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Questions and Answers
Which of the following can cause discomfort for sensitive skin when used to reduce fever?
Which of the following can cause discomfort for sensitive skin when used to reduce fever?
What is the recommended room temperature for a child with a fever?
What is the recommended room temperature for a child with a fever?
Which of the following can help reduce fever by aiding in heat dissipation?
Which of the following can help reduce fever by aiding in heat dissipation?
What is the maximum temperature at which a fever should be treated with alternative methods before seeking medical advice?
What is the maximum temperature at which a fever should be treated with alternative methods before seeking medical advice?
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What is the reason for avoiding excessive movement when a child has a fever?
What is the reason for avoiding excessive movement when a child has a fever?
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Which type of knowledge is based on the idea that something is true because it has always been done that way?
Which type of knowledge is based on the idea that something is true because it has always been done that way?
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Which of these examples describes the use of authoritative knowledge?
Which of these examples describes the use of authoritative knowledge?
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Which of the following is NOT a benefit of Evidence-Based Practice (EBP)?
Which of the following is NOT a benefit of Evidence-Based Practice (EBP)?
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What is the first step in the evidence-based practice process?
What is the first step in the evidence-based practice process?
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What is one of the key components of Evidence-Based Practice?
What is one of the key components of Evidence-Based Practice?
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Which of the following accurately describes the historical development of EBP?
Which of the following accurately describes the historical development of EBP?
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How does EBP contribute to professional development?
How does EBP contribute to professional development?
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Which step of EBP involves considering the patient's preferences and values in making a practice decision?
Which step of EBP involves considering the patient's preferences and values in making a practice decision?
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Which of the following is NOT a barrier to Evidence-Based Practice (EBP) in Nursing?
Which of the following is NOT a barrier to Evidence-Based Practice (EBP) in Nursing?
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What is the key benefit of participating in professional organizations for nurses in relation to EBP?
What is the key benefit of participating in professional organizations for nurses in relation to EBP?
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In the EBP case example, what is the 'Intervention' being considered?
In the EBP case example, what is the 'Intervention' being considered?
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What is the main reason the director of nurses is hesitant to recommend the air-fluidized mattresses?
What is the main reason the director of nurses is hesitant to recommend the air-fluidized mattresses?
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What is the 'Population' identified in the PICO question for the pressure ulcer case example?
What is the 'Population' identified in the PICO question for the pressure ulcer case example?
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Which of the following is the most appropriate research question for the EBP case example?
Which of the following is the most appropriate research question for the EBP case example?
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Which of these is NOT a common barrier to EBP implementation in nursing?
Which of these is NOT a common barrier to EBP implementation in nursing?
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Which of these is NOT a key component of a PICO question?
Which of these is NOT a key component of a PICO question?
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What should nurses do when they gather information during Evidence-Based Practice?
What should nurses do when they gather information during Evidence-Based Practice?
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Why is it important to question information gathered during Evidence-Based Practice?
Why is it important to question information gathered during Evidence-Based Practice?
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What is a crucial reason for sharing outcomes of Evidence-Based Practice changes?
What is a crucial reason for sharing outcomes of Evidence-Based Practice changes?
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Which step follows the integration of evidence into practice?
Which step follows the integration of evidence into practice?
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What role does a medical librarian play in Evidence-Based Practice?
What role does a medical librarian play in Evidence-Based Practice?
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What is not a key question to ask when critically appraising evidence?
What is not a key question to ask when critically appraising evidence?
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How is the reliability of scientific research typically assessed?
How is the reliability of scientific research typically assessed?
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What is a primary benefit of using cold compresses in children?
What is a primary benefit of using cold compresses in children?
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What is a limitation of using cold compresses for fever management?
What is a limitation of using cold compresses for fever management?
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In managing the fever of the child, what is an appropriate initial intervention according to current practices?
In managing the fever of the child, what is an appropriate initial intervention according to current practices?
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What role does continuous improvement culture play in Evidence-Based Practice (EBP)?
What role does continuous improvement culture play in Evidence-Based Practice (EBP)?
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What does Level I evidence consist of in the context of evidence-based practice?
What does Level I evidence consist of in the context of evidence-based practice?
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What is one potential risk associated with improper use of cold compresses?
What is one potential risk associated with improper use of cold compresses?
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How can artificial intelligence enhance evidence appraisal in nursing?
How can artificial intelligence enhance evidence appraisal in nursing?
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Which aspect of future nursing practice focuses on collaboration with patients?
Which aspect of future nursing practice focuses on collaboration with patients?
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Study Notes
Evidence-Based Practice in Nursing
- Evidence-Based Practice (EBP) is an approach to healthcare integrating clinical expertise, current best evidence, and patient values to provide high-quality care.
- Knowledge is awareness of reality, gained through learning or investigation.
- Individuals collect, organize, and arrange facts to build a knowledge base relevant to their personal reality.
Sources of Nursing Knowledge
- Traditional Knowledge: Information passed down through generations in nursing practice. Nurses often justify actions by saying "we've always done it this way," but there may be no evidence supporting this.
- Authoritative Knowledge: Accepted as truth based on an expert's perceived expertise, often from senior staff nurses teaching new graduates more efficient procedures, like IV catheter insertion.
- Scientific Knowledge: Knowledge derived from the scientific method—implying research. New ideas are tested and measured systematically using objective criteria.
Why EBP is Essential in Nursing
- Improves patient safety and outcomes.
- Encourages the use of up-to-date knowledge, supporting professional development.
- Bridges the gap between research and practice.
- Requires nurses to update their knowledge base.
Historical Development of EBP
- Florence Nightingale's use of data during the Crimean War is an early example of EBP.
- Evolution in the 1970s saw research-based practices become more prominent in nursing.
- 21st-century expansion in nursing education significantly expanded use of EBP.
Steps of Evidence-Based Practice
- 1. Ask a clinical question: Thinking critically about care for patients to clarify unclear or illogical procedures; asking questions like "How long have you had pain?" or "Can you describe your pain?"
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2. Collect the best evidence: Using scientific literature databases (like CINAHL, MEDLINE, EMBASE, PsycINFO), Cochrane Database of Systematic Reviews, and National Guidelines Clearinghouse to search for evidence, or Google Scholar.
- Use these databases for studies, summaries, guidelines, and other pertinent information.
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3. Critically appraise the evidence: Evaluating quality and applicability of gathered information to ensure accuracy, reliability, and relevance for specific patients to avoid harm.
- Ask critical questions like: "Is this information accurate?", "Is this information reliable?", "Will this work for my patient?"
- 4. Integrate the evidence: Applying the evidence to the patient's specific situation and clinical expertise to make a practice change or decision. Using the research to improve plan of care.
- 5. Evaluate the practice decision/change: Assessing the outcome of the applied evidence to see if it achieves the desired impact; asking "How does the intervention work?"
- 6. Share the outcomes: Communicating EBP changes' outcomes to other colleagues and organizations. Sharing results of the EBP at conferences, or in writing (e.g., abstracts, posters, presentations).
Barriers to Evidence-Based Practice in Nursing
- Lack of skills or knowledge in EBP.
- Misperceptions or negative attitudes toward research.
- Lack of belief that EBP improves outcomes.
- Information overload in journals.
- Lack of time and resources to search for and appraise evidence.
- Overwhelming patient loads.
- Organizational constraints; lack of administrative support.
- Lack of mentors to guide and support EBP.
- Demands from patients or pressure to practice in traditional ways.
- Resistance to change.
Overcoming Barriers to EBP
- Provide training programs in EBP.
- Ensure administrative support and commitment
- Encourage a culture of continuous improvement.
Future of EBP in Nursing
- Integration of artificial intelligence to support evidence appraisal.
- Focus on global health challenges.
- Patient participation in decision-making processes.
Conclusion
- EBP is essential for improving patient care, advancing nursing practice, and sustaining healthcare.
Case: Managing a Feverish Child
- Patient: An 8-year-old boy with a high fever and fatigue.
- Situation: The nursing team needs to decide on the best methods to manage the child's fever, given that existing treatments aren't working.
Simple Discussion Questions
- If you were the nurse, which intervention would you prioritize?
- What are the benefits and limitations of using cool compresses?
- Besides paracetamol, what other methods can be used to help reduce fever?
Benefits and Limitations of Using Cold Compresses
- Benefits: Reducing fever, pain relief, and swelling control, are affordable, and easily applied.
- Limitations: Only temporarily effective, possible risk of incorrect application (causing tissue damage or hypothermia), and ineffective if addressing the underlying cause of the fever.
Alternative Methods to Reduce Fever
- Lukewarm baths or gentle wiping.
- Maintaining a cool environment.
- Ensuring hydration.
- Using light clothing to prevent heat trapping.
- Cold compress or damp cloth; applied to forehead, underarms, or groin.
- Proper rest in proper position.
- Herbal remedies; seeking medical advice if fever exceeds 39°C or symptoms persist.
EBP Case Example
- Population: Adult inpatients at risk for pressure ulcers.
- Intervention: Air-fluidized mattress
- Comparison: Foam-mattress overlays.
- Outcome: Pressure ulcer rates.
- Time: Time to reduce rates of pressure ulcers.
- PICO Question: Is the use of air-fluidized mattresses associated with lesser rates of pressure ulcers than foam-mattress overlays among adult inpatients at risk for pressure ulcers?
- Finding: Systematic review suggests that both mattress types are equally effective in reducing pressure ulcers; air-fluidized mattresses are more expensive.
- Recommendation: Patient in this case wouldn't purchase expensive air-fluidized mattresses based on this information.
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Description
This quiz explores the fundamental concepts of Evidence-Based Practice (EBP) in nursing, focusing on sources of knowledge that inform nursing practices. It distinguishes between traditional, authoritative, and scientific knowledge, emphasizing the importance of integrating clinical expertise and research for high-quality patient care.
