Ch. 17 Evidence-Based Practice questions and answers

Components of a systematic review include: a. publication of study data. b. assessment of a study. c. determination of statistical tests. d. development of research guidelines. ANS: B Standard components of a systematic review are processes for (1) initiating, (2) finding and assessing individual studies, (3) synthesizing the body of evidence, and (4) reporting using a standard format A team has formed to determine which methods have worked best and which factors influence the implementation of an evidence-based practice program. This is known as _____ research. a. authoritarian b. autocratic c. transformational d. translational ANS: D Translational research includes testing the effect of interventions aimed at promoting the rate and extent of adoption of evidence-based practices by nurses, physicians, and other health care providers and describing organizational, unit, and individual variables that affect the use of evidence in clinical and operational decision making 00:32 01:03 Evidence-based practice includes: a. collaborative practice dynamics between health care professionals. b. documentation of patient care as evidence of nursing practice. c. integration of research with clinical expertise and patient values. d. mutual goal setting and application in the clinical setting. ANS: C Evidence-based practice is partnership between patients and providers thata process of shared decision making in a involves the integration of research and other best evidence with clinical expertise and patient values in health care decision making Opinion leaders are: a. formal leaders who lead evidence-based practice development teams. b. formal leaders who write new evidence-based practice guidelines. c. informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians use of evidence in clinical decision making. d. informal leaders who gather data about nursing practice changes. ANS: C Informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians' use of evidence in clinical decision making are referred to as opinion leaders. Opinion leaders are likeable, trustworthy, informative, and influential A clinical nurse specialist is meeting one on one with staff nurses while they are working to discuss data about the evidence-based practice. This is known as: a. academic detailing. b. champion coaching. c. individual instruction. d. professional mentoring ANS: A Academic detailing is a marketing strategy in which a trained individual meets one on one with practitioners in their setting to provide information about the evidence-based practice. A communication strategy used in the promotion of adopting evidence-based practice recommendations is: a. best practice evaluation. b. knowledge translation. c. shared governance. d. academic detailing. ANS: D Academic detailing involves a strategic approach to communication and discussions with clinicians. Clinicians tend to buy into the need for the practice change when there is a strong evidence base, the topic addresses an identified need, data demonstrate an opportunity for practice improvement within the clinical area, and the practice change offers a relative advantage. Which of the following will positively influence the sustainability of a practice change? a. Audit and feedback of key indicators. b. Incremental implementation of practice changes. c. Adhering to a strict action plan for implementation. d. The new practice is much different from current practice ANS: A The sustainability step in implementation is one of the most difficult in the EBP process. Audit and feedback of key indicators remains a necessary component of an integration plan (Ivers et al., 2012). Key indicators to monitor are drawn from the pilot data and include process (i.e., knowledge, attitudes, and practices) and outcomes The chief executive nursing officer has discussed implementation of evidence-based practice at hospital-wide nursing meetings. She is leading a team to incorporate evidence-based practice terminology into the vision and mission of the institution. She also is advising the multidisciplinary leadership team to incorporate evidence-based practice expectations into the performance appraisals of all staff members. The chief executive nursing officer is modeling: a. continuous quality improvement methodology and techniques. b. marketing tactics that will help familiarize the staff with new terminology. c. professional duties for new protocol acceptance throughout the institution. d. strategies for incorporation of evidence-based practice into the infrastructure of the organization. ANS: D Strategies for integration of evidence-based practice into the infrastructure of the organization include the following: incorporation of evidence-based practice into the mission, vision, strategic plan, and performance appraisals of staff; integration of work into nursing governance structure; and demonstration of valuing evidence-based practice through the behaviors of leadership. Once a new practice has been implemented on a unit, scaling up needs to be evaluated. What is scaling up? a. A method used to implement the previous practice if the new practice has been found to be detrimental to patient care b. A process used to expand the reach of effective clinical interventions in new settings c. Recruitment of new nurses from different institutions who can help with role modeling and communication of the new practice d. A tactic used to invigorate leaders to continue to communicate better with staff nurses and ancillary personnel ANS: B A reinfusion or reinforcement plan is a strategy for ongoing communication about the new practice until it becomes fully integrated into daily care. The responsibility to articulate the business case for evidence-based practice to senior leadership lies with: a. the staff nurse. b. nursing leadership. c. the governing board. d. the quality improvement committee. ANS: B Nursing leaders have a responsibility to clearly articulate EBP work in a way that will be heard by decision makers. Sharing results with senior leaders helps them recognize great work while reporting the business case for evidence-based care to governing boards The responsibility of developing the unit culture for evidence-based practice belongs to the: a. staff nurses. b. unit manager. c. medical director. d. chief executive officer ANS: B Nurse leaders are in key positions responsible for developing and sustaining an organizational infrastructure and creating an environment that affects adoption of EBPs and improves patient outcomes. The role of the project director is to: a. take meeting minutes. b. maintain the action plan. c. set the expectations for the unit. d. report project progress to the governing body ANS: B The project director is responsible for establishing meeting schedules and time lines with the group, running the meetings, maintaining the action plan, delegating work assignments, and overseeing the process and progress. The focus of the project director must always be on moving the project forward, despite challenges, as a key strategy for success. The project director may orchestrate discussions for identifying potential challenges, addressing those that cannot be avoided but continuing to move forward despite distractions