for which reasons? Select all that apply.
They help to rank the potential amount of bias of individual studies., They offer a way for clinicians to recognize the soundness of an individual study's design., They act as a hierarchy to prioritize which studies to read first when looking at a body of evidence
What is the best reason for attending a professional conference in order to advance evidence-based practice (EBP)?
To network and share EBP project findings with other nurses
All of the following statements represent nursing activities used in promoting evidence-based practice: participate in interdisciplinary evidence-based projects; join a journal club; and attend professional conferences.
True
Identify the I in this PICOT: Is spironolactone more effective than clonidine in reducing BP in teenagers?
Use of spironolactone
What elements will ensure a successful search? Select all that apply.
Use subject headings in the search strategy., Use a PICOT worksheet., Use keywords in the search strategy., Consult the Help pages of the databases primarily being searched., Consult a librarian whenever necessary.
Quality improvement:
generates and uses internal evidence to improve systems or processes within an organization.
