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PNC IV - Exam 2 Questions and Answers with complete actual solution
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PNC IV - Exam 21st Step of EBP - Ask a clinical question - ✅✅ -Always think about your practice when
caring for clients. Question what does not make sense to you and question what needs
clarification. Think about a problem or area of interest that is time consuming, costly, or not
logical (Callister and others, 2005). Examples of problem-focused trends include the
increasing number of client falls or incidence of urinary tract infections on a nursing unit.
Such trends lead you to ask, "How can I reduce falls on my unit?" or "What is the best way to
prevent urinary tract infections in postoperative clients?" The questions you ask will
eventually lead you to the evidence for an answer. In your 4th semester you will develop a
question.
2nd Step of EBP - Collect the most relevant and best evidence - ✅✅ -You will find the
evidence you need in a variety of sources: agency policy and procedure manuals, quality
improvement data, existing clinical practice guidelines, or computerized bibliographical
databases. Do not hesitate to ask for help to find appropriate evidence. Your faculty will of
course always be a key resource. When you are assigned to a health care setting, consider
using experts such as advanced practice nurses, staff educators, risk managers, and
infection control nurses.
3rd step of EBP - Critically appraise the evidence you gather - ✅✅ -Perhaps the most
difficult step in the EBP process is critiquing or analyzing the available evidence. The
critiquing of evidence involves its evaluation, which includes determining the value,
feasibility, and utility of evidence for making a practice change (ONS, 2005). When critiquing
evidence, first evaluate the scientific merit and clinical applicability of each study's findings.
Then with a group of studies and expert opinion determine what findings have a strong
enough basis for use in practice.
✅✅
4th step of EBP - Integrate all evidence with one's clinical expertise and client preferences
and values in making a practice decision or change - -Once you decide that the
evidence is strong and applicable to your clients and clinical situation, incorporate the
recommended evidence into practice. Your first step is to simply apply the research in your
plan of care for a client. Use the evidence you find as a rationale for an intervention you plan
to try. For instance, you learned about an approach to bathe older adults who are restless
and decide to use the technique during your next clinical assignment. You use the bathing
technique with your own assigned clients, or you work with a group of other students or
nurses in revising a policy and procedure or developing a new clinical protocol.
5th Step of EBP - Evaluate the practice decision or change - ✅✅ -After applying evidence
in your practice, your next step is to evaluate the effect. How does the intervention work?
How effective was the clinical decision for your client or practice setting? Sometimes your
evaluation is as simple as determining if the expected outcomes you set for an intervention
are met.
Access to Health Care - ✅✅ -national policy that is driven in part by economics. Americans
with health insurance are able to access available health care resources with relative ease.
,Uninsured Americans either do not seek care or they obtain through federal- and state
sponsored clinical facilities or in the nation's emergency departments.
Lack of secured access to primary care or to needed tertiary care results in a chaotic &
costly health care system where financial incentives drive health behavior & health
outcomes.
Nurses encounter a variety of patient care dilemmas caused by economic factors in daily
practice—from families/friends wanting confidential information (not entitled to) about the
patient, to patients not taking medications because of the cost.
Accreditation -✅✅ -is a peer review process for measuring the quality of an organization,
its products, and its services according to key benchmarks (or "best practices").
Requires an organization to examine its own performance ---(in Nursing Education this is
known as a "Self Study")
This is where strengths & weaknesses are identified & through this the school (organization)
improves its effectiveness & efficiency of performance.
Self-examination typically results in better planning & implementation & further evaluation.
(North Carolina Concept-Based Learning Editorial Board p. 2366)
Standards of the accrediting agency provide the structure for the organization's management
strategies & self review.
The on-site survey: verifies, clarifies & amplifies (ACEN review) the applications of the self
study and determines whether the company is actually performing according to the state
goals & objectives set in the self study. (North Carolina Concept-Based Learning Editorial
Board p. 2366)
Accrediting Bodies - ✅✅ --The Joint Commission
•Mission & Vision
•Focus
•Composition
-Nursing Education Program Accreditation
•Commission on Collegiate Nursing Education (CCNE)
Accreditation Commission for Nursing Education (ACEN)
ACEN Board of Directors - ✅✅ -consists of a total of 14 members: 9 Nursing Education
Representatives, 3 Nursing Service Representatives & 2 Public Representatives.
ACEN Goals - ✅✅ -•Promulgate a common core of standards and criteria for the
accreditation of nursing programs found to meet those standards and criteria.
•Strengthen educational quality through assistance to associated programs and schools, and
evaluation processes, functions, publications, and research.
•Advocate self-regulation in nursing education.
•Promote peer review.
•Foster educational equity, access, opportunity, and mobility, and preparation for
employment based upon type of nursing education.
•Serve as gatekeeper to Title IV-HEA programs for which the ACEN is the accrediting
agency. These include some practical and all hospital diploma programs eligible to
, participate in programs administered by the U.S. Department of Education or other federal
agencies.
adverse events - ✅✅ --untoward incidents
-therapeutic wrongdoing
-injuries
-wrongful occurrence related to care
-medical equipment failure
-misdiagnosis which treatment is not correct leading to harm or death
-not following procedures
-a patient fall with the bed in the high position
American Association of Colleges of Nursing (AACN) - ✅✅ -is the national voice for
America's baccalaureate & higher degree nursing educational programs . It works to
establish quality standards for those schools influence the nursing profession to improve
health care; and promote public support of baccalaureate & graduate education, research
and practice in nursing.
The Commission on Collegiate Nursing Education is an autonomous arm of this organization
that functions to accredit nursing schools.
American Nurse's Association - ✅✅ -Association (discussed previously in more detail) is
the only full service professional organization representing the nations 2.9 million registered
nurses through its 54 constituent member associations. (50 states, + Guam, Virgin Islands,
Washington D.C. & Federal Nurses Association)
ANA advances the nursing profession by fostering high standards of nursing practice,
promoting the rights of nurses in the workplace, projecting a positive & realistic view of
nursing & by lobbying Congress & regulatory agencies on health care issues affecting
nurses & the public.
American Nurses Association - ✅✅ -serves as the Nurses voice in policy planning. It
represents professional nurses (RNs) and the clients they serve.
The currently have many "position statements" which shows their stance regarding "issues
at hand."
Encourage you to visit their website, as well as take an active role in influencing the decision
making process.
Position Statements
-Recommendation for a course of action that reflects ANA's stance regarding the "concern."
-Involves internal deliberation by Congress on Nursing Practice
-& Economics
American Nurses Association on Health Policy - ✅✅ -Typical factors that affect the
development of health care policy include cost-benefit ratios, client care issues such as
safety, efficiency of service and equity of access to services
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