Deck 20: Evidence-Based Practice

Question 1

When completing Step 1 of Melnyk and Fineout-Overholt's evidence-based practice (EBP) process, which action does the NP student implement?

A) Cultivating a spirit of inquiry
B) Formulating a clinical question
C) Creating a culture of evidence-based practice
D) Searching for high-quality research evidence

Answer 1

B

Question 2

When searching for the best research evidence, which step does the nurse practitioner (NP) student complete first?

A) Expand the search using the explode option.
B) Combine searches generated from PICOT key words.
C) Establish inclusion and exclusion criteria.
D) Use tools to limit the search to the topic of interest.

Answer 2

C

Question 3

Based on the American Association of Critical Care Nurses (AACN) evidence-leveling system, which type of evidence demonstrates the greatest strength?

A) Meta-analysis of multiple controlled trials
B) Well-designed controlled studies
C) Peer-reviewed organizational standards
D) Theory-based evidence from multiple case reports

Answer 3

A

Question 4

The nurse practitioner (NP) student is seeking to learn more about palliative care patients' perceptions of the meaning of quality of life. Based on the Oxford Centre for Evidence-Based Medicine (OCEB) 2011 Levels of Evidence, which type of evidence will be most useful to the NP student's search?

A) Case-control studies
B) Nonrandomized controlled trials
C) Meta-synthesis of descriptive studies
D) Systematic review of randomized controlled trials

Question 5

During critical appraisal of the credibility of a research study, the nurse practitioner (NP) student considers which information?

A) Evidence of conflict of interest
B) Control of extraneous variables
C) Clarity of reported results
D) Selection of sampling procedure

Question 6

Describe the evolution of the definition of evidence-based medicine (EBM) to include patient values and preferences.

Question 7

Summarize the four key assumptions of evidence-based practice (EBP) in nursing.

Question 8

Explain the purpose of the PICOT method.

Question 9

Discuss the primary components of a PICOT question.

Question 10

Discuss three categories of barriers to implementation of evidence-based practice (EBP) in nursing.

Question 11

Write a clinical question in PICOT format for each template type for common practice problems encountered by NPs. Swap answers with a peer and provide feedback.

Question 12

Sign up for clinical practice alerts from the TRIP database in your specialty area.

Question 13

Think about a patient problem you have had in the clinical setting and answer the following:
a. What formal structures were in place to help you address the problem?
b. How did you use evidence to investigate the problem?
c. Did you have time to search for evidence? If no, what were the barriers?
d. What databases did you access for evidence and why?
e. Did you use a health sciences librarian to help with your search? Explain why or why not.

Question 14

Go to http://www.guideline.gov and search for chronic pain management clinical practice guidelines. Compare and contrast two guidelines.

Question 15

Find a clinical practice guideline from National Guideline Clearinghouse. Use the AGREE II Plus software to critically appraise the guideline with two or more peers.

Question 16

Find a recent randomized control trial on a topic of interest. Critically appraise the study using a tool from this chapter. Using an evidence hierarchy from this chapter identify the level of evidence. Enter the relevant data into an evidence summary table. Rate the quality of evidence using the JHNEBP quality rating. Summarize clinical significance using NNT and effective size.

Question 17

Using the databases described in this chapter find two or more of the following evidence types (research study, QI study, EBP project, or program evaluation). Describe the search process used. After reading the articles, compare and contrast the different methodologies. Did the authors provide support for the selected methodology? Give examples to support your answer.

Question 18

Identify areas where SDM can be used in your practice. Go to https://decisionaid.ohri.ca/ and browse the decision aids by topic. Select a decision aid and write a plan for how it can be incorporated into your practice setting.