Chapter 5 Flashcards
What action by a nurse leader would best implement evidence-informed practice at a community nursing centre that serves a large Cuban immigrant population?
a. Having university experts with cultural competency expertise review the centre’s policies
b. Having weekly staff meetings for the purpose of determining which methods seem to work best when helping immigrants
c. Including Cuban immigrants from the community on the centre’s advisory board
d. Sending centre staff to conferences and seminars that focus on providing health care to immigrants from Spanish-speaking countries
c. Including Cuban immigrants from the community on the centre’s advisory board
Including Cuban immigrants on the advisory board is the best choice because it represents the application of evidence-informed practice (EIP) in a real-world, community setting.
Evidence-informed practice isn’t just about reading journal articles or attending seminars—it’s about integrating:
• The best available research
• Clinical expertise
• And crucially, client values, preferences, and lived experiences
By involving Cuban immigrants directly in the care planning process, the nurse leader is applying EIP through the use of contextual and experiential evidence. This creates culturally relevant, community-driven strategies that align with the actual needs of the population being served
Which activity to determine the best way to address an outbreak of a new infectious disease exemplifies evidence-informed practice?
a. Reviews policies and procedures
b. Reviews outcomes of clinical trials
c. Reviews several nursing textbooks
d. Gets information from the Internet
b. Reviews outcomes of clinical trials
The key phrase in the question is “evidence-informed practice.”
Why is the correct answer “b. Reviews outcomes of clinical trials”?
• Evidence-informed practice (EIP) refers to making decisions based on the best available scientific research, clinical expertise, and patient preferences.
• Clinical trials provide the strongest form of evidence in healthcare because they use systematic research methods to test treatments and interventions.
• Reviewing clinical trial outcomes ensures that the decision-making process is based on high-quality, peer-reviewed, and scientifically validated evidence.
Why not the other options?
• (a) Reviews policies and procedures – While important, policies may be outdated and not necessarily based on the latest evidence.
• (c) Reviews several nursing textbooks – Textbooks can be useful, but they may not reflect up-to-date research or the latest clinical trial findings.
• (d) Gets information from the Internet – The internet has varying reliability, and not all sources are peer-reviewed or evidence-based.
What is the biggest challenge for community health nurses (CHNs) who are familiar with evidence-informed practice and want to implement it in their care of clients?
a. Interpreting vast amounts of evidence and integrating it into practice
b. Advocating for change and convincing others that it is beneficial
d. Distinguishing evidence-informed practice from practice based on old standards
d. Showing clients that evidence-informed practice will improve their health outcomes
a. Interpreting vast amounts of evidence and integrating it into practice
Why is “Interpreting vast amounts of evidence and integrating it into practice” the biggest challenge?
• Information overload: New research is constantly emerging, making it difficult to keep up.
• Conflicting evidence: Studies sometimes show different results, requiring critical analysis to determine the best approach.
• Time constraints: CHNs are already balancing patient care, community programs, and administrative work.
• Resource limitations: Not all healthcare settings have access to the latest research, training, or technology to support evidence-informed practice.
How do nurses manage this challenge?
1. Using Clinical Guidelines – Instead of reading every study, nurses rely on systematic reviews, meta-analyses, and guidelines from trusted organizations (e.g., WHO, CDC, RNAO).
2. Collaborating with Experts – Consulting with researchers, epidemiologists, or evidence-based practice specialists can help in decision-making.
3. Continuing Education – Attending workshops, webinars, and professional development courses helps nurses stay updated.
4. Applying Critical Thinking – Nurses evaluate research relevance, validity, and applicability to their patient population.
A community health nurse (CHN) plans to use evidence-informed practice to guide the development of health education programs that are most likely to increase retention of information in elementary school children. Which of the following represents the best way to use evidence-informed practice in this situation?
a. Asking other CHNs about what they included in their own education programs
b. Comparing and contrasting findings from randomized clinical trials related to learning in elementary school children
c. Developing a series of games to accompany the programs developed to promote health
d. Seeking out and examining information on the Internet on health education programs for elementary school children
b. Comparing and contrasting findings from randomized clinical trials related to learning in elementary school children
A health care provider is concerned about the high number of clients with type 2 diabetes who have poor glucose control. In order to implement evidence-informed practice to manage this problem, what would be the best reference for the health care provider to use?
a. Published protocols
b. Current research findings (scientific knowledge)
c. Opinions of colleagues
d. Media reports
b. Current research findings (scientific knowledge)
A community health nurse (CHN) implemented an education program that incorporated computer games to reinforce learning in a community of older persons. Although earlier research had demonstrated evidence of improved retention of information by using this method, the CHN found exactly the opposite effect in this group of clients.
What would be the most likely cause of the poor outcome in the education program?
a. Failure to consider client and contextual differences
b. Inadequate incorporation of evidence into practice
c. Inferior quality of the available research evidence
d. The CHN’s lack of skills in evaluating the evidence
a. Failure to consider client and contextual differences
This question is about evidence-informed practice (EIP) and the importance of contextualizing research findings before applying them to specific populations.
Why is the correct answer “a. Failure to consider client and contextual differences”?
• The nurse used research evidence, but it did not work in this setting because the population (older adults) was different from the research population.
• Context matters—what works for one group may not work for another due to age, culture, cognitive ability, health literacy, or access to technology.
• Older adults may not be comfortable or familiar with computer games, leading to frustration rather than learning.
Key Takeaways:
• Applying research blindly can lead to failure if client differences are ignored.
• Client-centered care means adapting interventions based on the specific needs, preferences, and abilities of the population.
• Best practices involve not only using evidence but also assessing its relevance to the community you’re serving.
A nursing administrator aims to develop a work environment conducive to the implementation of evidence-informed practice. What is the best approach to achieve this goal?
a. Conducting market research to determine customer satisfaction with evidence-informed practice
b. Eliciting opinions from CHNs on how evidence-informed practice will affect workload
c. Increasing access of nursing research sources, including nursing research journals, in the libraries of health care institutions
d. Sending staff to conferences related to incorporation of evidence-informed practice into practice
c. Increasing access of nursing research sources, including nursing research journals, in the libraries of health care institutions
Which of the following best represents the first step to take when using evidence-informed
practice in the clinical setting?
a. Eliminate all protocols and standards that are not evidence based.
b. Gather data on the clinical problem.
c. Formulate the clinical question.
d. Revise mission statements and organizational philosophies.
c. Formulate the clinical question.
The correct answer is “c. Formulate the clinical question” because the first step in evidence-informed practice (EIP) is identifying what needs to be answered.
Why is this the first step?
• A clear clinical question guides the research process by defining the problem, population, and intervention.
• Without a well-defined question, searching for relevant evidence becomes inefficient and unfocused.
• The PICO framework (Patient/Problem, Intervention, Comparison, Outcome) is often used to structure clinical questions.
Why not the other options?
• (a) Eliminate all protocols that aren’t evidence-based – This would be reckless without first determining what the best evidence is.
• (b) Gather data on the clinical problem – Data collection is important, but it should be based on a structured question to ensure relevant information is collected.
• (d) Revise mission statements and organizational philosophies – This is more of an administrative step and doesn’t directly influence evidence-based practice at the clinical level.
Key Takeaway
• Always start with the question before looking for answers—this ensures that the best available evidence is applied effectively in clinical practice.
What type of research should community health nurses consider when assessing culturally diverse populations?
a. Meta-analysis
b. Grounded theory research
c. Participatory action research
d. Random control studies on the entire population
c. Participatory action research
This question is about Participatory Action Research (PAR) and why it’s the best research method for assessing culturally diverse populations in community health nursing.
What is Participatory Action Research (PAR)?
• PAR is a collaborative research method where community members actively participate in identifying issues, designing research, and implementing solutions.
• It focuses on empowering communities by involving them in the research process rather than treating them as passive subjects.
• It is commonly used in public health, social justice, and healthcare disparities research.
Why is PAR the best choice for culturally diverse populations?
• Respects cultural differences – Engages the population in the research process to ensure that cultural values, beliefs, and norms are considered.
• Community-driven – Involves local knowledge and lived experiences, making interventions more relevant and effective.
• Builds trust – Reduces mistrust in research and healthcare systems by fostering relationships between researchers and communities.
• Leads to sustainable change – Solutions are co-created, making them more likely to be accepted and implemented long-term.
Why not the other options?
• (a) Meta-analysis – This is a statistical method that combines results from multiple studies, but it doesn’t directly involve communities in the research process.
• (b) Grounded theory research – This helps develop theories based on data, but it is not necessarily participatory or action-oriented.
• (d) Randomized control studies (RCTs) – These are rigid, controlled experiments that may not be appropriate for diverse communities due to cultural and ethical considerations.
Real-World Nursing Example
A community health nurse is working with an Indigenous population to improve diabetes management. Instead of imposing a Western diet plan, the nurse collaborates with the community to create a culturally relevant program, incorporating traditional foods and local healers—this is PAR in action.
