Foundations 10

Question 1

What are the steps of Evidence Based Practice

Answer 1

Cultivate a spirit of inquiry
Ask a question using PICOT
Search for evidence
Evaluate the evidence
Integrate the evidence, your clinical experience, and patient preference
Evaluate the outcomes
Communicate the outcomes

Question 2

What is a Sprit of Inquiry

Answer 2

The desire to clarify complex issues through research

Question 3

What is Systematic Review

Answer 3

A study of multiple good studies.

Question 4

What are the steps of PICOT?

Answer 4

P = Patient population
I = Intervention
C = Comparison / Control
O = Outcome
T = Time

Question 5

Credible Sources of Evidence

Answer 5

Highest Level = Systematic Review
Middle = Single Peer Reviewed study
Lowest Level = Expert opinion

Question 6

Time limit for good sources?

Answer 6

Published within 5 years is the best.

Question 7

What is Evidence Based Practice?

Answer 7

The use of evidence to improve nursing practice. This process involves reviewing current, credible scientific literature.

Question 8

Good Sources for Evidence Based Practice

Answer 8

AHRQ
Cochrane
CINAHL
Google Scholar

Question 9

Nursing Process Applied To Evidence Based Practice

Answer 9

Assessment
Analysis
Planning
Implementation
Evaluations

Question 10

Mixed Method Research

Answer 10

Mixed methods research combines:
Qualitative studies
AND
Quantitative designs, Used when either one alone would not answer the question adequately.

Question 11

Quantitative Research

Answer 11

Numbers, Counts, Statistics
Collected by observation or administering surveys
Usually two groups experiment and control

Question 12

Citations, References, Plagiarism

Answer 12

The nurse must cite or record every source that was used.
Failure to cite or give credit is plagiarism.
Healthcare citation formats:
APA - American Psychological Association
AMA - American Medical Association

Question 13

Clinical Practice guideline

Answer 13

Evidence Based Practice RECOMMENDAITONS for improving processes.

Question 14

Critical Pathway

Answer 14

Protocols YOU FOLLOW EXACTLY, such as the stroke algorithm

Question 15

Standards of Care

Answer 15

EBP interventions such as clohrohexadine to prevent UTIs in catheters.

Question 16

Sentinal Events

Answer 16

An accident involving death or serious physical/psychological injury.
Requires an immediate investigation.

Question 17

Watson’s Theory of Human Caring

Answer 17

Key Phrase: “We are not human beings having a spiritual experience. We are spiritual beings having a human experience.”
Core Concept: Nursing is a transpersonal, holistic, and caring-healing science, not just a technical act.
Focus: Caring is central to nursing, gives you results that are better than medical processes alone.
10 Caritas Processes: emphasize loving-kindness, faith-hope, and caring relationships.
Metaparadigm: Views the person as a holistic unity of mind-body-soul/spirit.

Question 18

Swanson’s Theory of Human Caring

Answer 18

A nurturing way of relating to a valued “other” toward whom one feels a personal sense of commitment and responsibility.
The 5 Caring Processes: maintaining belief, knowing, being with, doing for, and enabling
1. Knowing: Striving to understand an event as it has meaning in the life of the other; avoiding assumptions.
2. Being With: Being emotionally present to the other (conveying that their experience matters).
3. Doing For: Doing for the other as they would do for themselves if it were at all possible.
4. Enabling: Facilitating the other’s passage through life transitions and unfamiliar events (e.g., coaching, informing, supporting).
5. Maintaining Belief: Sustaining faith in the other’s capacity to get through an event or transition and face a future with meaning.
Core Concept:
Caring is a grounded, repeatable set of behaviors that improves patient outcomes by dignifying the individual.

Question 19

Do you want to show sympathy?

Answer 19

No, it is like pity. Show EMPATHY.

Question 20

Caring Behaviors

Answer 20

Listening
Touch
Being present
Providing Comfort
Showing Compassion

Question 21

Caring Behaviors: Listening

Answer 21

Pay Attention
Show that you are listening
Don’t get distracted
Put down your phone
Mute the TV
Make eye contact
Offer feedback after listening
Don’t jump to conclusions and avoid making unfair assumptions
“It sounds like you mean XX and I just want to clarify. Are you saying XX?” Given them a chance to clarify or rephrase

Question 22

Caring
Behaviors: Touch

Answer 22

Be aware of patient’s cultural practices and past experiences. Caring touch (depending on past experiences, even a simple touch can be perceived as invasive or a threat)(hold a hand, position a patient, give a back massage)

Question 23

Caring
Behaviors: Being Present

Answer 23

Being present is spending time at the bedside, sitting and actively listening, simply providing presence
Includes communication and understanding
Patients miss their family, friends and caregivers. Both Swanson’s and Watson’s theories include this.

Question 24

Caring
Behaviors: Providing Comfort

Answer 24

Pharmacological
Medications, pain, anxiety
Nonpharmacological
Simple things for pain and anxiety interventions
Can be very effective
Provide a drink, help them to wash face and hands/bathe, warm blankets, pillows, room temp, open/close curtains, providing a backrub, pet therapy, music therapy

Question 25

Caring Behaviors: Showing Compassion

Answer 25

Recognizing pain and suffering and taking actions to alleviate them Focus on humanizing factors. Showing compassion even if it’s a tough. Evaluate your own feelings.

Question 26

FICA Spiritual Assessment

Answer 26

F (faith and belief)(what spiritual beliefs aid you in coping?) I (importance)(do your spiritual beliefs impact how you care for yourself?) C (community)(are you part of a spiritual or religious community?) A (address in care)(how would you like me to address current issues in your health care?)

Question 27

HOPE Spiritual Assessment

Answer 27

Hope Organized religion Personal and spiritual practices Effects on care and end-of-life issues

Question 28

Spiritual Distress

Answer 28

A disruption in one’s beliefs, values or a sense of meaning or hope Causes people to question their identity and feel doubt, loss of faith, and a sense of being alone or abandoned, meaning of life

Question 29

Advocacy:

Answer 29

The act of protecting the rights, interests and safety of clients, especially those who are unable to do so themselves.

Question 30

An advocate protects:

Answer 30

Autonomy, serving as voice for patient, providing info, enabling patient to make informed decisions

Question 31

Medical futility

Answer 31

Treatments that will not provide a cure or extend life (cancer in multiple organs)

Question 32

Palliative care

Answer 32

medical care focused on providing relief from the symptoms and stress of a serious, chronic, or life-threatening illness. The primary goal is to improve quality of life