Evidence-Based Practice in Nursing, Exams of Nursing

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NR 449 EXAM PREP VERIFIED

Evidence – Based

Practice

COMPLETED

2023/

1. What are the three components of EBP in nursing?
   • The three components of EBP in nursing are:
     • The best available research evidence from systematic reviews, meta-analyses, randomized controlled trials, etc.
   • The clinical expertise and judgment of the nurse, based on education, experience, and skills.
   • The preferences, values, and needs of the patient, family, and community, taking into account their culture, beliefs, and expectations.
2. What are the benefits of EBP in nursing for patients, nurses, and healthcare systems?
   • The benefits of EBP in nursing for patients include:
     • Improved health outcomes, such as reduced complications, infections, readmissions, mortality, etc.
     • Enhanced satisfaction, quality of life, and empowerment.
     • Increased involvement and shared decision-making in their care.
   • The benefits of EBP in nursing for nurses include:
     • Improved knowledge, skills, and confidence.
     • Enhanced professional development and career opportunities.
     • Increased autonomy and accountability.
   • The benefits of EBP in nursing for healthcare systems include:
     • Improved quality and safety of care delivery.
     • Reduced costs and resource utilization.
     • Increased efficiency and effectiveness.
3. What are the levels of evidence in EBP in nursing and how are they ranked?
   • The levels of evidence in EBP in nursing are a way of ranking the quality and strength of research studies according to their design, methodology, validity, and applicability. There are different hierarchies of evidence, but one commonly used one is the following:
   • Level I: Systematic reviews or meta-analyses of randomized controlled trials (RCTs), or evidence- based clinical practice guidelines based on systematic reviews of RCTs.
   • Level II: One or more well-designed RCTs.
   • Level III: Well-designed controlled trials without randomization (e.g., quasi-experimental studies).
   • Level IV: Well-designed case-control or cohort studies.
   • Level V: Systematic reviews of descriptive or qualitative studies, or single descriptive or qualitative studies.
   • Level VI: Single descriptive or qualitative studies.
   • Level VII: Expert opinion or consensus statements.
4. What are some examples of EBP in nursing practice?
   • Some examples of EBP in nursing practice are:
     • Using bundles of interventions to prevent central line-associated bloodstream infections (CLABSI), such as hand hygiene, chlorhexidine skin antisepsis, maximal sterile barrier precautions, etc.
   • Implementing hourly rounding to reduce patient falls, call light use, and pressure ulcers, and to increase

patient satisfaction.

• Applying negative pressure wound therapy (NPWT) to promote wound healing and reduce infection rates.

5. What are the steps of the EBP process in nursing?

• The steps of the EBP process in nursing are:
• Step 1: Ask a focused clinical question using the PICO format (Population, Intervention, Comparison, Outcome)
• Step 2: Search for the best available evidence from relevant sources such as databases, journals, guidelines and websites
• Step 3: Appraise the quality and validity of the evidence using critical appraisal tools such as checklists, scales or frameworks
• Step 4: Apply the evidence to practice by integrating it with clinical expertise and patient preferences
• Step 5: Evaluate the outcomes of the practice change by measuring indicators such as patient satisfaction, clinical outcomes, cost-effectiveness and adverse events

6. What are some barriers to EBP in nursing and how can they be overcome?

• Some barriers to EBP in nursing are:
• Lack of time, resources or skills to access, appraise or apply evidence
• Lack of support, motivation or incentives from managers, colleagues or organizations to implement EBP
• Lack of awareness, knowledge or confidence about EBP among nurses or patients
• Resistance to change, tradition or authority from nurses, patients or other healthcare professionals
• Some strategies to overcome these barriers are:
• Providing education, training or mentoring on EBP for nurses at different levels of education and experience

1. What are the benefits of EBP in nursing for patients, nurses, and healthcare systems? Provide examples to support your answer. Answer: EBP in nursing is an approach to providing nursing care that uses the most current research available to improve the safety, health, and well-being of patients. Some of the benefits of EBP in nursing are:

• For patients, EBP can improve their outcomes, satisfaction, and quality of life by ensuring that they receive the best available care based on the latest evidence. For example, EBP can help prevent infections, reduce complications, and shorten hospital stays by implementing effective interventions such as hand hygiene, wound care, and pain management.
• For nurses, EBP can enhance their knowledge, skills, and confidence by enabling them to access, appraise, and apply the latest research in their practice. For example, EBP can help nurses update their clinical guidelines, protocols, and policies based on the best available evidence and feedback from patients and colleagues.
• For healthcare systems, EBP can reduce healthcare costs and variations in patient outcomes by eliminating

unnecessary or ineffective practices and promoting consistent and high-quality care. For example, EBP can help healthcare systems optimize their resources, improve their performance, and increase their accountability by using evidence to inform their decision-making, planning, and evaluation.

2. What are the steps of EBP in nursing and how can they be applied in a clinical scenario? Provide an example to illustrate your answer. Answer: The steps of EBP in nursing are:

• Ask a clinical question that is relevant, specific, and answerable. The question should be formulated using the PICO format: Population (the target group of patients), Intervention (the treatment or action of interest), Comparison (the alternative treatment or action), and Outcome (the desired result or effect). For example, a clinical question could be: In adult patients with chronic low back pain, is acupuncture more effective than usual care in reducing pain intensity and improving function?
• Search for the best available evidence that can answer the clinical question. The evidence should be reliable, valid, relevant, and current. The sources of evidence can include databases, journals, guidelines, systematic reviews, meta-analyses, randomized controlled trials, etc.. For example, a search for evidence could be done using keywords such as acupuncture, low back pain, pain intensity, function, etc.
• Appraise the quality and strength of the evidence using critical appraisal tools and criteria. The appraisal should assess the validity, reliability, relevance, applicability, and bias of the evidence. The levels of evidence can range from high (such as systematic reviews and meta-analyses) to low (such as expert opinions and case reports). For example, an appraisal of the evidence could use tools such as GRADE (Grading of Recommendations Assessment Development and Evaluation) or AGREE (Appraisal of Guidelines for Research and Evaluation).
• Apply the evidence to the clinical situation by considering the patient's preferences, values, needs, and circumstances. The application should also take into account the nurse's expertise, judgment, and experience. The application should involve shared decision-making with the patient and other stakeholders such as family members and healthcare providers. For example, an application of the evidence could involve discussing with the patient the benefits and risks of acupuncture versus usual care for low back pain and reaching a mutual agreement on the best course of action.
• Evaluate the outcomes of the application by measuring and monitoring the effects of the intervention on the patient's condition [^