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suncs suncs
wrote...
Posts: 505
Rep: 1 0
6 years ago
A nurse is developing a clinical question in a PICOT format. What components are included in the question? (Select all that apply.)
 
  a. Patient
  b. Comparison
  c. Outcome
  d. Implementation
  e. Time

Question 2

A nurse plans evidence-based care for a client on a medical-surgical unit. Which elements should the nurse assess when developing this plan of care? (Select all that apply.)
 
  a. Client values
  b. Nurse's experiences
  c. Organizational budget
  d. Staffing ratios
  e. Best available evidence

Question 3

A nurse manager educates staff nurses in the use of clinical practice guidelines. Which statement should the nurse include in this teaching?
 
  a. Clinical practice guidelines are implemented by The Joint Commission.
  b. Practice guidelines are based on hospital management staff's expertise.
  c. Clinical practice guidelines are official recommendations based on evidence.
  d. Practice guidelines allow for greater reimbursement from insurance companies.

Question 4

A cardiac nurse wants to know about the best practices to prevent pneumonia after open-heart surgery. In what order do the steps of the evidence-based practice (EBP) process take place?
 
  1. Asking burning clinical questions
  2. Making recommendations for practice improvement
  3. Implementing accepted recommendations
  4. Finding the very best evidence to try to answer those questions
  5. Evaluating outcomes
  6. Critically appraising and synthesizing the relevant evidence
  a.
  5, 1, 4, 6, 3, 2
  b.
  1, 5, 4, 3, 2, 6
  c.
  1, 4, 6, 2, 3, 5
  d.
  5, 2, 1, 4, 6, 3

Question 5

A research nurse meets with the nurse manager to discuss plans for the development of evidence-based practice (EBP) guidelines using the Reavy and Tavernier model. Which statement should the nurse include in the discussion?
 
  a. Our efforts should focus on forming a team to develop an EBP initiative.
  b. I will assist staff nurses with literature reviews and the synthesis of evidence.
  c. You should identify barriers to evidence-based implementation.
  d. I will develop a PICOT question and share it with the staff nurses.

Question 6

A nurse wants to explore why clients who receive patient-controlled analgesia (PCA) after abdominal surgery ambulate sooner than clients who receive nurse-administered pain medications. Which action should the nurse take first?
 
  a. Contact the medical center's clinical pharmacist.
  b. Search the medical library for the best evidence.
  c. Recommend PCA for all clients.
  d. Appraise data obtained through client chart audits.

Question 7

A nurse who wants to incorporate evidence-based practices into client care on a medical unit is meeting resistance. Which barrier does the nurse identify as preventing nurses from engaging in evidence-based practices?
 
  a. Difficulty accessing research materials
  b. Lack of value for client preferences
  c. Trouble understanding client needs
  d. Inadequate nurse-client ratios
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Replies
wrote...
6 years ago
The answer to question 1

ANS: B, C, E
The major components of a PICOT question are population, intervention, comparison, and outcome, with an added time component when appropriate.

The answer to question 2

ANS: A, B, E
Evidence-based practice incorporates best current evidence with the expertise of the clinician and the client's values.

The answer to question 3

ANS: C
Clinical practice guidelines are based on evidence and provide an official recommendation for the diagnosis and/or management of health problems. These are usually developed from high-quality evidence. Although The Joint Commission publishes guidelines, clinical practice guidelines are not implemented by The Joint Commission. The hospital's management staff may be involved in the development and implementation of clinical practice guidelines, but these guidelines should not be based solely on management expertise. Clinical guidelines provide for better client outcomes. These guidelines are not focused on reimbursement.

The answer to question 4

ANS: C
The process of EBP is systematic and includes the following steps: (1) asking burning clinical questions; (2) finding the very best evidence to try to answer those questions; (3) critically appraising and synthesizing the relevant evidence; (4) making recommendations for practice improvement; (5) implementing accepted recommendations; and (6) evaluating outcomes.

The answer to question 5

ANS: B
The Reavy and Tavernier model views the staff nurse as the clinical expert and believes that the expertise of a nurse researcher should facilitate the EBP process by supporting nursing staff in identifying areas for improvement, assisting staff with literature reviews and synthesis of evidence, and helping with the implementation and evaluation of EBP projects. Team forming is a component of the Iowa model. Identification of strengths and barriers to EBP implementation is a component of the ARCC model. Staff nurses should identify their own PICOT questions from burning clinical questions.

The answer to question 6

ANS: B
After asking the burning question, the nurse should find the very best evidence to try to answer it. The clinical pharmacist may be knowledgeable, but this is not the best evidence available. Information from client chart audits may demonstrate better outcomes with PCA, but this again is not the best evidence. The nurse should wait and recommend clinical practice changes until best evidence is found, appraised, and synthesized.

The answer to question 7

ANS: A
Major barriers that prevent nurses from engaging in evidence-based practice include lack of time, lack of value for research in practice, lack of understanding of organization or structure of electronic databases, difficulty accessing research materials, lack of computer skills, and difficulty understanding research articles.
suncs Author
wrote...
6 years ago
Thank you, thank you, thank you!
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