Question 1

Which of the following actions by the nurse executive would best implement evidence-informed practice at a community nursing centre that serves a large Cuban immigrant population?

Accepted Answer

Although all of the proposed options are good, in order to determine whether the centre's practice is serving the needs of the population, the nurse executive will need to consult members of the population being served.This means that evidence would be applied to practice with input from the community.For example, decisions related to the services to be offered in a community health nurse (CHN)-managed clinic would be made with input from the clinic's advisory board, which should include community leaders and consumers of the clinic's services.The needs of Cuban immigrants may not be the same as those of immigrants from other Spanish-speaking countries, such as Mexico or Spain.

Question 2

The CHN who best applies evidence-informed practice directly performs which of the following actions to determine the best way to address an outbreak of a new infectious disease?

Accepted Answer

Evidence-informed practice is defined as combining the best evidence derived from research with clinical practice, knowledge, expertise, and unique client expectations, preferences, or choices when making clinical decisions.Getting ideas from the Internet is helpful only if evidence-informed practice sites are accessed; however, most Internet sites do not offer information grounded in evidence-informed practice.

Question 3

A CHN plans to use evidence-informed practice to guide the development of health education programs that are most likely to increase retention of information in elementary school children.Which option represents the best way to use evidence-informed practice in this situation?

Accepted Answer

Randomized clinical trials are the gold standard for evidence gathering in evidence-informed practice.

Question 4

Which of the following is included in the ways in which a CHN can best facilitate incorporation of evidence-informed practice in the clinical setting?

Accepted Answer

Evidence-informed practice demands changes.It requires the incorporation of more practice-oriented research and more collaboration between clinicians and researchers.Emphasis should be on decision making using the various sources of evidence.When CHNs access scientific knowledge of all types, they need to choose the most relevant information for each client's clinical situation.

Question 5

A nursing administrator who wishes to develop a work environment conducive to the implementation of evidence-informed practice can best achieve it through which of the following actions?

Accepted Answer

Inadequacy of nursing research holdings, including nursing research journals, in the libraries of health care institutions can create a barrier to the implementation of evidence-informed practice in community-based nursing agencies.Increased nursing research holdings can help CHNs to quickly access current evidence-informed findings and recommendations.

Question 6

For CHNs who are familiar with evidence-informed practice and want to implement it in their care of clients, which of the following is the biggest challenge?

Accepted Answer

The challenge for the CHN is accessing the evidence and integrating it into practice, thus moving beyond practice based solely on experience, tradition, or ritual.

Question 7

Which of the following represents the first step to take when using evidence-informed practice in the clinical setting?

Accepted Answer

The first step in the evidence-informed practice process is formulating the question, which includes defining and refining the question.To answer the client clinical question that has been formulated, the sources of evidence-informed practice related to community health nursing include the best available evidence.

Question 8

A health care provider is concerned about the high number of clients with type 2 diabetes who have poor glucose control.In order to implement evidence-informed practice to manage this problem, which one of the following would be the best reference for the health care provider to use?

Accepted Answer

Evidence-informed practice in community health nursing challenges CHNs to integrate the best evidence into their clinical practice.Current research findings will explicate the evidence of the most successful interventions.(Randomized clinical trials are the gold standard of research for evidence-informed practice.) Protocols and opinions often reflect tradition rather than the most current scientific evidence.Although many nursing journals are peer reviewed, some are not; and even among those that are peer reviewed, many are not research based or focused on scientific evidence.

Question 9

A busy CHN who is concerned that obesity is increasing rapidly among children in her community wants to implement evidence-informed practice but faces barriers because of time constraints.A knowledge manager can help this CHN by doing which of the following?

Accepted Answer

The knowledge manager's role is to assist in the implementation of evidence-informed practice through collection and dissemination of the collective knowledge within an organization, gathering relevant information and applying it to community nursing practice, retrieving and evaluating the best evidence for clinical practice within a community, and staying informed about the community's politics and policy issues.To increase the likelihood of success, the knowledge manager can equip the CHN with needed information and knowledge to develop interventions that are research based.

Question 10

A CHN implemented an education program that incorporated computer games to reinforce learning in a community of older adults.Although earlier research had demonstrated evidence of improved retention of information by using this method, the CHN found exactly the opposite effect in this group of clients.Which one of the following is the most likely cause of the poor outcome in the education program?

Accepted Answer

Evidence-informed practice cannot be applied as a universal remedy without attention to client differences.When evidence-informed practice is applied at the community level, best evidence may point to a solution that is not sensitive to cultural issues and distinctions and thus may not be acceptable to that particular community.For example, computer games may be an excellent choice for younger groups but is often not suitable for older adults, who may face challenges with learning new technology.

Quiz 5: Evidence-Informed Practice in Community Health Nursing