A nurse implements an education program that incorporates computer games to reinforce learning for a group of older adults. Although the research demonstrates evidence of improved retention of this information, the nurse experiences exactly the opposite with this group. Which of the following is the most likely cause of such poor outcomes?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Failure to consider client and setting differences is the most likely cause because older adults may have different learning preferences and capabilities compared to other age groups. 2. Older adults may not be familiar or comfortable with computer games, leading to poor outcomes despite research evidence suggesting effectiveness. 3. Considering client and setting differences is crucial in implementing successful educational programs tailored to the specific needs of the target population. Summary: B: Inadequate incorporation of evidence into practice is incorrect because the research evidence has shown improved retention, indicating that the evidence was appropriately incorporated. C: Inferior quality of the available research evidence is incorrect as the research demonstrated evidence of improved retention. D: Lack of skills when evaluating the evidence is incorrect as the issue lies more with understanding the specific needs and preferences of the older adult population.

Correct Answer: C

Rationale: The correct answer is C because encouraging group reflection on the ideals and expectations of nursing care promotes a shared understanding and commitment to EBP. This strategy fosters collaboration, critical thinking, and engagement among staff, leading to a more effective implementation of EBP. A: Eliminating all non-evidence-based protocols may hinder practice improvement and overlook valuable experiences and insights. B: Without a specific action or strategy provided, it lacks a clear direction for promoting EBP. D: Without any information, it is difficult to determine how this strategy directly relates to facilitating EBP in the clinical setting.

Correct Answer: C

Rationale: Correct Answer: C Rationale: 1. Evidence-based decision-making (EBDM) involves using interventions with replicable results based on high-quality research evidence. 2. By utilizing interventions with replicable results, healthcare providers can ensure consistency and effectiveness in patient care. 3. This process helps in making informed decisions that are based on scientific evidence rather than personal biases or experiences. 4. Choosing interventions with replicable results leads to better patient outcomes and improved quality of care. Summary of Incorrect Choices: A: Incorrect. EBDM is not a one-step process; it involves multiple steps including identifying a clinical question, searching for evidence, appraising the evidence, and applying it to practice. B: Incorrect. EBDM aims to minimize subjective decision-making by relying on objective research evidence rather than personal opinions. D: Incorrect. While past nursing experiences can inform decision-making, EBDM emphasizes the use of current research evidence to guide practice.

Correct Answer: A

Rationale: The correct answer is A: Case reports. Case reports are considered the lowest level of evidence because they are anecdotal and provide information based on individual cases, lacking generalizability. Cohort studies, randomized control trials, and cross-sectional studies provide more robust evidence due to their study designs, larger sample sizes, and ability to establish causal relationships. Cohort studies follow a group over time, RCTs involve randomization and control groups, and cross-sectional studies provide a snapshot of a population at a specific point. Case reports are valuable for generating hypotheses but are not sufficient to establish strong evidence due to their limitations in terms of bias and generalizability.

Correct Answer: C

Rationale: The correct answer is C: Synthesizing the literature. In evidence-based decision-making, after conducting a literature search, the nurse needs to synthesize the information by compiling research findings and identifying trends in the data. This step involves analyzing and integrating the evidence to draw meaningful conclusions. Defining the problem (choice B) is the initial step before conducting a literature search. Appraising the literature (choice D) comes after synthesizing the information, where the nurse evaluates the quality and relevance of the studies.