Deck 21: Translating Research into Practice

Question 1

Before implementation of the new policy and procedure on central line catheter care,the nurse manager uses an appraisal system to evaluate the evidence.What is important in using an appraisal system to evaluate the evidence gathered in preparation for development of a new protocol?

A)Limiting the search to randomized clinical trials
B)Matching the appraisal tool to the type of evidence
C)Eliminating qualitative research studies
D)Using only pre-processed evidence

Answer 1

Matching the appraisal tool to the type of evidence

Question 2

At an organizational level,which of the following strategies would assist in ensuring that EBP is incorporated into nursing care?

A)Formation of nursing-only implementation teams
B)Restriction of evidence to RCTs
C)Formation of a network of individuals doing research and/or interested in research utilization
D)Avoidance of partnership with experienced researchers

Answer 2

Formation of a network of individuals doing research and/or interested in research utilization

Question 3

Marie is a long-term staff nurse on the rehab floor.Her unit manager has been eager to adopt evidence-based recommendations related to family-centered care on the unit.Marie's response has been that she rarely has time to provide care to patients,let alone families,and that there is no good reason to do anything different than what she is already doing.An approach that may gain Marie's support of the idea is to:

A)Invite Marie to review the studies for herself.
B)Suggest that she does not need to provide family-centered care.
C)Avoid discussion of the idea with her until she initiates it.
D)Secure the support of her closest colleagues on the unit.

Answer 3

Secure the support of her closest colleagues on the unit.

Question 4

As a nurse manager,you trial a new pain scale on your unit that is supported by numerous research studies.You compare the patient outcomes with the new scale against the existing scale.Feedback from staff suggests that the new scale is too difficult for patients who have limited language skills and who are already under duress to understand.The difficulty in implementing the new scale refers to testing:

A)Efficacy.
B)Effectiveness.
C)Practice failure.
D)Comparative error.

Question 5

The clinical guidelines for management of incontinence developed by the Registered Nurses Association of Ontario (RNAO):

A)Reflect practice that is fiscally directed and sound.
B)Articulate practice recommendations developed from synthesis and review of evidence.
C)Are intended to increase awareness of issues in incontinence management.
D)Reflect a compilation of information from a variety and range of sources related to incontinence.

Question 6

To help staff nurses adjust to using research in practice,what strategy would the nurse manager use?

A)Attendance at a regional research conference
B)Formal classes in electronic search techniques
C)Establishing a journal club
D)Issuing reports on the adverse consequences of outdated practices

Question 7

A strategic goal developed by the chief nursing officer is to implement an evidence-based practice program.What is an appropriate strategy that can be used by a nurse manager who is beginning to implement an evidence-based practice program?

A)Conducting a review of adverse events and incident reports
B)Soliciting input from staff members
C)Reviewing specialty organization guidelines
D)Identifying patients with extended lengths of stay

Question 8

Within a multisite healthcare system,the most appropriate strategy for translation of research would be:

A)Widespread development of protocols using EBP at unit levels.
B)Dissemination of EBP and recommendations to individuals, units, and the organization.
C)Development of the skills of individual managers on how to build guidelines based on EBP.
D)Establishment of an interdisciplinary center to guide and lead the translation of research findings into practice.

Question 9

The implementation of saline flushes for capped angiocatheters is an example of:

A)How multilevel and interprofessional application of a procedure can slow adoption of EBP.
B)How competition among disciplines can lead to negative patient outcomes.
C)The reluctance of hospital administrators to act on recommendations from EBP.
D)How a safe, well-known practice outweighs the benefits of adopting a newer practice.

Question 10

The nurse manager of an ICU wants to implement the revised policy and procedure on central line catheter care.What would be the most effective method of getting the staff nurses to incorporate a new evidence-based practice into their care?

A)Conducting an interactive educational workshop
B)Distributing educational materials on clinical units
C)Sharing the results of a chart audit with staff
D)Providing staff with a short DVD on the topic

Question 11

The chief nursing officer at a local hospital seeking Magnet™ status creates staff development classes concerning translation of research into practice (TRIP).What best describes TRIP?

A)Conducting an integrative review of the literature
B)Searching the literature for a systematic review
C)Providing the results of research studies to practitioners
D)Applying strategies that aid in adoption of research in practice

Question 12

The chief nursing officer at a local hospital seeking Magnet™ status creates staff development classes about incorporating evidence-based practice in nursing.What best describes evidence-based practice?

A)Applying best research evidence to care of patients
B)Using research-based information to develop practice guidelines
C)Conducting a randomized control trial to determine effectiveness of handwashing techniques
D)Developing standards for practice

Question 13

You are excited by evidence supporting the use of PDAs at the bedside to improve documentation and patient outcomes.You have disseminated the information through discussions and e-mails and are now ready to begin the process of considering implementation on the unit.To develop positive attitudes toward the use and implementation of the technology,you would discuss your ideas with (Rogers' diffusion of innovations theory):

A)Harvey, RN, a technology guru, who enthusiastically tries on all new software.
B)Berta, RN, who thoughtfully considers evidence and regularly uses it to try new approaches in her practice.
C)Carol, LPN, who is positive about new ideas but looks to her friends for their ideas about whether or not to try something new.
D)Ben, a 10-year veteran of the unit, who wonders why technology should be used at all. He says that he will use it when there is no chance of security breaks.

Question 14

What is a strategy that can be used by a small community hospital with limited resources to develop an evidence-based nursing practice program?

A)Hiring a nurse researcher
B)Partnering with nurse researchers at a local university
C)Subscribing to journals devoted to evidence-based nursing
D)Including research competencies in managers' job descriptions

Question 15

After searching the literature,Tara,the unit manager develops a table that outlines the findings of studies on management of incontinence.She then examines the studies in terms of risk and whether the findings fit within her practice context and for her population of moderately to severely cognitively impaired patients.This is which phase of Stetler's research utilization model?

A)Preparatory
B)Validation
C)Evaluation
D)Application

Question 16

Which of the following is an effective approach in the appraisal of research studies?

A)Accept only studies that use a RCT design.
B)When ranking research studies, choose RCTs over qualitative studies.
C)Select only studies with a large sample size.
D)Evaluate the quality of the research against the standards for that type of research.

Question 17

Tara,the unit manager,is telling her colleague about her recent project,which involves seeking the most effective approaches to incontinence care,with the intention of adopting evidence-supported approaches on her dementia care unit.Her colleague suggests that translation of research into practice is:

A)Less important than knowledge-generating research, which is required to advance the nursing profession.
B)A priority of all healthcare practitioners to improve patient care.
C)Characterized by lack of knowledge about how to use evidence to guide practice.
D)So difficult that it is useless to begin the query in the first place.

Question 18

The nurse manager decides to change staffing schedules in the intensive care unit.She chooses to use Rogers' diffusion of innovations theory to implement the change.What are the elements of Rogers' diffusion of innovations theory?

A)Assessment, planning, intervention, and evaluation
B)Preparation, validation, synthesis, and evaluation
C)Knowledge, persuasion, decision, implementation, and evaluation
D)Scanning, diagnosis, decision making, application, and reevaluation

Question 19

Which of the following would be most effective in implementing the findings of Dobbins et al.on treating problems associated with bowel motility?

A)Lecture by a nurse practitioner
B)Workshop for surgical nurses that involves discussion of case studies and application of evidence
C)Discussion of the findings on the bulletin boards at the workstation
D)Education of unit opinion leaders regarding the evidence presented in the studies

Question 20

The nurse manager wants to use evidence-based recommendations to prevent ventilator-associated pneumonia.In order to effectively gather evidence to guide practice,what is the critical first step?

A)Develop the clinical question.
B)Identify the databases to be used.
C)Appraise the evidence.
D)Integrate available evidence with unit expertise.

Question 21

Once evidence related to the use of prompted voiding in patients with cognitive impairment has been appraised and integrated with practice,it is important to:

A)Consider whether patients' families see this as necessary for the well-being of family members.
B)Search large databases such as CINAHL to amass further evidence.
C)Clarify the clinical practice question.
D)Solicit input regarding integration with practice.

Question 22

As the unit manager,you are interested in determining whether patient autonomy is preserved through informed consent in surgical settings.You determine that participatory action research is the best method to address this question.Which of the following is consistent with a participatory action research design?

A)You interview 125 patients who have recently undergone surgery and transcribe the interviews to determine themes. Themes are validated with an expert in informed consent.
B)You circulate a questionnaire to patients who recently underwent surgery and ask for their opinions regarding consent. Data are analyzed and the findings distributed to administration and other groups.
C)An audit is undertaken of signed consents for treatment, to determine if the consent is properly witnessed and signed. Findings are used to inform changes in policies.
D)You meet with a patient group to determine which questions should be asked about patient informed consent and what issues might be encountered and addressed during the research.

Question 23

A nurse manager introduces prompted voiding into nursing practice on a unit,which is supported by clinical guidelines based on evidence-based practice.The nurses on the unit resist implementation,indicating that the bathroom facilities are too far away for efficient implementation of the guidelines,and that resources are too few to accomplish the initial voiding observations.For the nurse manager in this situation,it is important to have further discussion with the staff regarding (select all that apply):

A)Compatibility of this intervention with the values of staff on the unit.
B)Advantages of prompted voiding over incontinence products and catheterizations.
C)Usefulness of prompted voiding with the particular population of patients on the unit.
D)Feasibility of the program with respect to unit design.
E)None of the above

Question 24

Which of the following is most accurate regarding evidence-based practice?

A)Evidence-based practice replaces continuous quality improvement.
B)Evidence-based practice began with medicine and assists in determining which medical models can be applied in nursing practice.
C)Effective and efficient care can already be demonstrated, which means that EBP will soon become redundant.
D)EBP is generally recognized across disciplines and by policymakers as state-of-the-art clinical practice.

Question 25

Which of the following is a meta-analysis?

A)Review of 35 studies on nurse work satisfaction to determine the significance of the aggregated research findings
B)Review of multiple chart audits to determine which errors are being reduced through implementation of evidence-based guidelines
C)RCT comparing the effectiveness of a local anesthetic in reducing the pain of venipuncture in young children
D)Analysis of factors contributing to nurse burnout and dissatisfaction at emergency room sites

Question 26

Volunteers in a study are assigned randomly to groups.Some of the volunteers receive an herbal supplement that is reputed to control nausea,and some of the volunteers are assigned to a control group where a placebo is administered.This is an example of a(n):

A)Longitudinal study.
B)RCT.
C)Meta-analysis.
D)Appraisal tool.