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N580 Midterm Questions and Answers Latest Updated

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Exam of 39 pages for the course N580 at N580 (N580 Midterm)

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N580 Midterm

Nurses on the cutting edge - answer promote improvement in patient outcomes
Accomplish this through: research, EBP, and QI

nurses achieve personal growth through and expand clinical decision-making skills
through... - answer development of clinical questions
literature reviews
evaluation of evidence in literature
application of "best available evidence" in your practice

nurses as knowledgeable consumers - answer nurses must be knowledgeable
consumers of research who can evaluate the strengths and weaknesses of research
evidence and use existing standards to determine the merit and readiness of research
for use in clinical practice
to use research for an EBP and to practice using the highest quality processes, you do
not have to conduct research; however, you do need to understand and appraise the
steps of the research process in order to read the research literature critically and use it
to inform clinical decisions

research definition - answera systematic investigation, including research development,
testing and evaluation, designed to develop or contribute to generalizable knowledge
quantitative and qualitative research
studies are guided by research questions
nurses employ the same methods used by other disciplines yet study questions are
relevant to nursing practice

quantitative vs. qualititative research - answerquantitative: encompasses the study of
research questions and/or hypotheses that describe phenomena, test relationships,
assess differences, seek to explain cause-and-effect relationships between variables,
and test for intervention effectiveness--numeric data are summarized and analyzed
using statistics--techniques are systematic and methodology is controlled
qualititative: question is about understanding the meaning of a human experience such
as grief, hope, or loss--meaning of an experience is based on the view that meaning
varies and is subjective--context of experience also plays a role--generally conducted in
natural settings and uses data that are words or text rather than numeric to describe the
experiences being studied--guided by research questions and data are collected from a
small number of subjects, allowing an in-depth study of a phenomenon--subjective
approach but systematic in its method

QI definition - answersystematic use of data to monitor the outcomes of care processes
and improvement methods to design and test changes to continuously improve the
quality and safety of health care systems

,uses currently available knowledge to improve health care delivery within the local
setting

QI elements - answer1. conducting an assessment
2. setting specific goals for improvement
3. identifying ideas for changing current practice
4. deciding how improvements in care are measured
5. rapidly testing practice changes
6. measuring improvements in care
7. adopting practice change as new standard of care
want to create measurable change across quality domains through application of these
7 steps, often through the plan, do, study, act model

research vs. QI - answerresearch studies generate new knowledge that is generalizable
to other populations and settings
QI projects use currently available knowledge to improve health care delivery within the
local setting
IRB should have a written policy and template for determining the difference between
humans subjects research and QI

research and EBP - answerbest research evidence, clinical expertise, and patient
values all come together in EBP (see Venn diagram)
EBP allows one to systematically use the best available evidence from research with
the integration of individual clinical expertise as well as the patient's values and
preferences to make clinical decisions

developing EBP expertise - answerconduct effective literature reviews
develop critical reading skill process
1. preliminary: skimming article abstracts, title
2. comprehensive: understanding the purpose of the study
3. analysis: examining the study components
4. synthesis: assessing the study's validity

levels of evidence - answersee pyramid
Level I: systematic review or meta-analysis of RCTs, evidence-based clinical practice
guidelines based on systematic reviews
Level II: well-designed RCT
Level III: controlled trial without randomization (quasi-experimental study)
Level IV: nonexperimental study (case-control, cohort studies)
Level V: systematic reviews of descriptive and qualitative studies (metasynthesis)
Level VI: qualitative studies or descriptive studies
Level VII: opinion of experts and authorities, expert committee reports or organizations,
not based on research

EBP steps - answerask
gather evidence

,assess, appraise, synthesize literature
act
evaluate

research article format - answerabstract
intro or background section: literature review, theoretical framework, hypothesis and/or
research question, purpose statement
methods: research design, sampling, instruments, data collection, data analysis plan
results
discussion (ties everything together): recommendations and implications
references

research journal article - answerqualitative, quantitative, mixed methods

systematic review - answersummation and assessment of group of studies that test a
similar research question

meta-analysis - answersummary of a number of studies focused on one question or
topic, and uses a specific statistical methodology to synthesize the findings in order to
draw conclusions about the area of focus--systematic review that uses statistical
techniques to summarize and assess studies

integrative review - answerfocused review and synthesis of research or theoretical
literature in a particular focus area, and includes specific steps of literature integration
and synthesis without statistical analysis; can include both quantitative and qualitative
articles (sometimes used interchangeably with systematic review)

meta-synthesis/meta-summary - answersynthesis of a number of qualitative research
studies on a focused topic using specific qualitative methodology

clinical guidelines - answerevidence-based guidelines are those developed using
research findings
consensus or expert-based guidelines are developed by expert panels
guidelines have been developed to assist in bridging practice and research
provide clinicians with an algorithm for clinical management, or decision making, for
specific diseases (e.g., colon cancer) or treatments (e.g., pain management)

NIH strategic plan - answer1. symptom science: promoting personalized health
strategies
2. wellness: promoting health and preventing disease
3. self-management: improving QOL for individuals with chronic illness
4. end of life and palliative care: science of compassion
integrate behavioral and biological sciences
cross-cutting areas are vital to the advancement of nursing science
1. promoting innovation: technology to improve health
2. 21st century nurse scientists: innovative strategies for research careers

, PICO question - answerproblem/patient population
intervention
comparison
outcome

nursing research is significant to the profession of nursing because it promotes... -
answergeneration of a specialized body of nursing knowledge for use in nursing
practice

action that demonstrates the role of a knowledgable consumer of nursing research -
answerevaluating the credibility of research findings

primary value of evidence-based practice in nursing - answerincorporating research
findings with clinical expertise when individualizing patient care

the research question and study purpose are located in the... - answerintroduction

critical step for the QI process in health care settings - answeradopting a practice
change as a new standard of care

the review of literature is important to the research process because... - answerit guides
all steps of the research process

most relevant and frequently used source of nursing literature - answerCINAHL

how far back should a literature search for an academic paper or project go? - answer3-
5 years

website that is an important source for clinical evidence but limited as a provider of
primary documents for literature reviews - answerCochrane Library (see pp. 52 & 56 for
tables)

where do research problems come from? - answerdirect clinical experience
critical appraisal from the scientific literature
theories and conceptual models

direct clinical experience - answerday-to-day interactions lead to questions: do patients
being discharged from a hospital have special learning needs?
literature search is needed to help you find out what has been done, and to refine or
focus in on the specific problem you will address

critical appraisal from the scientific literature - answerliterature can serve as a starting
point
a reader may begin to question practices or findings because of flaws in logic or
methodology, due to personal anecdotal experience or the source of the study

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