LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
Table of Contents
Part I. Introduction
1. Overview of Evidence-Based Practice
2. Models and Evidence
Part II. Processes of Developing EBP and Questions in Various Clinical Settings
3. Developing Compelling Clinical Questions
4. Search and Critical Appraisal of the Literature
5. Principles of Assessing Research Quality
6. Intervention Studies
7. Observational Studies
8. Systematic Reviews and Clinical Practice Guidelines
9. Qualitative Studies
10. Understanding Statistics for Evidence-Based Practice
Part III. Implementation
11. Evidence-Based Approaches for Improving Healthcare Quality
12. Planning for Success
13. Launching Implementation
14. Implementation Strategies for Stakeholders
15. Patient-Centered Evidence-Based Practices
Part IV. Evaluation and Dissemination
16. Evaluation of Evidence-Based Practice
17. Dissemination
, LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
Chapter 01: Overview of Evidence-Based Practice
LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality
Improvement, 1st Edition
MULTIPLE CHOICE
1. The first step in the evidence-based process is to
a. form a team of health care providers.
b. retrieve evidence.
c. select an EBP topic.
d. critically appraise evidence.
ANS: C
The steps for EBP are: select an EBP topic, form a team, evidence retrieval, critical appraisal of evidence,
evidence synthesis, set forth EBP recommendations, decision to change practice, convey EBP
recommendations to local standards, policies or procedures, implement practice change, evaluation, and
dissemination.
2. Which agency is the National Guideline Clearinghouse of publicly available database of evidence-
based clinical practice guidelines and related documents?
a. The Institute for Healthcare Improvement (IHI)
b. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
c. The United States Preventative Services Task Force (USPSTF)
d. The Agency for Healthcare Quality and Research (AHRQ)
ANS: D
AHRQ provides a variety of EBP function including serving as the National Guideline Clearinghouse: publicly
available database of evidence-based clinical practice guidelines and related documents. Updated weekly with
new content, NGC provides an accessible mechanism for obtaining objective, detailed information on clinical
practice guidelines to further dissemination, and implementation. Examples of IHI Evidence-Based Standards or
Recommendations include development of a patient and
family-centered ICU, Communication about end-of-life care, the opioid crisis and building systems of safety.
Examples of JCAHO Evidence-Based Standards or Recommendations include fall prevention, patient/family
education, prevention of CAUTI, and prevention of medication errors. The USPSTF assigns recommendations
for prevention and evidence-based health care a letter grade (an A, B, C, or D grade or an I statement) based on
, LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
strength of the evidence and balance of benefits and harms of a preventive service. The Task Force does not
consider costs of a preventive service when determining a recommendation grade.
3. Which of the following statements comparing evidence-based practice to the conduction of research is
true?
a. EBP poses research questions or hypotheses that advance the state of the science.
b. The purpose of EBP is to gain knowledge/science generation.
c. Standardized-dependent measures with known reliability and validity are used as evaluation methods
for EBP.
d. EBP evaluation includes quality improvement metrics that address both processes of care and patient
outcomes.
ANS: D
Conduct of research poses research questions or hypothesis that advance the state of the science. The purpose
of an EBP clinical question or purpose of the EBP project is derived from the PICO. Application of research
findings and/or other evidence in local practice and/or communities is another purpose of EBP. Standardized-
dependent measures with known reliability and validity are used as evaluation of conduction of research.
4. Which of the following is an example of an evidence-based practice approach?
a. Smoking cessation reports from participants for 6 months prior to implementation, mid-way during
implementation (3 months), and following implementation of a “Stop Smoking” program
b. Comparison of blood pressure in one group who walk 20 minutes a day/5 days a week versus another
group who are sedentary
c. Measuring heart rate on volunteers who listen to music prior to sleep versus volunteers who do not
listen to music prior to sleep
d. Comparison of patient satisfaction scores from two medical surgical units over a 3-month period
ANS: A
The approach in EBP is a nonresearch design. For a specific period of time measures are tracked pre-
implementation, during implementation, post-implementation. The other responses are examples of the
conduct of research approach which is aligned with the research questions/hypotheses (e.g., observational;
RCT; step-wedge design).
5. Which of the following is the best description of translational research? Translational research
, LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
a. is the systematic investigation of a phenomenon to answer research questions or hypotheses that
advances the state of the science.
b. focuses on the generation and synthesis of evidence that compares benefits and harms of alternative
methods to prevent, diagnose, treat, and monitor a clinical condition, or to improve the delivery of care.
c. is a dynamic continuum from basic research through application of research findings in practice,
communities, and public health settings to improve health and health outcomes, progresses across five phases.
d. is a field of science that focuses on testing implementation interventions to improve uptake and use of
evidence to improve patient outcomes and population health, and explicate what implementation strategies
work for whom, in what settings, and why.
ANS: C
Conduct of research is the systematic investigation of a phenomenon to answer research questions or
hypotheses that advances the state of the science. Comparative effectiveness research (CER) focuses on the
generation and synthesis of evidence that compares benefits and harms of alternative methods to prevent,
diagnose, treat, and monitor a clinical condition, or to improve the delivery of care. Implementation science
(also called translation science) is a field of science that focuses on testing implementation interventions to
improve uptake and use of evidence to improve patient outcomes and population health, and explicate what
implementation strategies work for whom, in what settings, and why.
6. Which statement regarding evidence-based practice is true?
a. The nursing profession is the sole contributor and user of EBP.
b. Evidence-based practice and conduct of research have distinct purposes, questions, approaches, and
evaluative measures.
c. Teams working with EBP should consist of only health care providers.
d. EBP and translation science are interchangeable terms.
ANS: B
Participation in and contribution to EBP is essential for many professionals to plan, provide, and evaluate
optimal care. The application of evidence to improve quality of care and patient outcomes is central to health
care improvement. The national agenda for EBP is clearly in the forefront of health care. When considering
members of the EBP team, consideration should be given to including lay-persons who have experience with
the selected topic. Involving consumers may increase their understanding of why certain EBPs are used in what
circumstances and why they are important. EBP and translation science are not interchangeable terms.
Translational science is a dynamic continuum from basic research through application of research findings in
practice, communities, and public health settings to improve health and health outcomes, progresses across five
phases.
Table of Contents
Part I. Introduction
1. Overview of Evidence-Based Practice
2. Models and Evidence
Part II. Processes of Developing EBP and Questions in Various Clinical Settings
3. Developing Compelling Clinical Questions
4. Search and Critical Appraisal of the Literature
5. Principles of Assessing Research Quality
6. Intervention Studies
7. Observational Studies
8. Systematic Reviews and Clinical Practice Guidelines
9. Qualitative Studies
10. Understanding Statistics for Evidence-Based Practice
Part III. Implementation
11. Evidence-Based Approaches for Improving Healthcare Quality
12. Planning for Success
13. Launching Implementation
14. Implementation Strategies for Stakeholders
15. Patient-Centered Evidence-Based Practices
Part IV. Evaluation and Dissemination
16. Evaluation of Evidence-Based Practice
17. Dissemination
, LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
Chapter 01: Overview of Evidence-Based Practice
LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality
Improvement, 1st Edition
MULTIPLE CHOICE
1. The first step in the evidence-based process is to
a. form a team of health care providers.
b. retrieve evidence.
c. select an EBP topic.
d. critically appraise evidence.
ANS: C
The steps for EBP are: select an EBP topic, form a team, evidence retrieval, critical appraisal of evidence,
evidence synthesis, set forth EBP recommendations, decision to change practice, convey EBP
recommendations to local standards, policies or procedures, implement practice change, evaluation, and
dissemination.
2. Which agency is the National Guideline Clearinghouse of publicly available database of evidence-
based clinical practice guidelines and related documents?
a. The Institute for Healthcare Improvement (IHI)
b. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
c. The United States Preventative Services Task Force (USPSTF)
d. The Agency for Healthcare Quality and Research (AHRQ)
ANS: D
AHRQ provides a variety of EBP function including serving as the National Guideline Clearinghouse: publicly
available database of evidence-based clinical practice guidelines and related documents. Updated weekly with
new content, NGC provides an accessible mechanism for obtaining objective, detailed information on clinical
practice guidelines to further dissemination, and implementation. Examples of IHI Evidence-Based Standards or
Recommendations include development of a patient and
family-centered ICU, Communication about end-of-life care, the opioid crisis and building systems of safety.
Examples of JCAHO Evidence-Based Standards or Recommendations include fall prevention, patient/family
education, prevention of CAUTI, and prevention of medication errors. The USPSTF assigns recommendations
for prevention and evidence-based health care a letter grade (an A, B, C, or D grade or an I statement) based on
, LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
strength of the evidence and balance of benefits and harms of a preventive service. The Task Force does not
consider costs of a preventive service when determining a recommendation grade.
3. Which of the following statements comparing evidence-based practice to the conduction of research is
true?
a. EBP poses research questions or hypotheses that advance the state of the science.
b. The purpose of EBP is to gain knowledge/science generation.
c. Standardized-dependent measures with known reliability and validity are used as evaluation methods
for EBP.
d. EBP evaluation includes quality improvement metrics that address both processes of care and patient
outcomes.
ANS: D
Conduct of research poses research questions or hypothesis that advance the state of the science. The purpose
of an EBP clinical question or purpose of the EBP project is derived from the PICO. Application of research
findings and/or other evidence in local practice and/or communities is another purpose of EBP. Standardized-
dependent measures with known reliability and validity are used as evaluation of conduction of research.
4. Which of the following is an example of an evidence-based practice approach?
a. Smoking cessation reports from participants for 6 months prior to implementation, mid-way during
implementation (3 months), and following implementation of a “Stop Smoking” program
b. Comparison of blood pressure in one group who walk 20 minutes a day/5 days a week versus another
group who are sedentary
c. Measuring heart rate on volunteers who listen to music prior to sleep versus volunteers who do not
listen to music prior to sleep
d. Comparison of patient satisfaction scores from two medical surgical units over a 3-month period
ANS: A
The approach in EBP is a nonresearch design. For a specific period of time measures are tracked pre-
implementation, during implementation, post-implementation. The other responses are examples of the
conduct of research approach which is aligned with the research questions/hypotheses (e.g., observational;
RCT; step-wedge design).
5. Which of the following is the best description of translational research? Translational research
, LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition
a. is the systematic investigation of a phenomenon to answer research questions or hypotheses that
advances the state of the science.
b. focuses on the generation and synthesis of evidence that compares benefits and harms of alternative
methods to prevent, diagnose, treat, and monitor a clinical condition, or to improve the delivery of care.
c. is a dynamic continuum from basic research through application of research findings in practice,
communities, and public health settings to improve health and health outcomes, progresses across five phases.
d. is a field of science that focuses on testing implementation interventions to improve uptake and use of
evidence to improve patient outcomes and population health, and explicate what implementation strategies
work for whom, in what settings, and why.
ANS: C
Conduct of research is the systematic investigation of a phenomenon to answer research questions or
hypotheses that advances the state of the science. Comparative effectiveness research (CER) focuses on the
generation and synthesis of evidence that compares benefits and harms of alternative methods to prevent,
diagnose, treat, and monitor a clinical condition, or to improve the delivery of care. Implementation science
(also called translation science) is a field of science that focuses on testing implementation interventions to
improve uptake and use of evidence to improve patient outcomes and population health, and explicate what
implementation strategies work for whom, in what settings, and why.
6. Which statement regarding evidence-based practice is true?
a. The nursing profession is the sole contributor and user of EBP.
b. Evidence-based practice and conduct of research have distinct purposes, questions, approaches, and
evaluative measures.
c. Teams working with EBP should consist of only health care providers.
d. EBP and translation science are interchangeable terms.
ANS: B
Participation in and contribution to EBP is essential for many professionals to plan, provide, and evaluate
optimal care. The application of evidence to improve quality of care and patient outcomes is central to health
care improvement. The national agenda for EBP is clearly in the forefront of health care. When considering
members of the EBP team, consideration should be given to including lay-persons who have experience with
the selected topic. Involving consumers may increase their understanding of why certain EBPs are used in what
circumstances and why they are important. EBP and translation science are not interchangeable terms.
Translational science is a dynamic continuum from basic research through application of research findings in
practice, communities, and public health settings to improve health and health outcomes, progresses across five
phases.
