Deck 23: Translating Research Into Practice

Question 1

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

A) How multilevel and interdisciplinary application of a procedure can slow adoption of evidence-based practice (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.

Answer 1

How multilevel and interdisciplinary application of a procedure can slow adoption of evidence-based practice (EBP).

Question 2

The chief nursing officer at a local hospital seeking Magnet status creates staff development classes concerning research utilization.What best describes research utilization?

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 the results of a research study to practice.

Answer 2

Applying the results of a research study to practice.

Question 3

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D) Issuing reports on the adverse consequences of outdated practices.

Answer 3

Establishing a journal club.

Question 4

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

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

Question 5

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 6

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 preprocessed evidence.

Question 7

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

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 8

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

A) Applying the results of a research study to practice.
B) Using research findings to develop practice guidelines.
C) Conducting a meta-analysis of a specific research question.
D) Developing standards for practice.

Question 9

Which of the following statements 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 takes into account patient values to optimize outcomes."

Question 10

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 the Cumulative Index to Nursing and Allied Health Literature (CINAHL)to amass further evidence.
C) Clarify the clinical practice question.
D) Solicit input regarding integration with practice.

Question 11

Which of the following is a meta-analysis?

A) Review of 35 studies to determine the significance of research in contributing to nurse work satisfaction.
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 anaesthetic in reducing the pain of venipuncture in young children.
D) Analysis of factors contributing to nurse burnout and dissatisfaction at emergency room sites.

Question 12

The nurse manager wants to use evidence-based recommendations to prevent ventilator-associated pneumonia.What type of research would provide the strongest evidence for this clinical issue?

A) A single,large-scale,randomized,clinical trial.
B) A systematic review of research studies.
C) A systematic review of research-based clinical guidelines.
D) Qualitative meta-synthesis.

Question 13

After searching the literature,Tara develops a table that outlines the findings of studies on management of incontinence; it includes an appraisal of such criteria as risk and applicability to her particular population of moderately to severely cognitively impaired patients.This is which phase of Stetler's (2003)research utilization model?

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

Question 14

The nurse manager decides to change staffing schedules in the intensive care unit.She chooses to use Rogers's (2003)diffusion of innovations theory to implement the change.What are the elements of Rogers's diffusion of innovations theory?

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

Question 15

Which of the following would be most effective in implementing the findings of Dobbins,Ciliska,Estabrooks,et al.(2005)on treating problems associated with bowel motility?

A) Face-to-face 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 16

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 17

The nurse manager of an intensive care unit 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 video on the topic.

Question 18

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-based approaches on her dementia care unit.Her colleague suggests that knowledge translation is:

A) Less critical than knowledge research generation,which is required to advance the nursing profession.
B) A priority of all health care practitioners to better patient care.
C) Plagued by lack of knowledge related to how to use research to guide practice.
D) So difficult that it is useless to begin the query in the first place.

Question 19

Which of the following has been identified as a significant factor in moving EBP into patient care?

A) Strong utilization models.
B) Development of stronger opinion leaders.
C) Technology.
D) Support by other disciplines.

Question 20

You are excited by evidence supporting the use of personal digital assistants at the patients' bedsides to improve documentation and patient outcomes.You have disseminated the information through discussions and emails 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 which of the following people (according to Rogers's [2003] diffusion of innovation theory)?

A) Harvey,registered nurse (RN),a technology guru,who enthusiastically tries out all new software.
B) Beatta,RN,who thoughtfully considers evidence and regularly uses it to try new approaches in her practice.
C) Carol,licenced practical nurse,who is positive about new ideas but relies on her friends for their ideas about whether to try something new.
D) Somya,RN,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 breaches.

Question 21

What is the typical time frame a research discovery to implementation occurs?

A) 10 years.
B) 17 years.
C) 7 years.
D) 13 years.

Question 22

Stetler's (2001)research utilization model provides direction for an individual and for group members.It has implications for nurses in leadership roles responsible for patient care management.Which description is recognized as the preparatory phase?

A) Involves practical aspects of implementing the plan for translating the research into practice at the individual,group,department,or organizational level.
B) Involves making a decision about the applicability of the studies by synthesizing cumulative findings; evaluating the degree and nature of other criteria,such as risk,feasibility,and readiness of the finding.
C) Involves searching,sorting,and selecting sources of evidence,defining external factors influencing the application of a research finding,and defining internal factors diminishing objectivity.
D) Focuses on utilization with an appraisal of study findings rather than the critique of a study's design and includes completing review tables to facilitate understanding each study and to facilitate decision-making.

Question 23

Which of the following would be considered research?

A) Evaluation of the effectiveness of implementation of evidence-based guidelines for prompted voiding.
B) Comparison of patient outcomes after implementation of practice guidelines against baseline (preimplementation)outcome data.
C) Audit of adverse events after implementation of evidence-based guidelines for pressure ulcers.
D) Interviews with terminally ill cancer patients regarding their experience of being terminally ill.

Question 24

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 to which a placebo is administered.This is an example of a(n):

A) Longitudinal study.
B) Randomized controlled trial (RCT).
C) Meta-analysis.
D) Appraisal tool.

Question 25

What is a key step in the EBP model?

A) Evaluating results.
B) Measuring daily practice against evidence-based guidelines.
C) Disseminating the results.
D) Measuring process and outcome changes.

Question 26

The Registered Nurses' Association of Ontario (RNAO,2012)released a comprehensive toolkit to assist nurses in the implementation of evidence-based guidelines.To sustain EBP,which of the following are required? (Select all that apply.)

A) Infrastructure needs to be created to facilitate EBP.
B) Leadership needs to support a research culture.
C) Providing recognition and technical support.
D) The organization needs capacity to engage in EBP.
E) None of above.

Question 27

A nurse manager introduces prompted voiding into nursing practice on a unit,which is supported by clinical guidelines derived from 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 which of the following? (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 above