Evidence Based Practice Final Exam: Questions &
Answers
The nurses on a nephrology unit wish to implement an evidence-based change in
the assessment and management of patients' arteriovenous fistulas. Which of the
following should perform the first (and possibly only) review for the ethical
considerations of this change?
a.) The hospital's ethics review board
b.) The state board of nursing's ethics committee
c.) Expert nurses on the unit
d.) The leadership and management of the unit
(Ans-
d. The leadership and management of the unit
Rationale:
The first review should be performed by the unit management and supervisors to
critically examine the strength of the evidence on which the change is based to
assure the project's scientific value and validity and to assure that the risk-benefit
ratio is appropriately low. The review also assures that resources are available and
are fairly distributed.
Controversy about ethical principles as applied to EBQI versus clinical research is
seen most clearly in which of the following domains of ethics?
a. Scientific validity
b. Social or scientific value
c. Fair subject selection
,d. independent review
(Ans- d. independent review
There is significant controversy surrounding the question of the need for
independent ethical review for EBQI, with many experts citing a different standard
for clinical research than evidence-based practice changes. It is generally agreed
that questions of scientific validity, social or scientific value, and fair subject
selection should be applied in similar degree to both; however, the need to have
EBP initiatives brought before an ethical review committee is still unclear.
Four essential elements needed to create and evidence-based clinical
environment
(Ans-
1. Create a vision for EBP
2. Engage Personnel and resources
3. Integrate EBP and Nourish the culture
4. Evaluate the evidence
Several reasons for an institution to develop an evidence-based clinical
environment
(Ans- Regulatory initiatives and insurance-mandated outcomes
Three aims of the National Quality Strategy: better care, healthy people/healthy
communities, affordable care
Magnet recognition program
,Magnet recognition program
(Ans- Expectations for transforming a nursing culture into an environment that
promotes superior performance through EBP
Six objectives and their related strategies that are essential for developing a vision
for EBP
(Ans-
1. Develop a mental framework
2. Establish a motivating image for change
3. Create specific goals
4. Gain administrative support
5. Establish a leadership team
6. Involve experts and EBP mentors in clinical practice
Develop a mental framework
(Ans- Develop a written summary of what you want to accomplish
Brainstorm with colleagues regarding the environment you want to create
Establish a motivating image for change
(Ans- Use creativity to capture attention of the clinical staff
, Take advantage of real clinical scenarios to stress the need for changes in practice
Create specific goals
(Ans- Focus on short-term, attainable goals
Establish only two to three goals at a time
Gain administrative support
(Ans- Contact administrators responsible for clinical practice
Create a presentation that reflects the need for transforming the culture into and
EBP environment
Seek administrators responsible for clinical practice
Establish a leadership team
(Ans- Identify key personnel with a passion for EBP
Conduct a small focus group meeting
Involve experts and EBP mentors in clinical practice
(Ans- Identify clinical experts and EBP mentors focused on the area
Answers
The nurses on a nephrology unit wish to implement an evidence-based change in
the assessment and management of patients' arteriovenous fistulas. Which of the
following should perform the first (and possibly only) review for the ethical
considerations of this change?
a.) The hospital's ethics review board
b.) The state board of nursing's ethics committee
c.) Expert nurses on the unit
d.) The leadership and management of the unit
(Ans-
d. The leadership and management of the unit
Rationale:
The first review should be performed by the unit management and supervisors to
critically examine the strength of the evidence on which the change is based to
assure the project's scientific value and validity and to assure that the risk-benefit
ratio is appropriately low. The review also assures that resources are available and
are fairly distributed.
Controversy about ethical principles as applied to EBQI versus clinical research is
seen most clearly in which of the following domains of ethics?
a. Scientific validity
b. Social or scientific value
c. Fair subject selection
,d. independent review
(Ans- d. independent review
There is significant controversy surrounding the question of the need for
independent ethical review for EBQI, with many experts citing a different standard
for clinical research than evidence-based practice changes. It is generally agreed
that questions of scientific validity, social or scientific value, and fair subject
selection should be applied in similar degree to both; however, the need to have
EBP initiatives brought before an ethical review committee is still unclear.
Four essential elements needed to create and evidence-based clinical
environment
(Ans-
1. Create a vision for EBP
2. Engage Personnel and resources
3. Integrate EBP and Nourish the culture
4. Evaluate the evidence
Several reasons for an institution to develop an evidence-based clinical
environment
(Ans- Regulatory initiatives and insurance-mandated outcomes
Three aims of the National Quality Strategy: better care, healthy people/healthy
communities, affordable care
Magnet recognition program
,Magnet recognition program
(Ans- Expectations for transforming a nursing culture into an environment that
promotes superior performance through EBP
Six objectives and their related strategies that are essential for developing a vision
for EBP
(Ans-
1. Develop a mental framework
2. Establish a motivating image for change
3. Create specific goals
4. Gain administrative support
5. Establish a leadership team
6. Involve experts and EBP mentors in clinical practice
Develop a mental framework
(Ans- Develop a written summary of what you want to accomplish
Brainstorm with colleagues regarding the environment you want to create
Establish a motivating image for change
(Ans- Use creativity to capture attention of the clinical staff
, Take advantage of real clinical scenarios to stress the need for changes in practice
Create specific goals
(Ans- Focus on short-term, attainable goals
Establish only two to three goals at a time
Gain administrative support
(Ans- Contact administrators responsible for clinical practice
Create a presentation that reflects the need for transforming the culture into and
EBP environment
Seek administrators responsible for clinical practice
Establish a leadership team
(Ans- Identify key personnel with a passion for EBP
Conduct a small focus group meeting
Involve experts and EBP mentors in clinical practice
(Ans- Identify clinical experts and EBP mentors focused on the area
