Deck 9: Evidence-Based Professional Nursing Practice

Question 1

How do I know what I know about nursing practice? Are my nursing decisions based on myths, traditions, experience, authority, trial and error, ritual, or scientific knowledge?

Answer 1

As a nurse, you can assess your knowledge about nursing practice by reflecting on the sources of your decision-making. Are your nursing decisions based on myths, traditions, experience, authority, trial and error, ritual, or scientific knowledge? It's important to critically evaluate the basis for your nursing practice.

Reflect on whether your decisions are influenced by myths or traditions that may not be supported by evidence-based practice. Consider whether your experience and authority are guiding your decisions, and if so, whether they align with current best practices in nursing. Evaluate whether trial and error or ritualistic approaches are shaping your nursing practice, and if these methods are supported by scientific knowledge.

Ultimately, the goal is to ensure that your nursing decisions are grounded in scientific knowledge and evidence-based practice. This means staying current with the latest research and guidelines in the field of nursing, and continually seeking to improve your practice based on the best available evidence. By critically examining the basis for your nursing decisions, you can ensure that your practice is aligned with the most current and effective approaches to patient care.

Question 2

How is new evidence disseminated to the bedside nurse in the organization in which you practice as a nursing student? How does the organization promote evidence-based practice? Do the nurses in the organization use current evidence in practice?

Answer 2

In the organization where I practice as a nursing student, new evidence is disseminated to the bedside nurse through a variety of channels. This includes regular staff meetings, in-service training sessions, and electronic communication such as emails and newsletters. Additionally, the organization has a dedicated team of nurse educators who are responsible for keeping the nursing staff updated on the latest evidence-based practices through workshops and seminars.

The organization promotes evidence-based practice by providing access to online databases and journals where nurses can access the latest research and evidence. They also encourage nurses to participate in research projects and quality improvement initiatives to further integrate evidence-based practices into their daily routines.

From my observations, the nurses in the organization do use current evidence in their practice. They are encouraged to critically evaluate the evidence and apply it to their patient care, and I have seen them incorporate new practices and protocols based on the latest evidence. The organization also has a system in place for nurses to discuss and share their experiences with implementing evidence-based practices, which further promotes a culture of continuous learning and improvement. Overall, the organization is committed to promoting evidence-based practice and ensuring that nurses have the resources and support they need to stay updated on the latest evidence in their field.

Question 3

Which factors should the nurse consider when implementing evidence-based practice?

A) Patient values
B) Current evidence
C) Nursing tradition
D) Current evidence and nursing tradition
E) Nursing tradition and patient values

Answer 3

E

Question 4

A nurse working on an oncology unit has noticed some problematic trends among patients on the unit and is searching for evidence related to the identified issue. Which of the following is a source of clinical guidelines based on best evidence?

A) National Guideline Clearinghouse
B) Registered Nurses Association of Ontario
C) Cumulative Index to Nursing and Allied Health Literature
D) Registered Nurses Association of Ontario and Cumulative Index to Nursing and Allied Health Literature
E) National Guideline Clearinghouse and Registered Nurses Association of Ontario

Question 5

A nurse working on a medical unit is committed to basing practice on evidence. As she reviews guidelines for the basis of a quality improvement initiative on the unit, she identifies recommendations that are based on the highest-level evidence. Which of the following is the highest level of evidence?

A) Individual quasi-experimental studies
B) Individual experimental studies
C) Meta-analysis of controlled studies
D) A series of nonexperimental studies
E) Program evaluation

Question 6

A nurse working on a surgical unit is committed to basing practice on evidence. As he reviews guidelines for the basis of a quality improvement initiative on the unit, he identifies recommendations that are based on the lowest-level evidence and decides that he will not include these recommendations in the current initiative. Which of the following is the lowest level of clinical practice evidence?

A) Opinions of authorities and/or reports of expert committees
B) Randomized controlled trials
C) Systematic review of descriptive and qualitative studies
D) Observational studies with controls
E) Single descriptive or qualitative study

Question 7

A nurse working on a pediatric unit is committed to basing practice on evidence. As she reviews guidelines for the basis of a quality improvement initiative on the unit, she appraises them using the AGREE II instrument. Which of the following categories does the AGREE II instrument examine?

A) Scope and purpose
B) Rigor of development
C) Editorial independence
D) All of these are correct.
E) None of these is correct.

Question 8

Which of the following is an Institute of Medicine (IOM) standard for the development of clinical practice guidelines?

A) Homogenous guideline development group composition
B) Use of systematic reviews
C) Establishing evidence and rating strength of recommendations
D) Updating every decade
E) Use of systematic reviews and establishing evidence and rating strength of recommendations

Question 9

Which of the following is an Institute of Medicine (IOM) standard for the development of clinical practice guidelines?

A) Transparency related to funding and development processes
B) Management of conflict of interest
C) Stating recommendations in standardized form
D) External review by stakeholders
E) All of these are correct.

Question 10

Which strategy should a nurse use to overcome barriers to evidence-based practice?

A) Ask questions such as, "What is the evidence for this intervention?"
B) Ask questions such as, "How do my patients respond to this intervention?"
C) Question the rationale for approaches to care that do not result in desired patient outcomes.
D) All of these are correct.
E) None of these is correct.

Question 11

Which of the following is a step in the evidence-based practice process?

A) Identify an issue and ask the question.
B) Search for and collect the best evidence to answer the clinical question.
C) Evaluate the outcome of any evidence-based practice change.
D) All of these are correct.

Question 12

A nurse is responsible for implementing a quality improvement initiative on several units in an organization. Which strategy should the nurse use because it is the key to using the Diffusion of Innovation Model to guide an implementation of change?

A) Work with the known naysayers in the organization.
B) Work with the informal leaders in the organization.
C) Work with the known innovators in the organization.
D) Work with the known naysayers and informal leaders in the organization.
E) Work with the known innovators and informal leaders in the organization.