LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality Improvement, 1st Edition Chapter 01: Overview of Evidence-Based Practice MULTIPLE CHOICE 1. The first step in the evidence-based process is to a. form a team of health care providers. b. retrieve evidence. c. select an EBP topic. d. critically appraise evidence. ANS: C The steps for EBP are: select an EBP topic, form a team, evidence retrieval, critical appraisal of evidence, evidence synthesis, set forth EBP recommendations, decision to change practice, convey EBP recommendations to local standards, policies or procedures, implement practice change, evaluation, and dissemination. 2. Which agency is the National Guideline Clearinghouse of publicly available database of evidence-based clinical practice guidelines and related documents? a. The Institute for Healthcare Improvement (IHI) b. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) c. The United States Preventative Services Task Force (USPSTF) d. The Agency for Healthcare Quality and Research (AHRQ) ANS: D AHRQ provides a variety of EBP function including serving as the National Guideline Clearinghouse: publicly available database of evidence-based clinical practice guidelines and related documents. Updated weekly with new content, NGC provides an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines to further dissemination, and implementation. Examples of IHI Evidence-Based Standards or Recommendations include development of a patient and family-centered ICU, Communication about end-of-life care, the opioid crisis and building systems of safety. Examples of JCAHO Evidence-Based Standards or Recommendations include fall prevention, patient/family education, prevention of CAUTI, and prevention of medication errors. The USPSTF assigns recommendations for prevention and evidence-based health care a letter grade (an A, B, C, or D grade or an I statement) based on strength of the evidence and balance of benefits and harms of a preventive service. The Task Force does not consider costs of a preventive service when determining a recommendation grade. 3. Which of the following statements comparing evidence-based practice to the conduction of research is true? a. EBP poses research questions or hypotheses that advance the state of the science. b. The purpose of EBP is to gain knowledge/science generation. c. Standardized-dependent measures with known reliability and validity are used as evaluation methods for EBP. d. EBP evaluation includes quality improvement metrics that address both processes of care and patient outcomes. ANS: D Conduct of research poses research questions or hypothesis that advance the state of the science. The purpose of an EBP clinical question or purpose of the EBP project is derived from the PICO. Application of research findings and/or other evidence in local practice and/or communities is another purpose of EBP. Standardized-dependent measures with known reliability and validity are used as evaluation of conduction of research. 4. Which of the following is an example of an evidence-based practice approach? a. Smoking cessation reports from participants for 6 months prior to implementation, mid-way during implementation (3 months), and following implementation of a “Stop Smoking” program b. Comparison of blood pressure in one group who walk 20 minutes a day/5 days a week versus another group who are sedentary c. Measuring heart rate on volunteers who listen to music prior to sleep versus volunteers who do not listen to music prior to sleep d. Comparison of patient satisfaction scores from two medical surgical units over a 3-month period ANS: Aread more
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