CAPA Evidence-Based Practice in PACU 5 — Questions and Answers
Question 1: When translating evidence-based research into PACU policy, which barrier most commonly impedes implementation?
- Excessive number of published studies
- Staff resistance and lack of time for protocol education (Correct answer)
- Overly simple clinical questions
- Abundance of nursing resources and staffing
Correct answer: Staff resistance and lack of time for protocol education
Staff resistance and insufficient time for education and training are the most frequently cited barriers to EBP implementation in clinical settings.
Question 2: Evidence supports which approach to postoperative respiratory monitoring in patients who received neuraxial opioids?
- Continuous pulse oximetry monitoring for at least 12–24 hours (Correct answer)
- Respiratory assessment every 4 hours only
- Discharge after 2 hours if no symptoms present
- Capnography monitoring only during the first 30 minutes
Correct answer: Continuous pulse oximetry monitoring for at least 12–24 hours
Neuraxial opioids carry delayed respiratory depression risk, requiring continuous pulse oximetry monitoring for 12–24 hours per evidence-based guidelines.
Question 3: A PACU team wants to evaluate whether their new EBP-based PONV protocol improved patient outcomes. Which method best measures program effectiveness?
- Staff satisfaction surveys about the new protocol
- Comparing pre- and post-implementation PONV incidence rates (Correct answer)
- Reviewing only the protocol documentation for completeness
- Counting the number of antiemetic agents ordered
Correct answer: Comparing pre- and post-implementation PONV incidence rates
Comparing pre- and post-implementation outcome data (PONV incidence) directly measures clinical effectiveness of the EBP change.
Question 4: Evidence-based practice in ambulatory PACU recommends which approach for patients with obstructive sleep apnea (OSA) receiving opioids?
- Standard monitoring without modification
- Enhanced monitoring with continuous pulse oximetry and CPAP availability (Correct answer)
- Routine intubation for all OSA patients post-procedure
- Administering benzodiazepines to improve airway relaxation
Correct answer: Enhanced monitoring with continuous pulse oximetry and CPAP availability
Evidence supports heightened vigilance with continuous pulse oximetry and access to CPAP for OSA patients receiving opioids due to increased respiratory risk.
Question 5: Which principle of evidence-based practice ensures that patient values are incorporated alongside research evidence in clinical decision-making?
- Randomization
- Shared decision-making (Correct answer)
- Blinding
- Statistical significance
Correct answer: Shared decision-making
Shared decision-making integrates patient preferences and values with clinical expertise and best evidence as a core EBP principle.
Question 6: A CAPA nurse notes that a patient's Aldrete score has been 8 for 30 minutes without improvement. What is the most evidence-supported next step?
- Discharge the patient to Phase II recovery immediately
- Reassess all Aldrete criteria and identify which component is not improving (Correct answer)
- Administer a stimulant medication to boost the score
- Transfer the patient to the surgical floor
Correct answer: Reassess all Aldrete criteria and identify which component is not improving
Evidence-based care requires targeted reassessment of each Aldrete parameter to identify and address the specific reason for stalled recovery.
Question 7: According to EBP, which preoperative teaching strategy most effectively reduces postoperative anxiety and improves PACU outcomes?
- Written pamphlets provided at the surgical center on the day of surgery
- Structured preoperative education delivered before the day of surgery (Correct answer)
- Verbal instruction given by the surgeon during the consent process
- Educational videos shown only to patients who request them
Correct answer: Structured preoperative education delivered before the day of surgery
Evidence shows that structured preoperative education given in advance reduces anxiety, improves satisfaction, and supports faster postoperative recovery.
CAPA Evidence-Based Practice in PACU 5
When translating evidence-based research into PACU policy, which barrier most commonly impedes implementation?