Integrating Evidence-Based Practice in Nursing, Exams of Advanced Education

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CHAPTER 9: EBP

As a starting point for an initiative to integrate more evidence into the nursing practice at a community hospital, the nursing leadership has begun by holding meetings and focus groups aimed at developing a shared mental framework. What will this framework encompass? A) A statement of the goals for practice at a designated point in the near future B) An action plan for implementing EBP C) The values and ideals of nurses that can inspire change D) A brief document that outlines the mission of the organization and the nurses - C Caregivers and leaders of a university medical center are pleased that their facility has recently been granted Magnet recognition by the American Nurses Credentialing Center (ANCC). What does this designation indicate about the hospital? A) The hospital has met specific outcomes for which EBP forms the foundation. B) The hospital has demonstrated positive patient outcomes and attracted practitioners from outside the geographic region. C) The hospital has proven to be a site where new research is conducted and new evidence is generated. D) The hospital has demonstrated the presence of a cohort of staff committed to providing EBP. - B Two recent nursing graduates have resolved to champion EBP on the hospital unit where they provide care. They should begin this initiative by A) identifying research that relates to their practice setting and patient population. B) creating a shared understanding of the type of practice environment they envision. C) identifying a list of achievable goals for practice. D) enlisting the help of expert nurses who have experience in producing and implementing research. - B In an effort to create an environment that exemplifies EBP, the nursing leadership has made a concerted effort to include as many caregivers as possible, from numerous levels, in the process. What is the most likely rationale for this aspect of the change process? A) Promoting engagement B) Identifying and removing barriers C) Identifying goals D) Prioritizing clinical issues - A A group of nurses has encountered difficulties at many points in their efforts to integrate EBP on the medical unit where they provide care. Which of the following barriers is likely to present the greatest challenge? A) The difficulty of identifying research that relates directly to their patient population B) Apathy and resistance on the part of a cohort of nurses on the unit C) Unfamiliarity of some nurses with the concept of EBP

D) The lack of a common vision for change among the nurses who are advocating EBP - B In the course of narrowing their focus in a campaign to implement EBP in their workplace, a group of nurses is currently choosing which nursing areas to address. The nurses should prioritize which of the following? A) Nursing activities that are most familiar to the educators on the unit B) Areas that relate to the outcomes necessary for Magnet recognition C) Nursing actions that are addressed in the most detail in the literature D) Interventions that nurses perform most often during their care - D Which of the following principles should guide the choice of leadership when implementing EBP? A) Staff nurses should be mentored into familiarity with EBP by experts. B) Nurses should independently guide the EBP process in order to facilitate their experiential knowledge. C) Experts from academic settings should be brought in to carry out the process. D) Hospital leaders and administrators, assisted by nurses, should guide the EBP process. - A How can an EBP implementation team best build engagement and buy-in among nurses? A) By emphasizing the pride and sense of accomplishment that can come from implementing EBP B) By emphasizing the positive outcomes that can be brought about by the change C) By identifying the relationship between EBP and the American Nurses Association's Nursing Standards D) By explaining the role of EBP in Magnet recognition - B The nurses on a pediatric unit have identified a need for changes to their assessment practices to minimize sleep disruption to patients. Which of the following strategies should the EBP implementation team use in an effort to disseminate the evidence that forms the foundation of EBP? A) Distributing new clinical practice guidelines that are reflective of EBP B) Combining information on relevant changes with stories of the effects of change C) Increasing nurses' access to online databases and journals D) Offering teaching sessions from an expert nurse during scheduled break times - B The nurses who provide care in the cardiac catheterization clinic of a large hospital are currently engaged in an EBP initiative. Which of the following factors will have the greatest effect on the success or failure of the initiative? A) Ensuring that practice guidelines are widely-distributed, clear, and well-understood B) Providing opportunities for staff to see EBP in action at other hospitals and care facilities C) Restructuring the flow and organization of work to allow EBP to be implemented D) Ensuring that examples of traditional practice that are not evidence-based are

identified and addressed - C The staff of a medical unit has agreed to pilot test a new, evidence-based educational initiative that addresses the learning needs of adults who have been recently diagnosed with type 2 diabetes. A pilot test is likely to accomplish which of the following? A) Determine whether the existing research on diabetes education is valid and reliable. B) Reduce the incidence of type 2 diabetes among local adults. C) Gauge whether nurses are qualified to perform patient and family teaching related to diabetes. D) Indicate whether the initiative is feasible to implement and applicable to the population. - D Nurses on a labor-and-delivery unit are in the early stages of planning an evidence-based initiative aimed at establishing evidence-based practice around fetal monitoring during labor. Which of the following guidelines should the nurses follow when planning the timeline of this EBP initiative? A) The nurses should be aware that if the initiative spans more than 3 months, it is very difficult to sustain momentum. B) Constraining the initiative to a written timeline compromises the success of the initiative. C) The nurses should identify the multiple variables that could affect the project and create a timeline accordingly. D) Most complex EBP initiatives can be implemented in 8 to 10 weeks. - C During the planning stages of an evidence-based falls-prevention initiative, the nurses at a convalescent facility are organizing the way that the initiative will be evaluated. When should the nurses plan to audit the incidence of falls at the facility? A) Immediately following the completion of the initiative B) One to 2 months after the project has been completed C) Before and immediately after the project D) Before and right after the project as well as several weeks or months after the change - D Use of a new, evidence-based method of securing intravenous catheters and tubing has resulted in 31% fewer incidents of accidental or intentional IV removal on a pediatric unit. This statistic is an example of what type of evaluation indicator? A) Risk reductions B) Environmental changes C) Efficiency of processes D) Outcome measures - D Which of the following phenomena would signal that an EBP initiative has resulted in environmental change? A) Hypo- and hyperglycemia are being addressed more quickly than before an EBP initiative. B) Nurses are consulting and implementing the unit policy and procedures manual

more often than before an initiative. C) Staff compliance with hand washing and hand sanitizing increased 26% over the course of an initiative. D) Sick calls and other forms of absenteeism have been reduced following the completion of an EBP initiative. - B