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.