Evidence-Based Practice and Ethics

Question 1

EBP

Answer 1

-Research: systematic collection and analysis of data r/t a problem
-Use of evidence in making decisions abt how to care for pts
-Clinical reasoning
-Correctly compose a clinical question
-Find appropriate database for systematic reviews
-Critically review the evidence
-Consult practice guidelines and expert practitioners
-Work w/ clients to develop plan

Question 2

EBP steps

Answer 2

1. Ask clinical question
2. Search for the best evidence
3. Appraise evidence for validity, reliability, and applicability
4. Integrate evidence w/ clinical expertise and pt preferences/values
5. Evaluate outcomes of decision or change based on evidence

Question 3

Types of research reviews

Answer 3

-Integrative or systematic reviews
-Scoping reviews
-Meta-analyses

Question 4

Integrative or systematic reviews

Answer 4

-Compile recent studies
-Summarize what is known abt the problem

Question 5

Scoping reviews

Answer 5

-New evidence on subject
-Types of evidence available in specific area
-Missing areas in body of literature

Question 6

Meta-analyses

Answer 6

-Combine results of multiple smaller, similar studies

Question 7

Impact of research on community health and nursing practice

Answer 7

-Public policy and community’s health
-Effectiveness of community health nursing practice
-Status and influence of nursing as a profession
-Nurse’s role in research

Question 8

Values

Answer 8

-Something perceived as desirable or personally held abstract belief abt the truth and worth of thoughts, objects, or behavior
-Motivation to behave in certain ways
-Derived from societal norms, family, religious beliefs
-Value system resulting from experience w/ others
-Fxn as standards that guide actions and behavior in daily situations (code of conduct)

Question 9

Qualities of values

Answer 9

-Endurance
-Hierarchical arrangement
-Prescriptive-proscriptive beliefs
-Reference

Question 10

Endurance

Answer 10

Relatively stable over time

Question 11

Hierarchical arrangement

Answer 11

Certain values have more weight than others

Question 12

Prescriptive-proscriptive beliefs

Answer 12

Descriptive (capable of being true or false), evaluative (judgments of good or bad)

Question 13

Reference

Answer 13

Terminal (end states of existence, spiritual salvation, peace of mind), instrumental (modes of conduct, confidentiality, keeping promises, honesty)

Question 14

Value systems

Answer 14

-Are: organizations of beliefs guiding behaviors, systems of ordered priority allowing for change over time based on changes in society, environment, or personal experience
-Involve: conflict in values as part of decision-making process, persistence in some values, affecting efforts to achieve “health care for all”

Question 15

Ethics

Answer 15

-Set of moral principles: theory or system of moral values
-Ethical decision-making: making a choice that is consistent w/ moral code or that can be justified
-Bioethics: involve biological, medical, or health care issues
-Ethical situations: involves issues w/ words eg “want, desire, refer, should, or ought” or “benefit, harm, duty, responsibility, right, or obligation”

Question 16

Ethical decision-making frameworks

Answer 16

1. Separate questions of fact from questions of value
2. Identify both clients’ and nurses’ value systems
3. Consider ethical principles and concepts

Question 17

Ethical principles

Answer 17

-Respect
-Autonomy
-Beneficence
-Nonmalefience
-Justice (distributive, egalitarian, restorative)
-Veracity
-Fidelity

Question 18

Respect

Answer 18

Treating people as unique, equal, and responsible moral agents

Question 19

Autonomy

Answer 19

-Freedom of choice and the exercise of people’s rights
-Involving clients in their decision-making process

Question 20

Beneficience

Answer 20

-Doing good or benefiting others
-Promote client’s well-being to ensure positive outcomes

Question 21

Nonmaleficience

Answer 21

-Avoiding or preventing harm to others as a consequence of a person’s own choices and actions
-Taking steps to avoid negative consequences
-Encourage providers to prescribe opioids within newest guidelines, promoting legislation to protect young ppl from vaping

Question 22

Justice

Answer 22

-Treating people fairly
-Fair distribution of both benefits and costs among society’s member
-Equal access to health care, fair distribution of resources after a disaster

Question 23

Veracity

Answer 23

-Telling the truth
-Give accurate info in timely manner
-Treating clients as equals

Question 24

Fidelity

Answer 24

-Remaining true to your word or keeping promises
-Nurse earns client’s respect and trust
-Allows ppl to count on commitments being met

Question 25

DECIDE model

Answer 25

-Define the problem
-Ethical review
-Consider the options
-Investigate outcomes
-Decide on action
-Evaluate results

Question 26

Values that guide decision-making

Answer 26

-Self-determination: individual anatomy, possible deterioration to self-interest
-Well-being: state of positive health
-Equity: justice, fair, or equal treatment

Question 27

Application of ethical principles to decision-making

Answer 27

-R/t value of self-determination
-R/t value of well-being
R/t value fo equity

Question 28

Value of self-determination

Answer 28

-Respect the choices of clients
-Protect privacy
-Provide for informed consent
-Protect the rights of clients w/ diminished capacity for self-determination

Question 29

Value of well-being

Answer 29

-Reduce or prevent harm and provide benefits to client populations
-Measure the effectiveness of nursing services
-Balance costs of services against real client benefits

Question 30

Value of equity

Answer 30

-Broadly distributing health goods (macroallocation issues)
-Deciding which populations will obtain available health goods and services (microallocation issues)
-Deciding which individuals or groups have access to genetic tests