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Chapter 11: Evidence-Based Decision-Making

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Chapter 11: Evidence-Based Decision-Making

16 problems · 0 figures

Case Study 11.1.1 §11.1 source ↗

Read the scenario, and then answer the questions that follow.

Recall from the beginning of this chapter that Amari and Milo have noticed an increased rate of anxiety in teens within their community and that the interventions they have used previously are not eliciting the same results. To efficiently identify possible interventions for this population, they know their best option is to use evidence-based practice strategies and that they must first draft a PICOT question as the foundation for their EBP project.

Amari and Milo develop the following PICOT question: Does daily exercise have an impact on anxiety rates in adolescents compared to those who do not engage in daily exercise over 3 months?

Which of the following components must be covered to be an effective PICOT question?
  1. a.
    Population, interest, cost, outcome, time
  2. b.
    Population, intervention, comparison, outcome, time
  3. c.
    Price, interest, comparison, overhead, time
  4. d.
    Price, intervention, company, outcome, time

Answer

B. Population, intervention, comparison, outcome, time
The components of an effective PICOT question are population, intervention, comparison, outcome, and time.

Case Study 11.1.2 §11.1 source ↗

Read the scenario, and then answer the questions that follow.

Recall from the beginning of this chapter that Amari and Milo have noticed an increased rate of anxiety in teens within their community and that the interventions they have used previously are not eliciting the same results. To efficiently identify possible interventions for this population, they know their best option is to use evidence-based practice strategies and that they must first draft a PICOT question as the foundation for their EBP project.

Amari and Milo develop the following PICOT question: Does daily exercise have an impact on anxiety rates in adolescents compared to those who do not engage in daily exercise over 3 months?

In the PICOT question developed by Amari and Milo, which of the following is the proposed intervention?
  1. a.
    Anxiety rates
  2. b.
    Adolescents
  3. c.
    Daily exercise
  4. d.
    3 months

Answer

C. Daily exercise
The intervention refers to the change or treatment that will be implemented for the identified population. The intervention in this PICOT is daily exercise.

Case Study 11.2.3 §11.2 source ↗

Read the scenario, and then answer the questions that follow based on all the case information provided in the chapter thus far. This case study is a follow-up to Case Study Part A.

Amari and Milo have developed the following PICOT question: Does daily exercise have an impact on anxiety rates in adolescents compared to those who do not engage in daily exercise over 3 months? They are now ready to move on to the next step of the evidence-based decision-making process.

After developing their PICOT question, what is the next step that Amari and Milo will take?
  1. a.
    Begin to develop an exercise program for adolescents
  2. b.
    Critically appraise the evidence found in the literature
  3. c.
    Search the literature for supporting research
  4. d.
    Implementing the intervention of daily exercise

Answer

C. Search the literature for supporting research
After the PICOT question has been developed, the next step is to search the literature for research evidence to support the proposed intervention of exercise to reduce anxiety in adolescents.

Case Study 11.2.4 §11.2 source ↗

Read the scenario, and then answer the questions that follow based on all the case information provided in the chapter thus far. This case study is a follow-up to Case Study Part A.

Amari and Milo have developed the following PICOT question: Does daily exercise have an impact on anxiety rates in adolescents compared to those who do not engage in daily exercise over 3 months? They are now ready to move on to the next step of the evidence-based decision-making process.

Amari and Milo are ready to start searching the databases and want to find one specific to public health and public policy. Which database would serve them best regarding these specifications?
  1. a.
    PubMed
  2. b.
    AHRQ
  3. c.
    Cochrane Library
  4. d.
    Medline Full Text

Answer

D. Medline Full Text
Though all of the above databases could be used, Medline Full Text specifically highlights articles regarding public health and public policy.

Case Study 11.3.5 §11.3 source ↗

Read the scenario, and then answer the questions that follow based on all the case information provided in the chapter thus far. This case study is a follow-up to Case Study Part B.

Using research databases, Amari and Milo found four quantitative studies and three qualitative studies regarding exercise and mental health. Additionally, they surveyed the community to identify components of community exercise programs. This survey included physical locations, cost, and general attendance of these classes and programs. They also spoke with the local school systems to determine how physical education is incorporated into the high school curriculum. Amari and Milo must now appraise the evidence in order to select which data points to use and to what degree.

Which factor should Amari and Milo consider in their appraisal of the evidence they found?
  1. a.
    The reputation of the researcher
  2. b.
    The cost of the study
  3. c.
    The length of the study
  4. d.
    The trustworthiness of the study

Answer

D. The trustworthiness of the study
Critically appraising each study for relevance and credibility is necessary to ensure the information provided is meaningful, trustworthy, and relevant. Information is considered trustworthy based on its confirmability and the reviewer’s confidence in the believability of the information produced in the literature.

Case Study 11.3.6 §11.3 source ↗

Read the scenario, and then answer the questions that follow based on all the case information provided in the chapter thus far. This case study is a follow-up to Case Study Part B.

Using research databases, Amari and Milo found four quantitative studies and three qualitative studies regarding exercise and mental health. Additionally, they surveyed the community to identify components of community exercise programs. This survey included physical locations, cost, and general attendance of these classes and programs. They also spoke with the local school systems to determine how physical education is incorporated into the high school curriculum. Amari and Milo must now appraise the evidence in order to select which data points to use and to what degree.

During their appraisal of the evidence, which type of study would provide Amari and Milo with the highest quality of evidence?
  1. a.
    Randomized controlled studies
  2. b.
    Anecdotal reports
  3. c.
    Cross-sectional studies
  4. d.
    Summaries

Answer

A. Randomized controlled studies
Researchers use a pyramid to rank the evidence. At the highest level of the pyramid, randomized controlled studies should be used first to compile the most effective evidence.

11-1 §11.RQ source ↗

The nurse is discussing the importance of evidence-based decision-making (EBDM) with a group of students. Which statement by a student indicates understanding of this process?
  1. a.
    “EBDM is a one-step process to make clinical decisions.”
  2. b.
    “EBDM utilizes subjective decision-making.”
  3. c.
    “EBDM uses interventions with replicable results.”
  4. d.
    “EBDM relies on past nursing experiences.”

Answer

C. “EBDM uses interventions with replicable results.”
EBDM provides a concrete, objective, and replicable process to ensure that interventions are supported by data.

11-2 §11.RQ source ↗

Which information is the nurse assessing when appraising the applicability of a research article?
  1. a.
    The intended audience of the article
  2. b.
    The degree to which the results relate to a specific population
  3. c.
    The accuracy or credibility of the research
  4. d.
    The purpose of the research

Answer

B. The degree to which the results relate to a specific population
The applicability of a research article refers to how well the results and data can pertain to broad or specific populations.

11-3 §11.RQ source ↗

While conducting a literature review for an evidence-based project, the nurse recognizes that which type of study represents the lowest level of evidence?
  1. a.
    Case reports
  2. b.
    Cohort studies
  3. c.
    Randomized control trials
  4. d.
    Cross-sectional studies

Answer

A. Case reports
Case reports and case studies are the lowest levels of the hierarchy of evidence or research.

11-4 §11.RQ source ↗

A nurse has developed the following PICOT question: In adult men, is zinc supplementation as effective as vitamin C supplementation in reducing the length of respiratory viral infections over six months? The nurse identifies “zinc supplementation” as which part of the PICOT question?
  1. a.
    Population
  2. b.
    Intervention
  3. c.
    Comparison
  4. d.
    Outcome

Answer

B. Intervention
Zinc supplementation is the intervention in this PICOT question. Intervention is the change or treatment that will be implemented for the identified client (population).

11-5 §11.RQ source ↗

A public health nurse has developed a research question and searched the literature for supporting evidence. In which step of evidence-based decision-making would the nurse compile the research findings and identify specific trends in the data?
  1. a.
    Defining the problem
  2. b.
    Synthesizing the literature
  3. c.
    Appraising the literature
  4. d.
    Adapting the information

Answer

B. Synthesizing the literature
Synthesizing the data involves compiling the information to determine what the research is saying about the concern/issue and identifying common trends in the data.

11-6 §11.RQ source ↗

Which database would the public health nurse use when conducting research to locate regularly updated systematic reviews?
  1. a.
    Cochrane Library
  2. b.
    Agency for Healthcare Research and Quality (AHRQ)
  3. c.
    Medline with Full Text
  4. d.
    Cumulative Index to Nursing and Allied Health Literature (CINAHL)

Answer

A. Cochrane Library
Databases, collections of information organized in a systematic method, are helpful during the process of searching for sources of existing literature related to the topic of one’s inquiry. The Cochrane Library database is a core source for EBP, including systematic reviews that are regularly updated.

11-7 §11.RQ source ↗

Which action will the public health nurse perform when conducting an ethical community study?
  1. a.
    Require each participant who provides informed consent to complete the study.
  2. b.
    Obtain informed consent only from vulnerable populations.
  3. c.
    Get informed consent only if the risks of participating in the study are high.
  4. d.
    Obtain informed consent from each participant in the study.

Answer

D. Obtain informed consent from each participant in the study.
Each participant in a research study should receive fully transparent information regarding the intent of the research and how the information will be used.

11-8 §11.RQ source ↗

The nurse is developing a PICOT question to study methods to promote smoking cessation in high school students in a rural community. Which statement identifies the targeted population?
  1. a.
    The rural community
  2. b.
    Community members who smoke
  3. c.
    All high school students in the community
  4. d.
    High school students in the rural community who smoke

Answer

D. High school students in the rural community who smoke
The population of a PICOT question is the individuals, community, or population being studied. In this research question, the nurse is studying high school students in a specific rural community who smoke.

11-9 §11.RQ source ↗

Which type of study will the nurse use to understand the experiences of an immigrant group in the community?
  1. a.
    Qualitative
  2. b.
    Randomized control
  3. c.
    Needs assessment
  4. d.
    Quality improvement

Answer

A. Qualitative
Qualitative research deals with nonnumerical data such as experiences, attitudes, and behaviors.

11-10 §11.RQ source ↗

Which activity would the nurse perform during the evaluation phase of evidence-based decision-making (EBDM)?
  1. a.
    Carrying out the proposed plan
  2. b.
    Deciding if the evidence is applicable to the population
  3. c.
    Determining the effectiveness of the plan
  4. d.
    Compiling the data

Answer

C. Determining the effectiveness of the plan
During the evaluation phase, the final step in EBDM, the nurse determines the effectiveness of the implemented plan by determining if the plan accomplished what was intended and, if not, what may need to be changed moving forward.

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Problems and answers are adapted from Population Health for Nurses by Jessica Ochs, Sherry L. Roper and Susan M. Schwartz, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/population-health/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.