Chapter 5: Evidence-Based Practice
Before conducting any study with human subjects, the researcher must obtain approval from the
agency's human subjects committee or institutional review board (IRB). The IRB ensures
that the researcher (Select all that apply.)
a. Obtains informed consent.
b. Minimizes risk to subjects.
c. Ensures confidentiality.
d. Identifies risks and benefits of participation.
e. Ensures that subjects complete the study. - ANS-ANS: A, B, C, D
Researchers must protect the confidentiality of those who participate in the study, obtain
informed consent, minimize risk to subjects, identify risks and benefits of participation, ensure
that participation in the study is voluntary, and allow subjects to withdraw from studies at any
time.
\In caring for patients, it is important for the nurse to realize that evidence-based practice is
a. The only valid source of knowledge that should be used.
b. Secondary to traditional or standard care knowledge.
c. Dependent on patient values and expectations.
d. Not shown to provide better patient outcomes - ANS-ANS: C
Even when the best evidence available is used, application and outcomes will differ based on
patient values, preferences, concerns, and/or expectations. Nurses often care for patients on
the basis of tradition or convenience, or the standard, "It has always been done this way."
Although these sources have value, it is important to learn to rely more on research evidence
than on non-research evidence. Patients who receive care based on the most recent and best
evidence experience 28% better outcomes
\In collecting the best evidence, the gold standard for research is
a. The randomized controlled trial (RCT).
b. The peer-reviewed article.
c. Qualitative research.
d. The opinion of expert committees - ANS-ANS: A
Individual RCTs are the gold standard for research. A peer-reviewed article means that a panel
of experts has reviewed the article; this is not a research method. Qualitative research is
valuable in identifying information about how patients cope with or manage various health
problems and their perceptions of illness. It does not usually have the robustness of an RCT.
Expert opinion is on the bottom of the hierarchical pyramid of evidence
\In conducting a research study, the researcher must guarantee that any information the subject
provides will not be reported in any manner that identifies the subject and will not be accessible
to people outside the research team. This concept is known as
a. Anonymity.
b. Confidentiality.
c. Informed consent.
, d. The research process. - ANS-ANS: B
Confidentiality guarantees that any information the subject provides will not be reported in any
manner that identifies the subject and will not be accessible to people outside the research
team. Anonymity occurs when even the researcher cannot link the subject to the data. Informed
consent means that research subjects (1) are given full and complete information about the
purpose of the study, procedures, data collection, potential harm and benefits, and alternative
methods of treatment; (2) are capable of fully understanding the research; (3) have the power to
voluntarily consent or decline participation; and (4) understand how confidentiality or anonymity
is maintained. The research process is a broader concept that provides an orderly series of
steps that allow the researcher to move from asking a question to finding the answer.
\In reviewing literature for an evidence-based practice study, the nurse realizes that the most
reliable level of evidence is the
a. Systematic review and meta-analysis.
b. Randomized control trial (RCT).
c. Case control study.
d. Control trial without randomization. - ANS-ANS: A
In a systematic review or meta-analysis, an independent researcher reviews all of the RCTs
conducted on the same clinical question and reports whether the evidence is conclusive, or if
further study is needed. A single RCT is not as conclusive as a review of several RCTs on the
same question. Control trials without randomization may involve bias in how the study is
conducted. Case control studies also have room for bias.
\Qualitative nursing research is valuable in that it
a. Excludes all bias.
b. Uses randomization in structure.
c. Determines associations between variables and conditions.
d. Studies phenomena that are difficult to quantify. - ANS-ANS: D
Qualitative nursing research is the study of phenomena that are difficult to quantify or
categorize, such as patients' perceptions of illness. No study can totally exclude bias. However,
randomization, such as that used in randomized control studies, helps. Qualitative
nursing research does not usually randomize its subjects. Control studies determine whether
there is an association between one or more predictor variables and the condition.
\The first step in evidence-based practice is to ask a clinical question. In doing so, the nurse
needs to realize that in researching interventions, the question
a. Is more important than its format.
b. Will lead you to hundreds of articles that must be read.
c. May be easier if in PICO format.
d. May be more useful the more general it is - ANS-ANS: C
The PICO format allows the nurse to ask questions that are intervention focused.
Inappropriately formed questions will likely lead to irrelevant sources of information. It is not
beneficial to read hundreds of articles. It is more beneficial to read the best four to six articles
that specifically address the question. The more focused the question asked, the easier it will
become to search for evidence in the scientific literature
\The hospital policy states that when starting an intravenous (IV) catheter, the nurse must first
prepare the potential IV site with alcohol and dress it using a gauze dressing. The nurse has
Before conducting any study with human subjects, the researcher must obtain approval from the
agency's human subjects committee or institutional review board (IRB). The IRB ensures
that the researcher (Select all that apply.)
a. Obtains informed consent.
b. Minimizes risk to subjects.
c. Ensures confidentiality.
d. Identifies risks and benefits of participation.
e. Ensures that subjects complete the study. - ANS-ANS: A, B, C, D
Researchers must protect the confidentiality of those who participate in the study, obtain
informed consent, minimize risk to subjects, identify risks and benefits of participation, ensure
that participation in the study is voluntary, and allow subjects to withdraw from studies at any
time.
\In caring for patients, it is important for the nurse to realize that evidence-based practice is
a. The only valid source of knowledge that should be used.
b. Secondary to traditional or standard care knowledge.
c. Dependent on patient values and expectations.
d. Not shown to provide better patient outcomes - ANS-ANS: C
Even when the best evidence available is used, application and outcomes will differ based on
patient values, preferences, concerns, and/or expectations. Nurses often care for patients on
the basis of tradition or convenience, or the standard, "It has always been done this way."
Although these sources have value, it is important to learn to rely more on research evidence
than on non-research evidence. Patients who receive care based on the most recent and best
evidence experience 28% better outcomes
\In collecting the best evidence, the gold standard for research is
a. The randomized controlled trial (RCT).
b. The peer-reviewed article.
c. Qualitative research.
d. The opinion of expert committees - ANS-ANS: A
Individual RCTs are the gold standard for research. A peer-reviewed article means that a panel
of experts has reviewed the article; this is not a research method. Qualitative research is
valuable in identifying information about how patients cope with or manage various health
problems and their perceptions of illness. It does not usually have the robustness of an RCT.
Expert opinion is on the bottom of the hierarchical pyramid of evidence
\In conducting a research study, the researcher must guarantee that any information the subject
provides will not be reported in any manner that identifies the subject and will not be accessible
to people outside the research team. This concept is known as
a. Anonymity.
b. Confidentiality.
c. Informed consent.
, d. The research process. - ANS-ANS: B
Confidentiality guarantees that any information the subject provides will not be reported in any
manner that identifies the subject and will not be accessible to people outside the research
team. Anonymity occurs when even the researcher cannot link the subject to the data. Informed
consent means that research subjects (1) are given full and complete information about the
purpose of the study, procedures, data collection, potential harm and benefits, and alternative
methods of treatment; (2) are capable of fully understanding the research; (3) have the power to
voluntarily consent or decline participation; and (4) understand how confidentiality or anonymity
is maintained. The research process is a broader concept that provides an orderly series of
steps that allow the researcher to move from asking a question to finding the answer.
\In reviewing literature for an evidence-based practice study, the nurse realizes that the most
reliable level of evidence is the
a. Systematic review and meta-analysis.
b. Randomized control trial (RCT).
c. Case control study.
d. Control trial without randomization. - ANS-ANS: A
In a systematic review or meta-analysis, an independent researcher reviews all of the RCTs
conducted on the same clinical question and reports whether the evidence is conclusive, or if
further study is needed. A single RCT is not as conclusive as a review of several RCTs on the
same question. Control trials without randomization may involve bias in how the study is
conducted. Case control studies also have room for bias.
\Qualitative nursing research is valuable in that it
a. Excludes all bias.
b. Uses randomization in structure.
c. Determines associations between variables and conditions.
d. Studies phenomena that are difficult to quantify. - ANS-ANS: D
Qualitative nursing research is the study of phenomena that are difficult to quantify or
categorize, such as patients' perceptions of illness. No study can totally exclude bias. However,
randomization, such as that used in randomized control studies, helps. Qualitative
nursing research does not usually randomize its subjects. Control studies determine whether
there is an association between one or more predictor variables and the condition.
\The first step in evidence-based practice is to ask a clinical question. In doing so, the nurse
needs to realize that in researching interventions, the question
a. Is more important than its format.
b. Will lead you to hundreds of articles that must be read.
c. May be easier if in PICO format.
d. May be more useful the more general it is - ANS-ANS: C
The PICO format allows the nurse to ask questions that are intervention focused.
Inappropriately formed questions will likely lead to irrelevant sources of information. It is not
beneficial to read hundreds of articles. It is more beneficial to read the best four to six articles
that specifically address the question. The more focused the question asked, the easier it will
become to search for evidence in the scientific literature
\The hospital policy states that when starting an intravenous (IV) catheter, the nurse must first
prepare the potential IV site with alcohol and dress it using a gauze dressing. The nurse has
