Evidence-Based Practice in Nursing

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Questions and Answers

What can prolonged use of cold compresses lead to?

  • Hypothermia (correct)
  • Vasodilation
  • Hyperthermia
  • Skin exfoliation

Which alternative method is NOT recommended to reduce fever?

  • Applying hot compresses to the forehead (correct)
  • Maintaining room temperature of 22-24°C
  • Ensuring proper hydration
  • Wiping with lukewarm water

Which of the following is a recommended practice to help manage fever in children?

  • Engaging the child in vigorous physical activity
  • Encouraging hydration to counteract fluid loss (correct)
  • Using ice packs directly on the skin
  • Dressing the child in heavy, layered clothing

What should be done if a child's fever exceeds 39°C and persists?

<p>Consult a doctor for medical advice (B)</p> Signup and view all the answers

Why might cold compresses cause discomfort for some individuals?

<p>Sensitive skin may become irritated (B)</p> Signup and view all the answers

What is the first step in the Evidence-Based Practice process?

<p>Ask a clinical question (B)</p> Signup and view all the answers

Why is it important to critically appraise the evidence gathered?

<p>To ensure the information used is accurate and reliable (C)</p> Signup and view all the answers

What should be done after integrating evidence into clinical practice?

<p>Evaluate the practice decision or change (D)</p> Signup and view all the answers

Who can assist in finding the best evidence when using scientific literature?

<p>A medical librarian (B)</p> Signup and view all the answers

What is a key aspect of the 'Evaluate the Practice Decision or Change' step?

<p>Determining how the intervention works (B)</p> Signup and view all the answers

During critical appraisal, which question is essential to ask?

<p>Will this information work for my patient? (A)</p> Signup and view all the answers

At what point should outcomes of Evidence-Based Practice changes be shared?

<p>After implementing a change (B)</p> Signup and view all the answers

What characteristic is NOT a reason to question and evaluate information in nursing?

<p>To adhere strictly to outdated practices (A)</p> Signup and view all the answers

What type of knowledge is considered to be passed down from generation to generation in nursing practice?

<p>Traditional Knowledge (A)</p> Signup and view all the answers

Which of the following best describes evidence-based practice (EBP) in nursing?

<p>An approach that integrates clinical expertise, current evidence, and patient values (A)</p> Signup and view all the answers

Which source of knowledge relies on expert opinion and is accepted as truth based on the perceived expertise of the individual?

<p>Authoritative Knowledge (B)</p> Signup and view all the answers

What role did Florence Nightingale play in the historical development of evidence-based practice?

<p>She used data to improve patient care during the Crimean War (A)</p> Signup and view all the answers

Which of the following is NOT a benefit of implementing evidence-based practice?

<p>Encourages the use of outdated knowledge (C)</p> Signup and view all the answers

What is the primary focus of scientific knowledge in the context of nursing?

<p>Knowledge derived from the scientific method and research (B)</p> Signup and view all the answers

What is the purpose of critically appraising the evidence in the EBP process?

<p>To ensure the evidence is relevant and reliable (A)</p> Signup and view all the answers

What is a key barrier to evidence-based practice (EBP) in nursing?

<p>Lack of administrative support (D)</p> Signup and view all the answers

What does the PICO question in the case example focus on comparing?

<p>Air-fluidized mattresses and foam mattress overlays (A)</p> Signup and view all the answers

Which of the following misconceptions about EBP may hinder its implementation?

<p>Belief that EBP is irrelevant to patient care (B)</p> Signup and view all the answers

In the context given, what challenge is related to information gathered from journals?

<p>Information overload (C)</p> Signup and view all the answers

Which finding was concluded from the systematic review regarding mattress types for preventing pressure ulcers?

<p>Both types of mattresses have equal preventive effectiveness. (A)</p> Signup and view all the answers

What is mentioned as a reason for resistance to EBP among nurses?

<p>Peer pressure to adhere to traditional methods (C)</p> Signup and view all the answers

Which of the following statements best describes the role of EBP mentors?

<p>They facilitate training and guidance on EBP skills. (D)</p> Signup and view all the answers

What outcome is associated with the proposed intervention of air-fluidized mattresses?

<p>Reduction in pressure ulcer rates (A)</p> Signup and view all the answers

What is the primary benefit of using cold compresses on a child with a fever?

<p>They effectively alleviate swelling and pain. (B)</p> Signup and view all the answers

What is a major limitation of using cold compresses for fever management in children?

<p>They provide only short-term relief from fever. (B)</p> Signup and view all the answers

Which of the following roles does evidence-based practice (EBP) play in nursing?

<p>Enhancing healthcare sustainability. (B)</p> Signup and view all the answers

What is a key method to overcome barriers to implementing evidence-based practice in healthcare?

<p>Encourage a culture of continuous improvement. (A)</p> Signup and view all the answers

Which aspect of evidence-based practice is highlighted as a future consideration in nursing?

<p>Integration of artificial intelligence in evidence appraisal. (D)</p> Signup and view all the answers

In managing a feverish child, what is one method the nursing team currently recommends?

<p>Encouraging the child to drink plenty of fluids. (A)</p> Signup and view all the answers

What concern is associated with the incorrect application of cold compresses?

<p>They may cause tissue damage due to cold burns. (B)</p> Signup and view all the answers

What is the desired outcome of evidence-based practice in nursing?

<p>Improve patient care and ensure healthcare sustainability. (C)</p> Signup and view all the answers

Flashcards

Traditional Knowledge

Knowledge rooted in tradition, passed down through generations without relying on scientific evidence.

Authoritative Knowledge

Knowledge based on an expert's authority or reputation. It's accepted as true because of the expert's perceived credibility.

Scientific Knowledge

Knowledge obtained through systematic research and rigorous scientific methods.

Evidence-Based Practice (EBP)

A healthcare approach that combines clinical expertise, current research evidence, and patient preferences to deliver high-quality care.

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Clinical Question

A question that focuses on a specific clinical problem and guides the search for relevant evidence.

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Critical Appraisal

The process of carefully evaluating the quality, relevance, and applicability of research findings.

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Integration of Evidence

The merging of evidence, clinical expertise, and patient values to make informed decisions about care.

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Evaluation of Practice Change

The systematic evaluation of the effectiveness of a practice change implemented based on evidence-based practice.

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Ask a Clinical Question

Formulating a well-defined question related to a clinical situation to guide the search for evidence.

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Collect the Best Evidence

The process of finding and gathering relevant research studies and other credible sources to answer a clinical question.

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Levels of Evidence

A system to assess the reliability and quality of research studies, helping determine the trustworthiness of evidence.

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Critically Appraise the Evidence

Evaluating the accuracy, reliability, applicability, and potential bias of gathered evidence.

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Integrate the Evidence

Incorporating the evidence into patient care, ensuring its relevance and suitability for the specific situation.

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Evaluate the Practice Decision

Monitoring the outcomes of the practice change implemented based on the evidence.

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Share the Outcomes

Sharing the results of the EBP change with other healthcare professionals to promote knowledge sharing and best practices.

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Barriers to EBP in Nursing: Lack of Skills and Knowledge

The lack of knowledge, skills, or negative attitudes towards evidence-based practice can hinder its implementation.

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Barriers to EBP in Nursing: Time, Resources, and Information Overload

Insufficient time, resources, or an abundance of information can make searching and evaluating evidence overwhelming.

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Barriers to EBP in Nursing: Organizational Constraints

Organizational constraints, lack of administrative support, or the absence of EBP mentors can create challenges.

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Barriers to EBP in Nursing: Traditional Practices and Peer Pressure

Peer pressure to maintain traditional practices can resist new evidence-based approaches.

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PICO Question

A structured question that guides the search for evidence, focusing on Population, Intervention, Comparison, Outcome, and Time.

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EBP Case Example: Pressure Ulcer Prevention

A situation where a nurse uses EBP to determine the best type of mattress for patients at risk for pressure ulcers.

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EBP Research

The systematic process of searching for, critically appraising, and synthesizing research to improve clinical practice.

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Cold Compresses for Fever

Applying cool compresses to the forehead, underarms, or groin can help reduce body temperature.

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Lukewarm Bath for Fever

A lukewarm bath can help lower a child's body temperature gently and safely.

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Cool Environment for Fever

Maintaining a cool room temperature can help regulate a child's body temperature during a fever.

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Hydration for Fever

Fever increases fluid loss, so ensuring adequate hydration can help regulate temperature.

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Light Clothing for Fever

Lightweight clothing allows for better heat dissipation and helps prevent overheating.

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What is a systematic review?

A systematic review is a type of research study that summarizes the findings of multiple individual studies on a specific topic, providing a higher level of evidence than a single study.

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What is Evidence-Based Practice (EBP)?

Evidence-Based Practice (EBP) is a healthcare approach that emphasizes using the best available evidence to make clinical decisions, ensuring that patient care is informed and effective.

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What is a PICO question?

A PICO question is a structured question that helps frame a clinical question for research, focusing on the population, intervention, comparison, and outcome of interest.

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How do cool compresses help manage a fever?

Cool compresses are a common method for managing fever, particularly in children. They work by applying cold to the skin surface, which can reduce fever by increasing heat loss from the body.

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What are limitations of using cool compresses for fever?

While cool compresses can provide temporary relief by reducing heat loss, they only address the symptom of fever and do not treat the underlying cause. This means that the fever may return once the compresses are removed.

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How does paracetamol help reduce fever?

Paracetamol, also known as acetaminophen, is a common fever-reducing medication. It can be used orally or rectally and works by reducing the production of prostaglandins, which contribute to fever.

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Besides cool compresses and medications, what else can help manage a fever?

Other methods for managing fever in children include increasing fluid intake to prevent dehydration, ensuring adequate rest, and maintaining a comfortable room temperature.

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How can Artificial Intelligence (AI) influence evidence appraisal?

Artificial Intelligence (AI) can play a significant role in evidence appraisal by automating tasks like literature searching, data extraction, and analysis, making it easier to identify, evaluate, and synthesize relevant evidence for EBP.

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Study Notes

Evidence-Based Practice in Nursing

  • Evidence-Based Practice (EBP) is an approach to healthcare integrating clinical expertise, best current evidence, and patient values to provide high-quality care.
  • Nursing knowledge is an awareness of reality acquired through learning and investigation.
  • Individuals organize facts to build a relevant knowledge base to their personal experience.

Sources of Nursing Knowledge

  • Traditional Knowledge: This knowledge is passed down through generations. Nurses may rely on what's "always been done". Research may not support these practices.
  • Authoritative Knowledge: Experts' knowledge perceived as factual, like when a senior nurse demonstrates technique to a new nurse.
  • Scientific Knowledge: This knowledge comes from research utilizing the scientific method, with new ideas tested objectively.

Why is EBP Essential in Nursing?

  • Improves patient safety and outcomes.
  • Encourages up-to-date knowledge.
  • Supports professional development.
  • Bridges the research-practice gap.

Historical Development of EBP

  • Florence Nightingale's use of data during the Crimean War is an early example.
  • EBP evolved in the 1970s with greater use of research.
  • Growth in nursing education and practice continues in the 21st century.

Steps of Evidence-Based Practice

  • 1. Ask a Clinical Question: Critically examine existing practice and formulate a question needing clarification.
    • Example questions "How long have you had pain?" and "Can you describe your pain?"
  • 2. Collect the Best Evidence: Use scientific literature and databases (like CINAHL, PubMed, Cochrane) to find relevant research.
  • 3. Critically Appraise the Evidence: Assess the evidence's accuracy, reliability, and applicability to the patient specifically.
    • Example questions are: "Is this information accurate?", "Is this information reliable?", and "Will this information work for my patient?"
  • 4. Integrate the Evidence: Apply the relevant research in the patient's plan of care considering patient preferences.
  • 5. Evaluate the Practice Decision or Change: Assess the consequences of the intervention.
  • 6. Share the Outcomes with Others: Communicate results, improvements, and learnings to share with colleagues and contribute to the wider nursing sphere.

Barriers to EBP in Nursing

  • Lack of EBP skills or knowledge.
  • Misperceptions or negative attitudes about research.
  • Lack of belief EBP improves outcomes.
  • Too much information in journals (overload).
  • Lack of time and resources for searching and appraising evidence.
  • Overwhelming patient loads.
  • Organizational constraints/lack of support.
  • Lack of EBP mentors.
  • Demands for specific treatments from patients.
  • Peer pressure to continue traditional practice.
  • Resistance to change.
  • Lack of consequences for not implementing EBP.
  • Lack of autonomy over practice.

Overcoming Barriers in EBP

  • Provide EBP training programs.
  • Ensure administrative support.
  • Encourage a culture of continuous improvement.

Future of EBP in Nursing

  • Integration of AI in evidence appraisal.
  • Focus on global health challenges.
  • Enhance patient participation in decision-making.

Conclusion

  • EBP is essential to improve patient care, advance nursing practice, and sustain the healthcare system.

Case Examples

  • Managing a Feverish Child: A case study of a child with a fever.
  • EBP Case Example (Mattresses): A case study for using EBP (research) in a situation with patient care relating to pressure ulcers (bed sores).

Further Steps in EBP

  • Identify the problem.
  • Formulate a PICO question.
  • Search for evidence.
  • Discuss the evidence (e.g., benefits/limitations, alternative strategies/questions).
  • Example Questions for Decision-Making (as a nurse): If prioritizing care for a client who is febrile; what intervention would you prioritize for this patient? What are the benefits and limitations of using cool compresses? Besides paracetamol, what other methods are there to reduce fever?

Benefits and Limitations of Using Cold Compresses**

  • Benefits: Fever reduction, pain relief, swelling control, easy/affordable.
  • Limitations: Temporary relief, incorrect application risks (burns, hypothermia), ineffectiveness addressing the cause, discomfort for sensitive skin/children.

Alternative Methods for Reducing Fever

  • Lukewarm bath or wiping.
  • Maintaining a cool environment.
  • Ensuring hydration.
  • Light clothing.
  • Cold compress (damp cloth).
  • Seeking medical advice for severe cases.

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