Determining the Credibility of Evidence and Resources

Determining the Credibility of Evidence and Resources

Quality or Safety Issue

The quality issue in this scenario is a new nurse using an evidence-based approach to manage a patient with ventilator-associated pneumonia. Ventilator-associated pneumonia is a nosocomial infection that occurs 8 hours or more after the start of mechanical ventilation (Papazian et al., 2020). Mechanical ventilation compromises the lower respiratory system and permits the entry of gastrointestinal secretions into this system (Papazian et al., 2020). This is an enabler for colonization of the lower respiratory tract by microorganisms, hence Ventilator-associated pneumonia (VAP) (Papazian et al., 2020).

VAP is associated with high morbidity and mortality rates. Furthermore, VAP has a negative financial impact on the patient and the healthcare facility. Patients incur extra costs due to prolonged hospitalizations (Sousa et al., 2019). Data demonstrates that patients incur an additional $41,000 on the management of VAP (Sousa et al., 2019). On the other hand, an increase in the incidence of VAP attracts penalties for healthcare facilities. By so doing, monetary reimbursements from insurers will reduce significantly (Sousa et al., 2019). Nurses and other healthcare providers should embrace evidence-based practices to prevent and manage VAP adequately to reduce treatment costs and improve patient safety.

Criteria to be Considered When Determining Credibility of Resources

Nurses and other healthcare providers should embrace the CRAAP (currency, relevance, authority, accuracy, and purpose) test to determine the credibility of resources. CRAAP test enables a researcher to develop a checklist to guide the evaluation process (Esparrago-Kalidas, 2021). Resources that fulfill the components of the checklist are considered credible and reliable. Firstly, currency determines when the resource was authored, posted, reviewed, or revised (Esparrago-Kalidas, 2021). Additionally, it evaluates whether the external links are valid. Secondly, relevance examines whether the resource applies to the research topic and the target population. Thirdly, the authority authenticates the authors by evaluating their qualifications and the organizations with which they are affiliated (Esparrago-Kalidas, 2021).

Furthermore, the uniform resource locators of resources and authors are assessed to determine their correctness and relevance. Fourthly, accuracy determines whether the information provided by the resources is verifiable, logically correct, and backed by evidence (Esparrago-Kalidas, 2021). Fifthly, purpose evaluates whether the goals and objectives of the resource are stated clearly.

Analyze Credibility and Relevance of Evidence within the Context of the Issue

In this scenario, the new nurse is managing a patient with VAP. She is supposed to locate credible evidence that provides detailed information on VAP, including its etiology, prevention, and management. Examples of resources that the nurse should embrace are authored by Branco et al. (2020), Kallet (2019), Martin-Loeches et al. (2018), Papazian et al. (2020), Sousa et al. (2019), Wu et al. (2019) and Yeganeh et al. (2019). The utility of the CRAAP test reveals that the articles provide credible and relevant evidence. Firstly, they offer the current information as evidenced by the year of their publication (within the past five years). Secondly, they are relevant because they provide critical information on VAP. Notably, they discuss the management, prevention, and practice essentials of VAP. Thirdly, the credentials of the authors and affiliated organizations are verifiable. Fourthly, the accuracy of the resources is demonstrated by the fact that they are peer-reviewed.

Additionally, their information is backed up by references and adequately referenced. The purpose of the resources is clearly defined and is harmonious with the quality issue of concern (ventilator-associated pneumonia). These resources will equip the new nurse with relevant knowledge of VAP and enable her to manage the patient adequately.

Importance of Incorporating Credible Evidence into the EBP Model

Evidence-based practice models give nurses a structured framework for research. As such, nurses embrace the best evidence in their clinical decision-making process. In this scenario, the Iowa model is relevant. The model acknowledges the role of all stakeholders in a healthcare facility in the decision-making process while selecting the best evidence (Cullen et al., 2020). By so doing, it promotes interdisciplinary collaboration. It has sequential phases: identifying an issue that necessitates change, evaluating the relevance of the issue to the facility, creating a problem statement, recruiting an interdisciplinary team to research the issue, and determining whether credible evidence is available (Cullen et al., 2020). Research is necessitated when credible evidence is absent. If credible evidence is present, the evidence-based practice is implemented on a pilot basis. After that, its success is evaluated.

The Iowa model applies to this scenario that involves VAP. In this context, VAP is the problem that necessitates change. It is relevant to the organization because it is associated with high morbidity and mortality rates. Additionally, it impacts monetary reimbursements from insurers. Research should be focused on the prevention and adequate management of VAP. Members of the interdisciplinary team, such as nurses, physicians, and pharmacists, should be involved in the research. Findings from research should form the basis of a pilot study on preventing and managing VAP. Evaluation of the pilot study will reveal the effectiveness of the chosen intervention.

 Conclusion

The quality issue in this scenario is a new nurse using an evidence-based approach to manage a patient with ventilator-associated pneumonia. The nurse should use the CRAAP test to evaluate the credibility and relevance of resources. Additionally, the healthcare facility can use the Iowa evidence-based practice model to choose the best evidence-based practice.

 References

Branco, A., Lourençone, E. M. S., Monteiro, A. B., Fonseca, J. P., Blatt, C. R., & Caregnato, R. C. A. (2020). Education to prevent ventilator-associated pneumonia in intensive care unit. Revista Brasileira de Enfermagem, 73(6), e20190477. https://doi.org/10.1590/0034-7167-2019-0477

Cullen, L., Hanrahan, K., Farrington, M., Anderson, R., Dimmer, E., Miner, R., … & Rod, E. (2020). Evidence-based practice change champion program improves quality care. JONA: The Journal of Nursing Administration, 50(3), 128-134. https://doi.org/10.1097/NNA.0000000000000856

Esparrago-Kalidas, A. J. (2021). The Effectiveness of CRAAP Test in Evaluating Credibility of Sources. International Journal of TESOL & Education, 1(2), 1–14.

Kallet, R. H. (2019). Ventilator bundles in transition: From preventing ventilator-associated pneumonia to preventing ventilator-associated events. Respiratory Care, 64(8), 994–1006. https://doi.org/10.4187/respcare.06966

Martin-Loeches, I., Rodriguez, A. H., & Torres, A. (2018). New guidelines for hospital-acquired pneumonia/ ventilator-associated pneumonia: USA vs. Europe. Current Opinion in Critical Care, 24(5), 347–352. https://doi.org/10.1097/MCC.0000000000000535

Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Medicine, 46(5), 888–906. https://doi.org/10.1007/s00134-020-05980-0

Sousa, A. S., Ferrito, C., & Paiva, J. A. (2019). Application of a ventilator-associated pneumonia prevention guideline and outcomes: A quasi-experimental study. Intensive and Critical Care Nursing, 51, 50–56. https://doi.org/10.1016/j.iccn.2018.10.001

Wu, D., Wu, C., Zhang, S., & Zhong, Y. (2019). Risk factors of ventilator-associated pneumonia in critically III patients. Frontiers in Pharmacology, 10(MAY), 1–7. https://doi.org/10.3389/fphar.2019.00482

Yeganeh, M., Yekta, H., Farmanbar, R., Khalili, M., Khaleghdoost, T., & Atrkar Roushan, Z. (2019). Knowledge of evidence-based guidelines in ventilator-associated pneumonia prevention. Journal of Evidence-Based Medicine, 12(1), 16–21. https://doi.org/10.1111/jebm.12188

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Introduction
The goal of using evidence-based research findings is to enhance the safety and quality of patient care and ensure optimal outcomes. It is expected to hear a nurse say, “Why change it as we’ve always done it this way.” However, this is no longer acceptable in today’s practice environment. Nursing has evolved, and the professional nurse is expected to have a scientific foundation to support the care provided. As the nursing profession continues to grow and engage in healthcare transformation, baccalaureate-prepared nurses are expanding, taking on leadership roles incorporating EBPs. To be able to do this, the nurse needs to understand the criteria and make a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into health care settings. The nurse will need to incorporate the use of evidence-based practice models. EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct users to incorporate scholarly findings into current practice. These EBP models lead the nurse to evaluate the literature to determine the best practice evidence for the practice issue or question.

Determining the Credibility of Evidence and Resource

It would be an excellent choice to complete the Vila Health Determining the Credibility of Evidence activity before developing the report. The activity is a media simulation that offers an opportunity to review a scenario and work on determining the credibility of the presented evidence. These skills will be necessary to complete Assessment 2 successfully. This media simulation is one potential source of context on which to base your assessment submission. This will take just a few minutes of your time and is not graded.

Professional Context
As a baccalaureate-prepared nurse, you will locate and identify credible and scholarly resources to incorporate the best available evidence to enhance clinical reasoning and judgment skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.

Scenario
For this assessment, you may choose from the following options as the context for the quality or safety issue or chosen diagnosis/health issue for researching and completing this assessment:

The specific diagnosis/health issue you identified in your previous assessment.
The simulation Vila Health: Determining the Credibility of Evidence.
A personal practice experience in which a sentinel event occurred.
Instructions
This analysis aims to understand better what constitutes the credibility of journal articles and websites. The role of the baccalaureate-prepared nurse in incorporating evidence-based research continues to grow in clinical practice. As quality improvement (QI) measures to reduce safety risks continue to be emphasized, the need for evidence-based models and templates is growing. This systematic approach to incorporating evidence-based findings allows nurses to make clinical and operational decisions based on the best available evidence. When the most up-to-date evidence-based findings are utilized, patient-centered care improves outcomes and enhances the patient experience.

Below is a quick review table of several well-known Evidence-Based Practice Models used to guide exploration:

Evidence-Based Practice Models
Iowa Model of Evidence-Based Practice
Stetler Model
Ottawa Model
PARiHS (Promoting Action on Research Implementation in Health Services) Model
ACE (Academic Center for Evidence-Based Practice) Star Model
ARCC (Advancing Research and Clinical Practice Through Close Collaboration) Mode
John Hopkins Model
KTA (Knowledge-to-Action) Model
For this assessment:

Explain the criteria that should be used when determining the credibility of journal articles and websites.
Support your explanations with references to the literature or research articles that describe criteria that should be used to determine credibility.
Your identification and determination of credibility should be made within the context of your chosen scenario for this assessment. For example, if you decide to use the provided Vila Health scenario, your initial identification of resources should be of resources that will best help address the presented issue. However, suppose you are locating resources to help provide evidence-based care for the diagnosis/health care issue you identified in the first assessment. In that case, you may want to begin your literature and evidence search from the databases that were placed. Any of the three scenario options are acceptable. So, pick the one that most interests you.
Be sure to address the following in this assessment, corresponding to the grading criteria in the scoring guide. Please study the scoring guide carefully to know what is needed for a distinguished score.

Describe a quality or safety issue or a chosen diagnosis that could benefit from an evidence-based approach.
Explain criteria when determining the credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within a quality or safety issue or a chosen diagnosis.
You select the specific resources to help address the issue in your chosen scenario.
Identify the Evidence-Based Practice model and explain the importance of incorporating credible evidence into the EBP model to address a quality or safety issue or a chosen diagnosis/health care issue. Review the literature below and select the appropriate model for your diagnosis/health care issue.
Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models help explain the various evidence-based nursing models.
Communicate using the current APA style using clear, logical, and professional writing with correct grammar and spelling.
Additional Requirements
Your assessment should meet the following requirements:

Length of submission: 2-4-page scholarly paper; this does not include the APA-formatted title page and reference list.
Number of references: Cite 3-5 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than five years old.
APA formatting: References and citations are formatted according to the current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

Competencies Measured
By completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 2: Analyze evidence’s relevance and potential effectiveness when deciding.
Explain criteria when determining the credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within a quality or safety issue or a chosen diagnosis.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Identify an evidence-based practice model (such as Iowa, Stetler, John Hopkins, etc.) and explain the importance of incorporating credible evidence into an EBP model to address a quality or safety issue or a chosen diagnosis/health care issue.
Competency 4: Plan care based on the best available evidence.
Describe a quality or safety issue or a chosen diagnosis that could benefit from an evidence-based approach.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Organize content so ideas flow logically with smooth transitions; contain few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.