Evidence-Based Practice Quiz 1 with 100% CORRECT ANSWERS GUARANTEE SUCCESS!!! 2024 EDITI, Exams of Nursing

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Evidence-Based Practice Quiz 1 with 100% CORRECT ANSWERS GUARANTEE SUCCESS!!! 2024 EDITION Steps of EBP (6) - SOLUTION 1) Ask an answerable question (Picot format) 2) Find the evidence to answer the question (using relevant research) 3) Critically appraise/evaluate the evidence 4) Integrate the appraised evidence into clinical practice with ones clinical expertise, patient preferences and values in making a decision or change 5) Evaluate the outcomes of the change 6) Disseminate (optional step) Goal of EBP - SOLUTION Reduce variability in practice to improve quality care by reducing costs and injury Quality Improvement - SOLUTION Utilizes a system to monitor and evaluate the quality and appropriateness of care (outcomes) based on EBP and research Occurs at the local level with the intent to improve outcomes Dimensions of EBP (3) - SOLUTION 1) Best available research 2) Clinical Expertise 3) Patient Preference Standards of Care - SOLUTION Type of evidence Baseline description of quality Identifies what a responsibly prudent nurse would do Clinical Practice guidelines - SOLUTION Type of evidence Broad-based recommendations - Are systemically developed statements that help clinicians and patients make decisions about healthcare for specific clinical circumstances. - ** National Guidelines: uses quantifiable measures with national benchmarks or quality goals Critical pathways - SOLUTION Type of evidence Identify key/critical activities that must occur in a predictable fashion Protocols - SOLUTION Type of evidence Detailed procedures on how to proceed with evaluation and treatment System Barriers to EBP - SOLUTION - Lack of time to locate and synthesize knowledge - Access to the internet and computerized resources - The perception of lack of authority to change practice - Organizational constraints and lack of support - Peer pressure to continue with practices that are steeped in tradition Individual Barriers to EBP - SOLUTION Knowledge Attitude Behaviors Steps of Research Process (7-8) - SOLUTION 1) Define the problem 2) Review of Literature 3) Formulate the hypothesis/research question 4) Select the research design 5) Data collection 6) Test the hypothesis through data analysis 7) Interpretation: compare results to previous established theory or findings Problem Statement - SOLUTION In step 1 of research 4) Aesthetic: Based on nurse intuition, interpretation, understanding, and personal values. When evaluating evidence people look at: - SOLUTION - Study design - Quality - Consistency - Applicability Quality Improvement Strategies - SOLUTION - Product improvement - Process improvement - People based improvement PDSA aka Explain - SOLUTION Deming Cycle Model of a pogical sequence of four repetitive steps for continuous quality improvement and learning Plan: Plan ahead for change. Analyze and predict results. Do: Execute the plan, taking small steps in controlled circumstaces Study: Check, study the results Act: Take action to standardize or improve the process Six Sigma - SOLUTION - Improves the quality of process outputs by identifying and removing the causes of defects and minimizing variability - Statistical process control, design of experiments, failure more and effects analysis (FMEA) in an overall framework - Disciplined, data-driven approach and methodology for eliminating defects - Creates an infrastructure of quality people within the organization, similar to a black belt system. FMEA - SOLUTION Failure mode and effect analysis used in six sigma Phases of Six Sigma (5) - SOLUTION 1) Define: Who is the customer and what are their needs? 2) Measure: How is the process defined and how are defects measured? 3) Analyze: What are the most important causes of the defects? 4) Improve: How can the causes of the defects be eliminated? 5) Control: What actions are needed to sustain improvement? Lean Product System - SOLUTION Maximize customer value while minimizing wastes to provde perfect value through a perfect value creation process that has zero waste. Lean Product System Phases* - SOLUTION 1) Identify patient population and value 2) Map value stream 3) Get rid of waste 4) Respond to what patients see as valuable 5) Pursue perfection Root Cause Analysis - SOLUTION - Objective is to identify the real cause of a problem, not the symptoms. - Root causes are: - Statements describing the deepest underlying cause, or causes, of performance challenges Root Cause Analysis Tools - SOLUTION 5 Whys Model Fish Bone diagram Fish Bones (6) - SOLUTION - Man (people) - Machines - Mother Nature (environment) - Methods - Materials - Measurements Components of Background Question - SOLUTION 1) The starting place of the question (how, why, when where, what) 2) The outcome of interest Ex: How does advil affect fever? Foreground Question - SOLUTION - PICOT - Asks for specific scientific evidence about diagnosing, treating, or educating patients Intervention Question - SOLUTION What intervention most effectively leads to an outcome? In __________(P), how does _________(I) compared to _________(C) affect _________(O) within _____(T)? Prognosis/Prediction Question - SOLUTION - What indicators are more predictive of an outcome? In __________(P), how does _________(I) compared to _________(C) influence/predict _________(O) over _____(T)? Diagnosis Question - SOLUTION - What test most accurately diagnosis an outcome? Etiology Question - SOLUTION - To what extent is a factor associated with an outcome? - Are __________(P) who have _________(I) compared to those without _________(C) at risk for _________(O) over _____(T)? Meaning Questions - SOLUTION - How does an experience influence an outcome? - How do __________(P) with _________(I) perceive _________(O) during _____(T)? Quality Indicators - Critically appraise the conduct of research - Critically appraise the outcomes - Appraise the overal quality - Strengths, weakness, contributions, suggestions? Ethical Considerations of Quantitative Research - SOLUTION - autonomy/confidenciality - non-malfience - beneficence - justice Validity - SOLUTION Ability of an instrument to measure what it is supposed to measure Face validity - SOLUTION assesses the constcut you wish to study? - Thermometer measures temp Construct Validity - SOLUTION Is the construct measured by the tool the right construct? Criterion related Validity - SOLUTION used to predict future performance: - relationship between course grades and NCLEx scores Inter-rater Reliability - SOLUTION degree to which different judges agree in their assessment Test-retest Reliability - SOLUTION reliability obtained by administering the same test twice over a period of time to a group of individuals Parallel forms Reliability - SOLUTION reliability of administering different versions of an assessment Internal consistency Reliability - SOLUTION do test items probe the same construct with similar results? Odds Ratio - SOLUTION Measure of association between an exposure and an outcome. The odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in absence of that exposure Relative Risk Ratio/Risk Ratio: - SOLUTION Ratio of probability of an event occurring in an exposed group to the probability of the event occurring in a comparison, non exposed group. Similar compenents between qualitative and qunaititative - SOLUTION Title Abstract Intro Reivew of literature Triangulation - SOLUTION looked at things from more than one angle in qualitative research Failure Models Steps - SOLUTION Select a high-risk process and assemble a team - Diagram the process - Brainstorm potential failure modes 1) Calculate the risk priority number 2) Prioritize failure modes 3) Identify contributing factors of failure modes 4) Redesign process 5) Analyze and test the new process 6) Implement and monitor the redesigned FADEE QI Model - SOLUTION Failure Model FOCUS: define and verify the process to be improved ANALYZE: Collect and analyze data to establish baselines, identify root causes and point toward possible solutions DEVELOP: Based on the data, develop action plans for improvement, including implementation, communication, and measuring/monitoring EXECUTE: Implement the action plans, on a pilot basis as indicated and EVALUATE: Install an ongoing measuring or monitoring (process control) system to ensure success Quality Indicators In Evidence Based resources - SOLUTION Title Author Abstract Writing style