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Canadian Clinical Nursing Skills and Techniques, 1e Griffin Perry, Potter, Ostendorf, Cobbett (Test Bank all Chapters)

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Chapter 01: Evidence-Informed Nursing Practice

Perry et al.: Canadian Clinical Nursing Skills & Techniques, 1st Edition

MULTIPLE CHOICE

• Evidence-informed practice is a problem-solving approach to making decisions about

patient care that is grounded in

• the latest information found in textbooks.
• systematically conducted research studies.
• tradition in clinical practice.
• quality improvement and risk-management data.

ANS: B

The best evidence comes from well-designed, systematically conducted research studies described in scientific journals. Portions of a textbook often become outdated by the time it is published. Many health care settings do not have a process to help staff adopt new evidence in practice, and nurses in practice settings lack easy access to risk-management data, relying instead on tradition or convenience. Some sources of evidence do not originate from research. These include quality improvement and risk-management data, infection control data, retrospective or concurrent chart reviews, and clinicians’ expertise.Although non–research-based evidence is often very valuable, it is important that you learn to rely more on research-based evidence.

DIF: Cognitive Level: Comprehension REF: Purpose

OBJ: Differentiate between evidence-based and evidence-informed practice.

TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment (management of care)

• When evidence-informed practice is used, patient care will be
• standardized for all.
• unhampered by patient culture.
• variable according to the situation.
• safe from the hazards of critical thinking.

ANS: C

Using your clinical expertise and considering patients’ cultures, values, and preferences ensures that you will apply available evidence in practice ethically and appropriately. Even when you use the best evidence available, application and outcomes will differ; as a nurse, you will develop critical thinking skills to determine whether evidence is relevant and appropriate.

DIF: Cognitive Level: Application REF: Purpose

OBJ: Differentiate between evidence-based and evidence-informed practice.

TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment (management of care)

• When a PICO(TS) question is developed, the letter that corresponds with the usual

standard of care is

• P.
• I. 2 / 4

• C.
• O.

ANS: C

C = Comparison of interest. What standard of care or current intervention do you usually use now in practice?P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health problem.I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic factor) do you think is worthwhile to use in practice?O = Outcome. What result (e.g., change in patient’s behaviour, physical finding, and change in patient’s perception) do you wish to achieve or observe as the result of an intervention?

DIF: Cognitive Level: Understanding REF: Ask a Clinical Question OBJ: Explain the components of a PICO(TS) question. TOP: PICO KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

• A well-developed PICO(TS) question helps the nurse
• search for evidence.
• include all five elements of the sequence.
• find as many articles as possible in a literature search.
• accept standard clinical routines.

ANS: A

The more focused a question that you ask is, the easier it is to search for evidence in the scientific literature. A well-designed PICOT question does not have to include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always question and use critical thinking to consider better ways to provide patient care.

DIF: Cognitive Level: Analysis REF: Ask a Clinical Question OBJ: Explain the components of a PICO(TS) question. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

• The nurse is not sure that the procedure the patient requires is the best possible for the

situation. Using which of the following resources would be the quickest way to review research on the topic?

• CINAHL
• PubMed
• MEDLINE
• The Cochrane Database

ANS: D

The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized evidence (i.e., preappraised evidence). The Cochrane Database includes the full text of regularly updated systematic reviews and protocols for reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and represent the scientific knowledge base of health care.

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DIF: Cognitive Level: Synthesis REF: Search for the Best Evidence

OBJ: Discuss the process for critiquing evidence in the literature.

TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

• The nurse is getting ready to develop a plan of care for a patient who has a specific need.

The best source for developing this plan of care would probably be

• The Cochrane Database.
• MEDLINE.
• NGC.
• CINAHL.

ANS: C

The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. The NGC is a valuable source when you want to develop a plan of care for a patient. The Cochrane Community Database of Systematic Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., preappraised evidence).

DIF: Cognitive Level: Synthesis REF: Search for the Best Evidence

OBJ: Discuss the process for critiquing evidence in the literature.

TOP: Evidence-Informed Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

• The nurse has done a literature search and found 25 possible articles on the topic that he or

she is studying. To determine which of those 25 best fit his or her inquiry, the nurse first should look at

• the abstracts.
• the literature reviews.
• the “Methods” sections.
• the narrative sections.

ANS: A

An abstract is a brief summary of an article that quickly tells you whether the article is research based or clinically based. An abstract summarizes the purpose of the study or clinical query, the major themes or findings, and the implications for nursing practice. The literature review usually gives you a good idea of how past research led to the researcher’s question. The “Methods” or “Design” section explains how a research study is organized and conducted to answer the research question or to test the hypothesis. The narrative of a manuscript differs according to the type of evidence-informed article—clinical or research.

DIF: Cognitive Level: Application REF: Critique the Evidence

OBJ: Discuss the process for critiquing evidence in the literature.

TOP: Randomized Controlled Trials KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

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