Author Question: Nursing is said to be a science and an art. If best research evidence represents the science of ... (Read 198 times)

dollx · **on:** Jul 8, 2018

Nursing is said to be a science and an art. If best research evidence represents the science of nursing, what represents the art?

a. Clinical expertise
b. Patient values and needs
c. Synthesis of best research evidence
d. Eye-hand coordination

Question 2

If a trigger is defined as a condition of actual or potential harm to the patient, the nurses, or the institution, the Iowa model becomes a reactive problem-prioritization and problem-solving process. What is its tie-in with evidence-based practice?

a. The Iowa model addresses utilization of research findings at an individual level.
b. Individual nurses enact an Iowa decision tree when they examine risk-management data.
c. Available published evidence drives the process, as scholars review the literature and bring it forward for committee focus.
d. When evidence is available, it is used for problem-solving.

tuate · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

ANS: A
Evidence-based practice (EBP) is the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care. Best research evidence is largely fact-based and is intended to produce consistent interventions, usually of a technical nature. Patient values and needs emanate from the patient. Clinical expertise provides the art of nursing practice.

Answer to Question 2

ANS: D
The Iowa Model of Evidence-Based Practice provides direction for the development of EBP in a clinical agency. In a health care agency, triggers initiate the need for change, and the focus should always be to make changes based on best research evidence. These triggers can be problem-focused and evolve from risk management data, process improvement data, benchmarking data, financial data, and clinical problems. The triggers can also be knowledge-focused: for example, new research findings, changes in national agencies or organizational standards and guidelines, an expanded philosophy of care, or questions from the institutional standards committee. The triggers are evaluated and prioritized based on the needs of the clinical agency. If a trigger is considered an agency priority, a group is formed to search for the best evidence to manage the clinical concern. In some situations, the research evidence is inadequate to make changes in practice, and additional studies are needed to strengthen the knowledge base. Sometimes the research evidence can be combined with other sources of knowledge (theories, scientific principles, expert opinion, and case reports) to provide fairly strong evidence for developing research-based protocols for practice. The strongest evidence is generated from meta-analyses of several RCTs and systematic reviews that usually include meta-analyses, and individual studies. Thus, systematic reviews provide the best research evidence for developing evidence-based guidelines. The research-based protocols or evidence-based guidelines would be pilot-tested on a particular unit and then evaluated to determine the impact on patient care. If the outcomes are favorable from the pilot test, the change would be made in practice and monitored over time to determine its impact on the agency environment, staff, costs, and the patient and family. An agency can promote EBP by using the Iowa model to identify triggers for change, implement patient care based on the best research evidence, and monitor changes in practice to ensure quality care.