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Keeping It Real: Evidence-Based Practice in Home Healthcare

doi: 10.1097/01.NHH.0000361923.14550.2c
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Keeping it Real: Evidence-Based Practice in Home Healthcare


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To discuss for registered professional nurses a step-by-step evidence-based practice method that incorporates the nursing process, from assessment of current practice through evaluation of the effectiveness and efficacy of the selected interventions.

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After reading this article and taking this test, you should be able to:

  1. Summarize the concept and sources of evidence-based practice and its relevance for home healthcare nursing.
  2. Outline the essential steps of implementing evidence-based practice in clinical situations.

1. According to Strauss and colleagues, evidence-based practice (EBP) integrates research with clinical expertise and incorporates

a. patients' needs.

b. nurses' values.

c. optimal outcomes.

d. professional issues.

2. Couvillon recommends that home health nurses maintain current knowledge of clinical practice guidelines by

a. meeting regularly with home healthcare staff to discuss changes in practice.

b. becoming familiar with the home healthcare agency's policies and procedures.

c. reviewing the research literature applicable to their area of clinical practice.

d. generating new clinical research derived from their own area of expertise.

3. The first essential step of the method Kitson and colleagues recommend for implementing EBP is

a. recognizing the various stepwise and hierarchical levels of clinical evidence.

b. understanding the various unique terms used in research methodology.

c. developing a well-designed question addressing a problem in clinical practice.

d. searching the literature to obtain evidence in the form of current research.

4. The I in a PICO question stands for a statement of the

a. inquiry.

b. investigation.

c. interpretation.

d. intervention.

5. One of the top six barriers Retsas reported that keeps medical–surgical nurses from engaging in and using research is that

a. they lack the skills needed to evaluate research.

b. statistical analyses are not understandable.

c. they lack support from nursing administration.

d. research is more medical- than nursing-oriented.

6. According to Retsas, one of the three main factors that help nurses participate in and use research is

a. managerial support for research endeavors.

b. programs that teach them search techniques.

c. the availability of a research librarian.

d. professional advice from experienced researchers.

7. One of the first places recommended for home health nurses to use to find evidence is

a. nurse managers.

b. public libraries.

c. the Internet.

d. nursing textbooks.

8. Before best practices can be accepted, they must be applicable to the situation and

a. systematically reviewed.

b. available to users.

c. made mandatory.

d. federally endorsed.

9. Which of the following is a free online database of biomedical journal citations and abstracts created by the U.S. National Library of Medicine?

a. PubMed

b. Medline

c. the Cochrane Collaboration

d. the National Guideline Clearinghouse

10. Which of the following provides access to systematic reviews of healthcare research and promotes the use of EBP?

a. PubMed

b. Medline

c. the Cochrane Collaboration

d. the National Guideline Clearinghouse

11. Which of the following brings together authoritative information from the National Institutes of Health and other government agencies and health-related organizations?

a. PubMed

b. Medline

c. the Cochrane Collaboration

d. the National Guideline Clearinghouse

12. Excluding research, the least understood and explored source of evidence is

a. patients.

b. caregivers.

c. clinical experts.

d. the local context and environment.

13. According to Rycroft-Malone and colleagues, the challenge is to ensure that each type of evidence is

a. robust.

b. reliable.

c. accurate.

d. applicable.

14. The most critical step of EBP is to

a. evaluate the evidence for usefulness, relevance, accuracy, and validity.

b. search the literature for evidence addressing the clinical question.

c. evaluate how the application of the evidence has affected the patient.

d. apply the evidence collected in the previous steps to a patient situation.

15. Murtaugh's agency-driven "push" method that identifies patients who are candidates for a particular EBP guideline and then e-mails the guideline to the nurse prior to each visit is called the

a. resource-delivery approach.

b. visit-specific method.

c. just-in-time approach.

d. ready-set-go method.

16. In 2003, how many of the 1,026 guidelines summarized in the National Guidelines Clearinghouse mentioned home care?

a. 35

b. 135

c. 235

d. 335



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