Chapter 2 Evidence-Based Practice

Answers CHAPTER 2 EVIDENCE-BASED PRACTICE AUDIO CASE STUDY Marie and Evidence-Based Practice 1. Thirdhand smoke is the dangerous toxins of smoke that linger on hair, clothing, furniture, and other surfaces in an area after a cigarette is put out. Marie learned that exposure to these toxins can be neurotoxic to children and can trigger asthma attacks in sensitive people. 2. Evidence-based practice is considered the gold standard of health care. 3. Step 1: Ask the burning question. Step 2: Search and collect the most relevant and best evidence available. Step 3: Think critically. Appraise the evidence for validity, relevance to the situation, and applicability. Step 4: Measure the outcomes before and after instituting the change. Step 5: Make it happen. Step 6: Evaluate the practice decision or change. 4. Combination therapy with a nicotine patch and nicotine lozenges worked best, although bupropion (Zyban) and nicotine lozenges worked well, too. A Cochrane Review found that advice and support from nursing staff can increase patients’ success in quitting smoking, especially in a hospital setting. VOCABULARY 1. Evidence-based practice: A systematic process that uses current evidence in making decisions about patient care. 2. Evidence-informed practice: Consideration of patient factors along with the use of evidence for shared decisionmaking between the health care provider and the patient. 3. Randomized controlled trials: True experimental studies in which as many factors as possible that could falsely change the results are controlled. 4. Research: Scientific study, investigation, or experimentation to establish facts and analyze their significance. 5. Systematic review: A review of relevant research using guidelines. 6. Health literacy: Degree to which a person has the capacity to obtain, process, and understand basic health information and services to make the best-informed health decisions. EVIDENCE-BASED PRACTICE 1. proof 2. context 3. quality 4. care 5. randomized 6. outcomes 7. gold 8. nursing 9. patient’s 10. information CRITICAL THINKING 1. By questioning the existing way of doing things to ensure that the patient receives the best care possible. 2. A thorough search of the literature in the area of music therapy. 3. Cumulative Index to Nursing and Allied Health Literature (CINAHL) Database, Joanna Briggs Institute evidence-based resources, Cochrane Reviews, Medline/PubMed. 4. Measure patient outcomes before instituting the evidence-based change in practice so comparisons can be made after implementation to determine if the intervention worked. 5. Evaluate the results to determine whether the change made a significant difference and if it was worthwhile in terms of cost and time. REVIEW QUESTIONS—CONTENT REVIEW The correct answers are in boldface. 1. (2) is Level I evidence. (1, 3, 4) are not examples of the best evidence. 2. (1) is a nursing database. (2, 3, 4) are primarily medical databases. 1 2 Chapter 2 Answers 3. (3) is the website for the Joint Commission, where you can find the National Patient Safety Goals. (1, 2, 4) are incorrect. 4. (2) is the definition of a randomized clinical trial. (1, 3, 4) are incorrect. 5. (1) is correct. Evidence-based practice begins with a burning question designed to solve a clinical problem. (2, 3, 4) are incorrect. REVIEW QUESTIONS—TEST PREPARATION The correct answers are in boldface. 6. (2, 3, 4, 5, 6) are all independent nursing interventions because no health care provider’s order is required. (1) is a dependent function because it requires a health care provider’s order. 7. (1, 5) are Level I research. (2, 3, 4) are not systematic reviews of randomized controlled trials. 8. (1, 3, 5, 6) because the evidence-based practice process involves “ASKMME!”: ask, search, think, measure, make it happen, and evaluate. (2, 4) are not steps in the process. 9. (2, 3, 5) are correct, as they have been found to be best practice for oral care. (1, 4) do not remove plaque and only freshen the mouth. 10. (4) is correct. The search should be narrowed to include the focus on the question. (1, 2, 3) do not focus on the question being asked.