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NHS8065 Foundations of Evidence-Based Practice in Health Care Exam Questions with Answers, Exams of Nursing

Capella UniversityNursing

NHS8065 Foundations of Evidence-Based Practice in Health Care Practice Exam with Questions and Correct Answers Already A+ Graded-Capella University

Typology: Exams

2024/2025

Available from 06/17/2025

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NHS8065 Foundations of Evidence-Based
Practice in Health Care Practice Exam with
Questions and Correct Answers Already A+
Graded-Capella University
What is a clinical guideline?
- Clinical guidelines are systematically developed statements that assist members of
the health care team and their patients to make appropriate decisions about a specific
condition or treatment. They arise following an examination of the current best
evidence, and other knowledge relevant to a specific health problem.
Overview/history of clinical guidelines
- Nurses have always developed and used tools to guide clinical decision-making
related to interventions in practice
- Since then, to assist them in making appropriate decisions about patient care that
eventuate in the best desired patient outcomes, nurses have continued to use tools.
-The guideline-based approach to healthcare originated in the United States in the 90's
- Today, guidelines are produced at international, national levels by clinical
associations.
Clinical Guidelines are NOT:
- Step-by-step 'recipes' for assessment and treatment
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Download NHS8065 Foundations of Evidence-Based Practice in Health Care Exam Questions with Answers and more Exams Nursing in PDF only on Docsity!

NHS8065 Foundations of Evidence-Based

Practice in Health Care Practice Exam with

Questions and Correct Answers Already A+

Graded-Capella University

What is a clinical guideline?

  • Clinical guidelines are systematically developed statements that assist members of the health care team and their patients to make appropriate decisions about a specific condition or treatment. They arise following an examination of the current best evidence, and other knowledge relevant to a specific health problem. Overview/history of clinical guidelines
  • Nurses have always developed and used tools to guide clinical decision-making related to interventions in practice
  • Since then, to assist them in making appropriate decisions about patient care that eventuate in the best desired patient outcomes, nurses have continued to use tools.
  • The guideline-based approach to healthcare originated in the United States in the 90's
  • Today, guidelines are produced at international, national levels by clinical associations. Clinical Guidelines are NOT:
  • Step-by-step 'recipes' for assessment and treatment
  • Nursing procedures that most nurses in the speciality already perform
  • Standing orders
  • Simple descriptions of aetiology (cause), prevalence (spread) and assessment. Distinctions between Guidelines and Protocols Guidelines:
  • Composed of elements describing aspects of the patient's condition and the care given
  • Recommendations for management are supported by evidence Protocols:
  • Specify details concerning the treatment and/or procedure endorsed by the employing agency
  • Vary in the degree to which they are optional
  • Vary in the specificity and quantity of operational information they contain
  • Context dependent
  • Not always evidence-based What do clinical guidelines look like?
  • Three main types:
  1. Clinical guidelines
  2. Deterministic guidelines

NB - potential harms

  • Rigorously developed evidence based guidelines do minimise the potential harm, but it must always be remembered that they are only one option for improving the quality of care
  • May always be variations from the guideline (we are all individuals) so clinical judgement and patient choice may also be appropriate/should be included in decision- making. Important for nurses (clinical guidelines)
  • Confirm by way of independent sources that the information contained within the Clinical Guideline is correct e.g. own search of the evidence/make sure it is up to date
  • Remember that Clinical Guidelines are NOT a substitute for proper diagnosis, treatment, or the provision of advice by an appropriate health professional. Choosing a clinical guideline
  • If no guideline exists in clinical area (you might have moved to a remote area or to a more senior position)
  • Two options:
  • Adapt an existing guideline
  • Develop a new guideline Developing a clinical guideline: Guiding principles
  • Evaluation should be outcome focused
  • Guidelines should be based on the best available evidence
  • The synthesise method for available evidence should be strong
  • Should be multi-disciplinary and should include consumers
  • Guidelines should be flexible and adaptive to varying local conditions
  • Guidelines should be developed with resource constraints in mind
  • Target audiences should be taken into account
  • The validity and usefulness of the guidelines should be evaluated
  • Guidelines should be revised regularly Dissemination and Implementation (Clinical Guidelines)
  • Identify potential obstacles to implementation
  • Tailoring implementation strategies to the particular contexts in which the guidelines are to be introduced
  • Usually published centrally (within a central authority's intranet, policy database) or may be available as booklets, leaflets, etc.
  • Use of opinion leaders and champions
  • Endorsement of clinical groups
  • Practice visits from influential experts
  • Education of patients and staff
  • Seminars and conferences (preferably with active involvement of audiences)
  • Reminder systems incorporated into clinicians' daily work
  • Prompts in patient records

How to spread the word of EBP?

  • Collaborate with peers; proofread and soundboard
  • Select a catchy title, write a catchy abstract
  • Write introduction aimed at your target group
  • Present your clinical purpose early on, and write with your target in mind
  • Presents results simply, clearly and concisely
  • Focus discussion on clinical implications Barriers to Dissemination and Publication
  • Lack of confidence and experience
  • Organisational restrains
  • Fear of scrutiny (peers and editors)
  • Lack of time
  • Lack of research skills and experiences to recall evidence critically
  • Structure
  • Interactions Overcoming Barriers
  • Be confident
  • Start small and work your way up
  • Work with others
  • Know your medium
  • Keep it simple and brief
  • Be patient
  • Develop skills and knowledge Other forums for research dissemination
  • It may take years to publish an article
  • Academic Journals are considered the most effected way to reach a broad audience, but is not the only way to disseminate findings
  • Oral dissemination: local clinical forums, national and international conferences. May be granted a poster presentation if unsuccessful or apply for poster forum as first choice.
  • Create or use an established research or evidence-based practice bulletin board, which can be simple as a cord board on each of the nursing units with a nursing research title or a specially created board with holders for handouts. Getting research into practice
  1. The establishment of effective change measures
  2. National Governance
  3. Clinical guidelines Getting evidence into practice
  4. Searching for the best international evidence

Importance of EBP: Conclusion

  • Research drives any and all decisions to be made in the future... the basis of proper health policies and concepts behind new innovations
  • Our future calls for continued searching and building on our knowledge to integrate new, more effective forms of health
  • Remaining informed, keeping up to date and disseminating relevant findings is paramount Inquiry Rigorous and systematic thinking about professional practice, and the context in which it occurs. Rationale for inquiry
  • Inquiry is not a project or a fad, it is a way of professional being/being professional, and so is a career-long project. Inquiry capabilities include the capacity to:
  • Clarify meaning
  • Identify issues/problems/dilemmas/puzzles
  • Develop inquiry questions
  • Collect data
  • Locate and draw on research
  • Critically interrogate (ask questions of) practice and data
  • Analyse/interpret and theorise data
  • Develop and implement strategies for action
  • Assess outcomes Inquiry-based health care
  • Ideally incorporates/includes reflective practice:
  • Reflection on action
  • Reflection for action
  • Reflection in action
  • It involves the recognition of and critical reflection on the impact and influence of institutional and social contexts on clinical practice. On an individual level, inquiry-based health care:
  • Involves a commitment to personal professional development
  • Includes developing and refining an inquiry toolbox of approaches and skills Conditions that will support inquiry are ones that:
  • Encourage discussion and debate
  • Reject certainty and dogmatism
  • Structures, processes and policies that are consistent with inquiry Recognised barriers
  • Inability to obtain research findings in one's own area of practice
  • Lack of relevance of the findings
  • Time and costs involved in implementing research
  • Resistance to change in the workplace
  • Lack of understanding of or agreement with research conclusions
  • Lack of rewards for implementation of research findings
  • Change - supporting communities are differentiated from those that reinforce the status quo by the set of norms that govern dialogue (the way people in the community speak)
  • When members of communities are characterised by a culture of inquiry encounter evidence that conflicts with their expectations, the dissonance (conflict/discord) that this creates/becomes the catalyst for working towards improvement At a systems level:
  • Communities of practice/cultures of inquiry at each layer of the system should be characterised by
  • If leaders are to establish a culture of inquiry, they need to:
  • Involve others in interpreting and engaging with data
  • Stimulate an internal sense of urgency
  • Make time
  • Use critical friends

To foster EBP health professionals need:

  • A never ending spirit of inquiry and consistently question current clinical practices
  • Strong beliefs in the value of EBP
  • Knowledge of, and skills in EBP along with the confidence to use it
  • A commitment to deliver the highest quality evidence-based care to patients and their families. Questions & Answers to evidence based practice Questions:
  • How does evidence apply in nursing/health care?
  • What point is there in doing nursing research?
  • Why should I be doing this unit? Answers:
  • Clinicians are expected to use current best evidence to underpin their clinical practice
  • Educators are required to use evidence of current best practice to engage students, link theory to practice and inspire future researchers. Evidence-based healthcare
  • Should be based on information derived from research
  • EBP promotes an attitude of inquiry amongst health professionals (gets us thinking 'why am I doing this?')
  • It is our professional responsibility to be integrating the best/most recently available evidence into our practice
  • When we integrate (combine) the best available evidence with information from our clinical knowledge, patients and practice context, the reason behind our clinical decisions becomes more apparent and this serves to reinforce both our accountability and our claim to be a health professional
  • Important role to play in wise resource use/allocation:
  • Finite resources in all aspects of healthcare
  • Evidence is used to support funding
  • If no evidence supports effectiveness of a particular intervention
  • Good quality evidence that a particular intervention is harmful or not effective, then it will not be funded 5 main steps in the EBP process
  1. Convert the need for evidence into an answerable question
  2. Track down the best evidence with which to answer that question
  3. Critically appraise the evidence for impact, applicability, and validity
  4. Integrate the evidence into your practice
  5. Evaluate how well you did steps 1-4 and, what steps might be needed to improve/complete the process Asking answerable questions
  • Patient and/or problems
  • Intervention
  • Comparison intervention (where relevant)
  • Outcomes (clinical)
  • Time-frame
  • We want a question that helps us search the literature for evidence from research that has already been done Patient with poorly controlled blood pressure (example)
  • "Is exercise a better strategy than medication to manage hypertension for adult men?"
  • No - have to do the research to answer this
  • "What strategies are recommended to optimise management of hypertension in adult men?
  • Yes - can search the literature for evidence from research that has already been done Locating the evidence
  • Searching (usually libraries) for most up to date and relevant research reports and their recommendations for practice
  • There is no longer a place in modern healthcare for clinical practice to be based on personal medical clinician preference, folklore, or 'watch one, do one, teach one' mentality What is wrong with opinion-based clinical practice?

The systematic and rigorous process of inquiry which aims to describe phenomena and to develop and test explanatory concepts and theories. Systematic Has a clearly organised approach to data gathering and analysis which can be followed by future readers; an organised method with inter-related parts. Rigorous Precise standards by which the quality of all research is measured: if the study is rigorous its results are 'strong'. Not all evidence is necessarily the best

  • Not all clinical research/published material provided the same level (strength) of evidence to answer a clinical question
  • Not everything that is published (even in refereed journals) constitutes 'good' evidence
  • Health professionals need a little bit of knowledge about research to be able to look at a paper and say:
  • Yes: well done, useful and applicable
  • No
  • Hierarchies/levels of evidence have been developed as a guide to what/which study designs are likely to produce the 'best' evidence for different types of practice

Critical appraisal

  • Critical appraisal is the process of deciding whether a piece of research (and thus the evidence it claims to provide) will be useful to support your practice. There are three questions you need to ask about any kind of research: 1)Is it valid 2)Is it important 3)Is it applicable to the patient?
  • This is a skill that requires some understanding of research methods and lots of practice Integration of EBP in clinical practice
  • Can be most challenging phase:
  • Can be associated with change and change is often ferociously resisted since the status quo is more comfortable
  • Simply sending out/emailing directives and policies is seldom effective
  • Effective EBP is as much about changing culture as it is about changing practice Evidence in clinical practice/in health care
  • Examples:
  • Clinical guidelines
  • Clinical protocols
  • Best practice sheets
  • Health policies and protocols