Chapter 5: Evidence-Informed Practice in Community Health Nursing Flashcards
- What aotion 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
ANS: C
Although all of the proposed options are good, in order to determine whether the centre’s
practice is serving the needs of the population, the nurse executive will need to consult
members of the population being served. This means that evidence would be applied to
practice with input from the community. For example, decisions related to the services to be
offered in a community health nurse (CHN)-managed clinic would be made with input from
the clinic’s advisory board, which should include community leaders and consumers of the
clinic’s services. The needs of Cuban immigrants may not be the same as those of immigrants
from other Spanish-speaking countries, such as Mexico or Spain
- 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
ANS: B
Evidence-informed practice is defined as combining the best evidence derived from research
with clinical practice, knowledge, expertise, and unique client expectations, preferences, or
choices when making clinical decisions. Getting ideas from the Internet is helpful only if
evidence-informed practice sites are accessed; however, most Internet sites do not offer
information grounded in evidence-informed practice
- What is the biggest challenge for 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
c. Distinguishing evidence-informed practice from practice based on old standards
d. Showing clients that evidence-informed practice will improve their health
outcomes
ANS: A
The challenge for the CHN is accessing the evidence, interpreting it, and integrating it into
practice, thus moving beyond practice based solely on experience, tradition, or ritual.
- A 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. What 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
ANS: B
Randomized clinical trials are the gold standard for evidence gathering in evidence-informed
practice.
- 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
c. Opinions of colleagues
d. Media reports
ANS: B
Evidence-informed practice in community health nursing challenges CHNs to integrate the
best evidence into their clinical practice. Current research findings will explicate the evidence
of the most successful interventions. (Randomized clinical trials are the gold standard of
research for evidence-informed practice.) Protocols and opinions often reflect tradition rather
than the most current scientific evidence. Although many media reports seek expert opinion,
many are not research based or focused on scientific evidence.
- A CHN implemented an education program that incorporated computer games to reinforce
learning in a community of older adults. 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
ANS: A
Evidence-informed practice cannot be applied as a universal remedy without attention to
client differences. When evidence-informed practice is applied at the community level, best
evidence may point to a solution that is not sensitive to cultural issues and distinctions and
thus may not be acceptable to that particular community. For example, computer games may
be an excellent choice for younger groups but is often not suitable for older adults, who may
face challenges with learning new technology.
- 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 evidenceinformed 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
ANS: C
Inadequacy of nursing research sources, including nursing research journals, in the libraries of
health care institutions can create a barrier to the implementation of evidence-informed
practice in community-based nursing agencies. Increased nursing research holdings can help
CHNs to quickly access current evidence-informed findings and recommendations.
- How can a CHN best facilitate incorporation of evidence-informed practice in the clinical
setting?
a. Elimination of all protocols and standards that are not evidence based
b. Group reflection on the ideals and expectations of nursing care
c. Incorporation of more client/practice-oriented research into decision making
d. Revision of mission statements and organizational philosophies
ANS: C
Evidence-informed practice demands changes. It requires the incorporation of more practiceoriented research and more collaboration between clinicians and researchers. Emphasis should
be on decision making using the various sources of evidence. When CHNs access scientific
knowledge of all types, they need to choose the most relevant information for each client’s
clinical situation.
- What best represents the first step to take when using evidence-informed practice in the
clinical setting?
a. Eliminating all protocols and standards that are not evidence based
b. Gathering data on the clinical problem
c. Formulating the clinical question
d. Revising mission statements and organizational philosophies
ANS: C
The first step in the evidence-informed practice process is formulating the question, which
includes defining and refining the question. To answer the client clinical question that has
been formulated, the sources of evidence-informed practice related to community health
nursing include the best available evidence.
