Unit 2_1-5: Stages of Evidence-Based Practice
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Questions and Answers

What was the main driving force behind the emergence of evidence-based practice in healthcare?

  • The need to reduce healthcare costs
  • Government regulations mandating evidence-based practice
  • An increase in patient demand for evidence-based care
  • The absence of evidence supporting medical treatment decisions (correct)

    • Which individual is often referred to as the 'father of evidence-based medicine'?

  • Stetler Model
  • Iowa Model
  • Archibald Cochrane (correct)
  • Johns Hopkins

    • In what decade did the evidence-based practice movement officially begin?

  • 2000s
  • 1980s (correct)
  • 1960s
  • 2010s

    • Which journal published the breakthrough article that launched the evidence-based medicine movement in 1992?

    <p>Journal of the American Medical Association</p> Signup and view all the answers

    What type of evidence is considered most scientific and reliable?

    <p>Random clinical trials</p> Signup and view all the answers

    Who can help nurses sift through a large amount of medical information and filter studies for a practice change?

    <p>Medical science librarians</p> Signup and view all the answers

    What is the primary focus of the Canadian Task on the Periodic Health Examination's Levels of Evidence?

    <p>Grading evidence for practice change</p> Signup and view all the answers

    Which type of study identifies causality and effect on participants?

    <p>Observational studies</p> Signup and view all the answers

    What is Level III evidence according to the Canadian Task on the Periodic Health Examination's Levels of Evidence?

    <p>Expert opinions</p> Signup and view all the answers

    What provides a high level of confidence due to its evaluation based on systematic reviews?

    <p>Random clinical trials</p> Signup and view all the answers

    'A systematic review summarizes the results of available carefully designed healthcare studies (controlled trials).' Which organization or group provided this definition in the text?

    <p>The Cochran Collaboration</p> Signup and view all the answers

    'Librarians have an excellent skill set for conducting scholarly searches.' This statement implies that librarians are skilled in what specific task?

    <p>Conducting scholarly searches</p> Signup and view all the answers

    'The first level in grading the evidence is focused on evidence that is derived from random clinical trials.' What is the key characteristic of evidence at this level?

    <p>'Evidence that is often evaluated based on systematic reviews'</p> Signup and view all the answers

    'Systematic reviews are most often used with the development of clinical guidelines.' What role do systematic reviews play in developing clinical guidelines?

    <p>'Promote a standard of care'</p> Signup and view all the answers

    What does the absence of clear evidence to support a practice change prompt healthcare providers to consider?

    <p>Considering qualitative data and expert opinions</p> Signup and view all the answers

    Besides understanding different types of research studies, what does grading evidence require primary care providers to determine?

    <p>The strength of the evidence collected</p> Signup and view all the answers

    What does Evidence-Based Medicine (EBM) de-emphasize according to the text?

    <p>Pathophysiologic rationale</p> Signup and view all the answers

    What is the expanded definition of Evidence-Based Practice (EBP) according to the text?

    <p>Integrating high-quality studies, clinician's expertise, and patient preferences</p> Signup and view all the answers

    What was the predominant method governing nursing practice years ago according to the text?

    <p>Tradition, textbooks, and senior nurses' standards</p> Signup and view all the answers

    What prompted a paradigm shift in nursing practice thinking according to the text?

    <p>All of the above</p> Signup and view all the answers

    What is the primary challenge highlighted in relation to new medical knowledge according to the text?

    <p>Translating knowledge into clinical practice</p> Signup and view all the answers

    What does translational research entail according to the text?

    <p>Transferring empirically based understanding into clinical practice</p> Signup and view all the answers

    What describes the skill set required for PCPs in translational research according to the text?

    <p>Translating evidence through grading and critique</p> Signup and view all the answers

    How is defining practice change typically initiated for PCPs according to the text?

    <p>&quot;Why&quot; questions about existing policies or procedures</p> Signup and view all the answers

    What does a tedious search of evidence involve according to the text?

    <p>Skillful filtering through hundreds of research articles</p> Signup and view all the answers

    Who often initiates the search for evidence-based interventions for defining best practice standards according to the text?

    <p>Single providers asking questions about current policies or procedures</p> Signup and view all the answers

    What is a mandatory requirement for improving healthcare delivery according to Qidwai?

    <p>Application of latest research findings into clinical practice</p> Signup and view all the answers

    What is essential for PCPs in conducting a strong and accurate search of the literature according to the text?

    <p>Skill set to filter through hundreds of articles for relevant information</p> Signup and view all the answers

    What is the primary purpose of the evaluation for a primary care provider (PCP) researcher, according to the text?

    <p>To weigh the ability to operationalize recommended interventions</p> Signup and view all the answers

    Which type of research methodology is associated with the purpose of 'What is it?' as outlined in Table 2.2?

    <p>Structured interviews</p> Signup and view all the answers

    What aspect does the evidence ranking system in Table 2.2 help primary care providers understand better?

    <p>How evidence can support practice change</p> Signup and view all the answers

    Which level of question in Table 2.2 aims to determine cause-and-effect relationships among variables?

    <p>Level III</p> Signup and view all the answers

    According to Table 2.3, which grade signifies being very confident that the estimate of effect is close to the true effect?

    <p>High</p> Signup and view all the answers

    What type of studies are used in Level II questions as per Table 2.2?

    <p>Cross-sectional studies</p> Signup and view all the answers

    The evidence ranking system can best inform which of the following aspects for primary care providers?

    <p>Policy development or revision</p> Signup and view all the answers

    'To determine predictability of hypothesized outcome at specific dose in selected population' corresponds to which level of question in Table 2.2?

    <p>IV</p> Signup and view all the answers

    What does high grade strength of evidence signify according to Table 2.3?

    <p>High confidence in effect estimate</p> Signup and view all the answers

    What is the main focus of Level III questions in Table 2.2?

    <p>Determining cause-and-effect relationships among variables</p> Signup and view all the answers

    In which type of study might you observe a 'Mann-Whitney U test' based on Table 2.2?

    <p>Cross-sectional study</p> Signup and view all the answers

    What is the key determinant for primary care providers when deciding which evidence to include in the supportive literature?

    <p>Ease of applicability and implementability of recommended interventions</p> Signup and view all the answers

    What is the purpose of grading the strength of evidence in health care interventions?

    <p>To ensure a practice change is promoted</p> Signup and view all the answers

    In Lewin's change theory, what is the first step in the three-step model of change?

    <p>Unfreezing</p> Signup and view all the answers

    What distinguishes Lewin's theory of planned change from accidental or imposed change?

    <p>Force-field analysis</p> Signup and view all the answers

    What does Lewin's change theory suggest to achieve successful organizational change?

    <p>Analyzing and understanding forces</p> Signup and view all the answers

    Which characteristic best describes Lewin's theory of behavior change according to the text?

    <p>Dynamic balance</p> Signup and view all the answers

    What term did Kurt Lewin introduce to distinguish planned change from other types of change?

    <p>'Planned' change</p> Signup and view all the answers

    In Lewin's force-field analysis, what do driving forces do?

    <p>Facilitate movement toward change</p> Signup and view all the answers

    What does Lewin suggest is necessary to shift the balance towards planned change?

    <p>'Understanding' and 'analyzing' the forces</p> Signup and view all the answers

    What characterizes successful organizational change according to Kurt Lewin?

    <p>Analyzing and understanding forces.</p> Signup and view all the answers

    In Lewin's force-field analysis, what do driving forces aim to do?

    <p>Facilitate movement towards desired change.</p> Signup and view all the answers

    What is the last stage in Rogers' innovation-decision process?

    <p>Confirmation</p> Signup and view all the answers

    What are the five categories of adopters identified by Rogers in the diffusion of innovation theory?

    <p>Innovators, Early adopters, Early majority, Late majority, Laggards</p> Signup and view all the answers

    What does Rogers identify as one of the attributes that predict the rate of adoption of innovations?

    <p>Complexity</p> Signup and view all the answers

    Which element of the diffusion process does Rogers NOT propose as a fundamental element?

    <p>Innovation-decision process</p> Signup and view all the answers

    What is the first stage individuals pass through during the adoption of a new idea according to Rogers' innovation-decision process?

    <p>Knowledge</p> Signup and view all the answers

    Which group is characterized as being change averse, conservative, and skeptical of change in Rogers' diffusion of innovation theory?

    <p>Laggards</p> Signup and view all the answers

    What is the process in which an individual develops an attitude about an innovation according to Rogers?

    <p>Persuasion</p> Signup and view all the answers

    According to Rogers, who are likely to be opinion leaders embracing change opportunities?

    <p>Early adopters</p> Signup and view all the answers

    What is the term used for hardwiring a desired change through new norms and operating procedures as per the text?

    <p>Refreezing</p> Signup and view all the answers

    Which stage in Rogers' innovation-decision process involves putting the innovation into use and potentially seeking additional evidence?

    <p>Implementation</p> Signup and view all the answers

    What is the term used to describe individuals who are willing to take risks and are the first to adopt innovations?

    <p>Innovators</p> Signup and view all the answers

    According to Rogers, what category of adopters typically adopt new ideas slower than others and are not often leaders?

    <p>Early majority</p> Signup and view all the answers

    What are the key factors proposed by the PARIHS framework that influence successful implementation of evidence-based practices?

    <p>Quality and type of evidence, characteristics of the setting or context, and the way evidence is introduced</p> Signup and view all the answers

    What was the key update made to the PARIHS framework in 2015?

    <p>Refinement of the original framework</p> Signup and view all the answers

    Which term describes the way new knowledge moves into practice according to the PARIHS framework?

    <p>Implementation facilitation</p> Signup and view all the answers

    What does the PARIHS framework propose as a determinant factor for successful implementation of evidence-based practices?

    <p>Interplay and interdependence of factors</p> Signup and view all the answers

    What is the purpose of determinant frameworks, classic theories, and implementation theories?

    <p>To understand and explain what influences implementation outcomes</p> Signup and view all the answers

    Which model is described as widely used and practical for the systematic implementation of evidence-based practice (EBP)?

    <p>Iowa Model of Evidence-Based Practice to Promote Quality Care</p> Signup and view all the answers

    What does the Iowa Model of Evidence-Based Practice use to guide decision-making?

    <p>Flowchart</p> Signup and view all the answers

    Which model explicitly includes patient and family values and preferences in its revised version?

    <p>Iowa Model of Evidence-Based Practice to Promote Quality Care</p> Signup and view all the answers

    What is the major focus of the ACE Star Model of Knowledge Transformation?

    <p>Knowledge transformation</p> Signup and view all the answers

    What are the stages depicted in the ACE Star Model of Knowledge Transformation?

    <p>Discovery research, evidence summary, translation to guidelines, practice integration, process evaluation</p> Signup and view all the answers

    What significant change was made to the Iowa Model of Evidence-Based Practice in the revised version?

    <p>Explicit inclusion of patient and family values and preferences</p> Signup and view all the answers

    What distinguishes the ACE Star Model from other models discussed in the text?

    <p>Comprehensive framework for translating evidence into practice</p> Signup and view all the answers

    What drives the development of classic theories and implementation theories according to the text?

    <p>Influences on implementation outcomes</p> Signup and view all the answers

    Which model is designed for nurses and other clinicians at the point of care?

    <p>Iowa Model of Evidence-Based Practice to Promote Quality Care</p> Signup and view all the answers

    What is a characteristic that sets the Iowa Model apart from other models discussed in the text?

    <p>Diversity in application settings</p> Signup and view all the answers

    Which stage of the ACE Star Model of Knowledge Transformation involves implementing evidence and causing a change in practice?

    <p>Practice integration</p> Signup and view all the answers

    What is the primary aim of the JHNEBP model mentioned in the text?

    <p>To facilitate incorporation of research findings into patient care</p> Signup and view all the answers

    Which model is described as a practitioner-oriented process model that emphasizes critical thinking and links research use with evidence-informed practice?

    <p>Stetler Model</p> Signup and view all the answers

    How many phases does the Stetler Model consist of according to the text?

    <p>5 phases</p> Signup and view all the answers

    Which model was refined in 1994 and updated in 2001, placing significant emphasis on the critical thinking process?

    <p>Stetler Model</p> Signup and view all the answers

    What is the starting point in the 2017 revised JHNEBP model?

    <p>&quot;Inquiry&quot;</p> Signup and view all the answers

    The implementation of an evidence-based clinical practice guideline would typically fall under which stage of the ACE Star Model of Knowledge Transformation?

    <p>Translation into action</p> Signup and view all the answers

    Which model provides a practical guide for clinicians to incorporate the latest research findings and best practices into patient care?

    <p>JHNEBP Model</p> Signup and view all the answers

    'Practice integration' in the ACE Star Model primarily focuses on what aspect of evidence-based practice implementation?

    <p>&quot;Implementing evidence and causing a change in practice&quot;</p> Signup and view all the answers

    What essential process does the JHNEBP model assist clinicians with according to the text?

    <p>Translating research findings into actionable guidelines for practice</p> Signup and view all the answers

    Which phase of the Stetler Model focuses on facilitating critical thinking about the practical application of research findings?

    <p>Comparative evaluation/decision-making</p> Signup and view all the answers

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