Chapter 2: Evolution of Research in Building Evidence-Based Nursing Practice

Chapter 2: Evolution of Research in Building Evidence-Based Nursing Practice

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. In which way did Florence Nightingale contribute to evidence-based practice?

ANS:  C

Nightingale gathered data on soldier morbidity and mortality rates and the factors influencing them and presented her results in tables and pie charts, a sophisticated type of data presentation for the period. Nightingale’s research enabled her to instigate attitudinal, organizational, and social changes. She changed the attitudes of the military and society toward the care of the sick. The military began to view the sick as having the right to adequate food, suitable quarters, and appropriate medical treatment, which greatly reduced the mortality rate.

DIF:    Cognitive Level: Application           REF:   Page 17

2. If a nurse manager wants to study how well last year’s policies governing implementation of a “bundle” of interventions to prevent cross-contamination of MRSA have been working in her units, which of the following strategies would she use?

ANS:  A

Outcomes research emerged as an important methodology for documenting the effectiveness of health care services in the 1980s and 1990s. This type of research evolved from the quality assessment and quality assurance functions that originated with the professional standards review organizations (PSROs) in 1972. During the 1980s, William Roper, the director of the Health Care Finance Administration (HCFA), promoted outcomes research for determining the quality and cost-effectiveness of patient care. Intervention research investigates the effectiveness of a nursing intervention in achieving the desired outcome or outcomes in a natural setting. Through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on human behavior and health. Experimental studies have three main characteristics: (1) a controlled manipulation of at least one treatment variable (independent variable), (2) administration of the treatment to some of the subjects in the study (experimental group) and not to others (control group), and (3) random selection of subjects or random assignment of subjects to groups, or both. Experimental studies usually are conducted in highly controlled settings, such as laboratories or research units in clinical agencies.

DIF:    Cognitive Level: Analysis                REF:   Page 22

3. A researcher publishes a paper describing how faith, pain, adherence to therapy, and meditation interact during the rehabilitation process. The description of the process is based on many interviews the researcher conducted with persons during and following rehabilitation experiences. The methodology is

ANS:  D

Grounded theory methodology emphasizes observation and the development of practice-based intuitive relationships among variables. Throughout the study, the researcher formulates, tests, and redevelops propositions until a theory evolves. The theory developed is “grounded,” or has its roots in, the data from which it was derived.

DIF:    Cognitive Level: Synthesis              REF:   Page 27

4. A panel of researchers conducts several studies, all drawn from an existent hospital and clinic database. The studies focus on quality and effectiveness within that system. The specific studies address mortality rates in elders within a year after hip fracture, functional outcomes six months after admission to a neurosurgical ICU after traumatic brain injury, rate of nurse injuries in an emergency department, and number of patient falls on various floors of the hospital. What type of research is this?

ANS:  B

The spiraling cost of health care has generated many questions about the quality and effectiveness of health care services and the patient outcomes. Consumers want to know what services they are buying, and whether these services will improve their health. Health care policy makers want to know whether the care is cost-effective and of high quality. These concerns have promoted the development of outcomes research, which examines the results of care and measures the changes in health status of patients. It can also examine costs related to care delivery within a hospital system.

DIF:     Cognitive Level: Comprehension          REF:    Page 27