Research and Such

Question 1

What is evidenced-based practice and why is it important in healthcare?

Answer 1

Evidence-based practice (EBP) is defined by Duke University Medical Center as “the integration of clinical expertise, patient values and the best research evidence into the decision-making process for patient care. EBP improves outcomes.

Question 2

Gold standards for research

Answer 2

Random clinical trials and systematic reviews (analysis of many trials)

Question 3

Evidence Levels

Answer 3

1 - Random control trial
2.1 - Cohort study or case control study
2.2 - Time series or uncontrolled study
3 - Expert opinion

Question 4

Study Strengths

Answer 4

High - repeatable in another study
Moderate - Deficiencies exist but same results in repeat studies
Low - Many deficiencies exist
Insufficient - no confidence in results

Question 5

Iowa Model of Evidence-Based Practice to Promote Quality Care

Answer 5

Method to EBP for nurses

Guide to steps that help identify issues, research solutions and implement changes

Question 6

Ace Star Model

Answer 6

The ACE Star Model emphasizes crucial steps to convert one form of knowledge to the next and incorporate best research evidence with clinical expertise and patient preferences thereby achieving EBP

Question 7

Johns Hopkins Model for EBP

Answer 7

powerful problem-solving approach to clinical decision-making, and is accompanied by user-friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse.

Question 8

The Stetler model of research

Answer 8

The Stetler model of research use is based on the notion that the user’s internal characteristics, as well as external environmental factors, influence use of knowledge.

Question 9

Models for Chronic Care Coordination

Answer 9

Patient centered medical home
Self management
Telehealth
House Calls
Integrated care management

Question 10

Translational Research

Answer 10

Moving empirically based understanding into practice

Must be able to grade, scope, and validate research

Question 11

Lewin Change Model

Answer 11

Unfreeze, Change, Re-Freeze

process of change entails creating the perception that a change is needed, then moving toward the new, desired level of behavior and, finally, solidifying that new behavior as the norm.

Question 12

Healthy People 2030

Answer 12

Adds 10 year targets for objectives and better defines health literacy

Question 13

Disease Prevention Framework

Answer 13

Local - Individual and community efforts

State - inspections, codes, health screenings

Federal - regulatory policy, national efforts

Question 14

Primary Prevention

Answer 14

Intervene before illness via vaccines, behavior changes, banning substances

Question 15

Secondary Prevention

Answer 15

Screening to identify early disease or risks (BP screenings, mammograms)

Question 16

Tertiary Prevention

Answer 16

Manage disease after a diagnosis to slow or stop it

Question 17

Epidemiological Triad

Answer 17

Disease requires - Agent, Host, and Environment

Different diseases have different balance of these three factors but doesn’t explain multi-factorial disease like cardiovascular disease

Question 18

Palliative Care

Answer 18

Align treatment outcome with patient / family goals
Improve quality of life
Minimize pain
Lessen emotional stress
Assist with safety, mobility

Question 19

NNDS

Answer 19

National notifiable disease system

Enables all levels of healthcare providers to share info and monitor occurrences and spread of disease

Question 20

Social Determinants of Health

Answer 20

Conditions in the environment that people are born into, live in, and age. Play a role in quality of life and health outcomes

-Age, socioeconomic, environment, race, gender, education

Question 21

Domains of Wellness

Answer 21

Physical.
Emotional.
Intellectual.
Social.
Spiritual.
Environmental.
Occupational.
FINANCIAL

Question 22

Accountable Care Orgs

Answer 22

Groups that coordinate care to improve outcomes and lower costs

Question 23

Levels of Accountable Care Orgs

Answer 23

1 - lowest risk / requirements; get savings for meeting benchmarks
2 - Better chronic care / infrastructure; get better reimbursement but more requirements
3 - Comprehensive care; very strict but best reimbursement

Question 24

Value Based Purchasing

Answer 24

CMS effort and part of ACA

Measures hospital performance on safety, care, efficiency, and patient experiences

Question 25

Explain the reasons why transitions of care increase risks for adverse events.

Answer 25

Transitions increase the risk of adverse events due to the potential for miscommunication as responsibility is given to new parties. Hospital discharge is a complex process representing a time of significant vulnerability for patients

Question 26

Explain the difference between synchronous and asynchronous telemedicine and the significance of this type of healthcare delivery in the US.

Answer 26

Synchronous or real-time telehealth requires the presence of both parties at the same time

Asynchronous telehealth involves acquiring medical data (e.g., medical images, biosignals, voice recordings) and then transmitting these data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time.