Question 1

Opinion leaders are:
A) formal leaders who lead evidence-based practice development teams.
B) formal leaders who write new evidence-based practice guidelines.
C) informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians use of evidence in clinical decision making.
D) informal leaders who gather data about nursing practice changes.

Accepted Answer

Informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians' use of evidence in clinical decision making are referred to as opinion leaders. Opinion leaders are likeable, trustworthy, informative, and influential (Flodgren et al., 2011).

Question 2

A communication strategy used in the promotion of adopting evidence-based practice recommendations is:
A) best practice evaluation.
B) knowledge translation.
C) shared governance.
D) academic detailing.

Accepted Answer

Academic detailing involves a strategic approach to communication and discussions with clinicians. Clinicians tend to buy into the need for the practice change when there is a strong evidence base, the topic addresses an identified need, data demonstrate an opportunity for practice improvement within the clinical area, and the practice change offers a relative advantage.

Question 3

A rigorous scientific process used to combine findings from research (usually randomized controlled trials) into a powerful and clinically useful report to guide practice is known as a systematic review. Standard components of a systematic review to consider are: (Select all that apply.)
A) process for initiating.
B) standard reporting format.
C) reliability and validity of data.
D) process for synthesizing the body of evidence.
E) process for finding and assessing individual studies.

Accepted Answer

Standard components of a systematic review to consider are: (1) process for initiating; (2) process for finding and assessing individual studies; (3) process for synthesizing the body of evidence; and (4) standard reporting format. Rigor used in development varies considerably among reports.

Question 4

The _____ Act provides incentives for adoption and implementation of electronic health records (EHRs) while enhancing privacy and security for patients and providing incentives for practitioners and hospitals to engage in meaningful use.
A) Stark
B) HIPAA
C) HITECH
D) Anti-kickback

Accepted Answer

The HITECH Act provides incentives for adoption and implementation of EHRs while enhancing privacy and security for patients and providing incentives for practitioners and hospitals to engage in meaningful use.

Question 5

Nurse managers are responsible for developing the unit culture supporting innovation and evidence-based care. The nurse manager can facilitate and support EBP work by: (Select all that apply.)
A) set the staffing schedule.
B) allocate resources as needed.
C) set the expectations for the unit.
D) promote staff questioning practice.
E) encourage and respond to new ideas.

Accepted Answer

Nurse managers are responsible, parallel to the nurse executive, for developing the unit culture supporting innovation and evidence-based care (Aarons et al., 2015; Cullen, 2015; Huis et al., 2013; Ubbink et al., 2013). Nurse managers can facilitate and support EBP work in the following ways: set unit expectations, discuss importance of EBP with unit nurses and inter-professional team members, encourage and respond to new ideas, promote staff questioning practice, support the team with project work time, promote the project's importance, track progress, facilitate movement of the project through the institutional shared governance approval process, and allocate resources (Paparone, 2015; RNAO, 2013).

Question 6

Components of a systematic review include:
A) publication of study data.
B) assessment of a study.
C) determination of statistical tests.
D) development of research guidelines.

Accepted Answer

Standard components of a systematic review are processes for (1) initiating, (2) finding and assessing individual studies, (3) synthesizing the body of evidence, and (4) reporting using a standard format (Institute of Medicine, 2011b).

Question 7

Once a new practice has been implemented on a unit, scaling up needs to be evaluated. What is scaling up?
A) A method used to implement the previous practice if the new practice has been found to be detrimental to patient care
B) A process used to expand the reach of effective clinical interventions in new settings
C) Recruitment of new nurses from different institutions who can help with role modeling and communication of the new practice
D) A tactic used to invigorate leaders to continue to communicate better with staff nurses and ancillary personnel

Accepted Answer

A reinfusion or reinforcement plan is a strategy for ongoing communication about the new practice until it becomes fully integrated into daily care.

Question 8

Evidence-based practice includes:
A) collaborative practice dynamics between health care professionals.
B) documentation of patient care as evidence of nursing practice.
C) integration of research with clinical expertise and patient values.
D) mutual goal setting and application in the clinical setting.

Accepted Answer

Evidence-based practice is a process of shared decision making in a partnership between patients and providers that involves the integration of research and other best evidence with clinical expertise and patient values in health care decision making (Sackett et al., 2000).

Question 9

Clinicians tend to buy into the need for practice change when: (Select all that apply.)
A) there is a strong evidence base.
B) the topic addresses an identified need.
C) the practice change offers a relative advantage.
D) the practice change is endorsed by organizational executive leadership.
E) data demonstrate an opportunity for practice improvement within the clinical area.

Accepted Answer

Clinicians tend to buy into the need for the practice change when there is a strong evidence base, the topic addresses an identified need, data demonstrate an opportunity for practice improvement within the clinical area, and the practice change offers a relative advantage. Localizing or adapting practice recommendations to fit the local setting and culture is an essential step in the process, often using the role of the opinion leader and team of local experts.

Question 10

Which of the following will positively influence the sustainability of a practice change?
A) Audit and feedback of key indicators.
B) Incremental implementation of practice changes.
C) Adhering to a strict action plan for implementation.
D) The new practice is much different from current practice.

Accepted Answer

The sustainability step in implementation is one of the most difficult in the EBP process. Audit and feedback of key indicators remains a necessary component of an integration plan (Ivers et al., 2012). Key indicators to monitor are drawn from the pilot data and include process (i.e., knowledge, attitudes, and practices) and outcomes (Bick & Graham, 2010; Parry et al., 2013)

Question 11

The role of the project director is to:
A) take meeting minutes.
B) maintain the action plan.
C) set the expectations for the unit.
D) report project progress to the governing body.

Accepted Answer

The project director is responsible for establishing meeting schedules and time lines with the group, running the meetings, maintaining the action plan, delegating work assignments, and overseeing the process and progress. The focus of the project director must always be on moving the project forward, despite challenges, as a key strategy for success. The project director may orchestrate discussions for identifying potential challenges, addressing those that cannot be avoided but continuing to move forward despite distractions.

Question 12

The cardiac care unit is putting together a shared governance committee. To develop expertise in evidence-based practice processes, the members of the committee should have skills that include the ability to: (Select all that apply.)
A) report results.
B) perform research.
C) critique and synthesize evidence.
D) statistically analyze quality improvement.
E) develop an implementation and evaluation plan.

Accepted Answer

Critical skills for shared governance committee members who supplement point-of-care clinical experts include appraisal and synthesis of the evidence, development of an implementation and evaluation plan, statistical analysis for quality improvement, and reporting of results (Cullen et al., 2010, 2012).

Question 13

The responsibility to articulate the business case for evidence-based practice to senior leadership lies with:
A) the staff nurse.
B) nursing leadership.
C) the governing board.
D) the quality improvement committee.

Accepted Answer

Nursing leaders have a responsibility to clearly articulate EBP work in a way that will be heard by decision makers. Sharing results with senior leaders helps them recognize great work while reporting the business case for evidence-based care to governing boards (Aarons et al., 2014).

Question 14

A clinical nurse specialist is meeting one on one with staff nurses while they are working to discuss data about the evidence-based practice. This is known as:
A) academic detailing.
B) champion coaching.
C) individual instruction.
D) professional mentoring.

Accepted Answer

Academic detailing is a marketing strategy in which a trained individual meets one on one with practitioners in their setting to provide information about the evidence-based practice.

Question 15

When articulating the business case for evidence-based practice to governing boards, key messages to share with board members include: (Select all that apply.)
A) reporting of patient safety events.
B) reporting of anticipated outcomes.
C) reporting only projects that have cost savings.
D) functional responsibility of committees within the organizational and nursing infrastructure.
E) reporting the linkages between evidence-based practice and the organization's mission, values, and strategic plan.

Accepted Answer

Key messages to share with board members include reporting the linkages between evidence-based practice and the organization's mission, values, strategic plan, and committee's functional responsibility within the organizational and nursing infrastructure. Reporting of project results is essential to garner continued support and recognition for the program. Reports will best capture attention when addressing three to five key talking points or takeaway messages with clear links to organizational priorities and infrastructure. Reporting anticipated outcomes can be helpful early in the process. Cost savings or cost avoidance may not be achieved with every project but should be calculated whenever possible.

Question 16

Strategies for building a strong organizational context of evidence-based practice include: (Select all that apply.)
A) linking quality improvement and patient safety.
B) periodically evaluate the infrastructure and context for EBP in their organization.
C) development of a mission, vision, and strategic plan inclusive of EBP language.
D) inclusion of EBP components in performance appraisals across all job classifications.
E) incorporating evidence-based practice into organizational information systems.

Accepted Answer

When working to sustain evidence-based practice, strategies are needed to hardwire the work into the organizational system. Nurse leaders should periodically evaluate the infrastructure and context for EBP in their organization. Linking quality improvement and EBP is another strategy for building a strong organizational context. Development of a mission, vision, and strategic plan inclusive of EBP language provides a sturdy foundation for this work at all levels of the organization and begins the process of building a culture in which evidence-based health care is the expected norm (Stetler et al., 2014). Inclusion of EBP components in performance appraisals across all job classifications-from top executives to all levels throughout the system-promotes positive reinforcement and priority setting in the busy work environment. Organizational information systems must be designed to incorporate EBPs into clinical work flow if adoption is to occur and best outcomes achieved (Piscotty et al., 2015).

Question 17

To promote an organizational culture that embraces evidence-based practice, an organization must: (Select all that apply.)
A) recognize and reward the work.
B) adopt an evidence-based practice model.
C) provide education about evidence-based practice.
D) discourage nurses from questioning their practice.
E) recruit nurses with interest in evidence-based practice.

Accepted Answer

An organizational culture that promotes use of evidence values nurses questioning their practice, provides education about evidence-based practice, adopts an evidence-based practice model, and recognizes and rewards the work. Recruiting and hiring nurses with interest in EBP will help build the desired culture and capacity.

Question 18

The responsibility of developing the unit culture for evidence-based practice belongs to the:
A) staff nurses.
B) unit manager.
C) medical director.
D) chief executive officer.

Accepted Answer

Nurse leaders are in key positions responsible for developing and sustaining an organizational infrastructure and creating an environment that affects adoption of EBPs and improves patient outcomes.

Question 19

The chief executive nursing officer has discussed implementation of evidence-based practice at hospital-wide nursing meetings. She is leading a team to incorporate evidence-based practice terminology into the vision and mission of the institution. She also is advising the multidisciplinary leadership team to incorporate evidence-based practice expectations into the performance appraisals of all staff members. The chief executive nursing officer is modeling:
A) continuous quality improvement methodology and techniques.
B) marketing tactics that will help familiarize the staff with new terminology.
C) professional duties for new protocol acceptance throughout the institution.
D) strategies for incorporation of evidence-based practice into the infrastructure of the organization.

Accepted Answer

Strategies for integration of evidence-based practice into the infrastructure of the organization include the following: incorporation of evidence-based practice into the mission, vision, strategic plan, and performance appraisals of staff; integration of work into nursing governance structure; and demonstration of valuing evidence-based practice through the behaviors of leadership.

Question 20

A team has formed to determine which methods have worked best and which factors influence the implementation of an evidence-based practice program. This is known as _____ research.
A) authoritarian
B) autocratic
C) transformational
D) translational

Accepted Answer

Translational research includes testing the effect of interventions aimed at promoting the rate and extent of adoption of evidence-based practices by nurses, physicians, and other health care providers and describing organizational, unit, and individual variables that affect the use of evidence in clinical and operational decision making.

Quiz 17: Evidence-Based Practice: Strategies for Nursing Leaders

Opinion leaders are:

A communication strategy used in the promotion of adopting evidence-based practice recommendations is:

A rigorous scientific process used to combine findings from research (usually randomized controlled trials) into a powerful and clinically useful report to guide practice is known as a systematic review. Standard components of a systematic review to consider are: (Select all that apply.)

The _____ Act provides incentives for adoption and implementation of electronic health records (EHRs) while enhancing privacy and security for patients and providing incentives for practitioners and hospitals to engage in meaningful use.

Nurse managers are responsible for developing the unit culture supporting innovation and evidence-based care. The nurse manager can facilitate and support EBP work by: (Select all that apply.)

Components of a systematic review include:

Once a new practice has been implemented on a unit, scaling up needs to be evaluated. What is scaling up?

Evidence-based practice includes:

Clinicians tend to buy into the need for practice change when: (Select all that apply.)

Which of the following will positively influence the sustainability of a practice change?

The role of the project director is to:

The cardiac care unit is putting together a shared governance committee. To develop expertise in evidence-based practice processes, the members of the committee should have skills that include the ability to: (Select all that apply.)

The responsibility to articulate the business case for evidence-based practice to senior leadership lies with:

A clinical nurse specialist is meeting one on one with staff nurses while they are working to discuss data about the evidence-based practice. This is known as:

When articulating the business case for evidence-based practice to governing boards, key messages to share with board members include: (Select all that apply.)

Strategies for building a strong organizational context of evidence-based practice include: (Select all that apply.)

To promote an organizational culture that embraces evidence-based practice, an organization must: (Select all that apply.)

The responsibility of developing the unit culture for evidence-based practice belongs to the:

A team has formed to determine which methods have worked best and which factors influence the implementation of an evidence-based practice program. This is known as _____ research.