Determining the Credibility of Evidence and Resources

Determining the Credibility of Evidence and Resources

Evidence-based practice (EBP) optimizes the quality of care by allowing nurses to uphold current evidence. Healthcare providers should collaborate with patients to implement EBP. This paper describes a quality issue that necessitates EBP. Furthermore, it discusses the criteria for evaluating the credibility of resources and identifies an EBP model used to tackle the quality issue.

Quality or Safety Issue

The quality issue is the use of evidence-based practices to manage and prevent central-line-associated bloodstream infection (CLABSI). CLABSI is a nosocomial infection that occurs within forty-eight hours (Haddadin et al., 2022). Gram-positive and negative bacteria and candida species have been implicated as the etiological agents for CLABSI (Haddadin et al., 2022). Notably, gram-positive bacteria account for more than forty percent of the cases, whereas gram-negative bacteria account for more than twenty percent of the cases (Haddadin et al., 2022). It is worth noting that the incidence of CLABSI is higher when non-tunneled catheters are used (Haddadin et al., 2022). Other factors that increase the risk of CLABSI include immunocompromised states, chronic illnesses, and malnutrition (Haddadin et al., 2022).

CLABSI increases morbidity rates, prolongs hospitalizations, and increases healthcare costs. CDC.gov (2023) reports that more than 30,000 cases of CLABSI are reported in the USA annually. CLABSI prolongs hospital stays and increases treatment costs; for instance, managing each case costs more than $45,000 (Haddadin et al., 2022). Furthermore, Larsen et al. (2019) report that the annual cost of managing CLABSI in the USA is more than $1.9 billion. Haddadin et al. (2022) report that CLABSI accounts for more than twenty-eight thousand deaths annually in the USA. As such, CLABSI is an issue of concern that should be addressed via concerted efforts among nurses and other clinicians.

Criteria Used to Determine the Credibility of Resources

Researchers can use various strategies to evaluate the credibility of resources. Notably, the CRAAP criteria provide an elaborate framework for evaluating five aspects of the resources. To begin with, it evaluates the currency of a resource. Currency checks whether or not the article is updated and reviewed and the functionality of external links (Esparrago-Kalidas, 2021). Secondly, relevance evaluates whether or not the resource addresses the research topic and the needs of the researcher (Esparrago-Kalidas, 2021). Thirdly, the authority evaluates the sources of the resource. This addresses aspects such as the credentials and affiliations of authors. Fourthly, accuracy evaluates the correctness of the information by focusing on aspects such as references, supporting evidence, and typographical errors (Esparrago-Kalidas, 2021). Finally, purpose checks whether or not the authors identified their objects and the presence of bias.

Credibility and Relevance of Evidence and Resources

In this context, the nurse seeks to manage and prevent future cases of CLABSI. As such, he should leverage peer-reviewed articles that discuss the aetiology, prevention, and management of CLABSI. Examples of relevant resources have been authored by  Awadh et al. (2021), Buetti et al. (2022), Park et al. (2020), and Selby et al. (2021). These resources fulfil the CRAAP test. To begin with, their currency is evidenced by the fact that they were published within the past four years. Furthermore, their relevance is evidenced by the fact that they discuss various aspects of CLABSI: the causes, risk factors, management, and prevention. Also, the authority of the resources is credible because the authors indicate their credentials and affiliations. The accuracy of the resources is evidenced by the presence of in-text citations, references, supporting evidence, and the absence of typographical errors. In addition, the authors identified the purpose of the articles. The articles aim to explore strategies for preventing and managing CLABSI.

Evidence-Based Practice Model

The nurse can embrace the Iowa Model of EBP to manage the patient and prevent future cases of CLABSI. This model acknowledges the role of patients, healthcare practitioners, the hospital’s management, and the infrastructure in implementing EBP (Cullen et al., 2022). As such, the model is an enabler for teamwork among the multidisciplinary team. The model requires the team to identify decision points and solve problems pragmatically. Researchers embrace sequential steps when using this model. Firstly, they should identify a problem that requires a change in practice (Cullen et al., 2022). Secondly, they should determine whether or not the problem is relevant to the healthcare facility (Cullen et al., 2022). Thirdly, they should formulate a research topic and assemble a team to participate in the research process. Fourthly, the team should ascertain whether or not quality evidence about the topic exists (Cullen et al., 2022). The absence of evidence necessitates research. Fifthly, the presence of credible evidence warrants a pilot test of the EBP. Finally, the success of the pilot project should be evaluated, and findings should be disseminated promptly (Cullen et al., 2022).

In this scenario, CLABSI is the problem that necessitates a change in practice. CLABSI is relevant because it prolongs hospital stays and increases healthcare costs and mortality rates. Research should focus on the management and prevention of CLABSI. Examples of stakeholders who should participate in research include laboratory technicians, nurses, pharmacists, and physicians. The team should embrace evidence from research to initiate a pilot test on the management and prevention of CLABSI. The stakeholders should evaluate the success of the pilot project and disseminate their findings.

Conclusion

CLABSI is a quality issue of concern because it is associated with prolonged hospital stays and high healthcare costs. The CRAAP test can be leveraged to assess the credibility of resources. This will enable researchers to incorporate the best evidence in their study. In addition, the Iowa Model of EBP will enable nurses to collaborate with patients and other healthcare practitioners to manage CLABSI.

References

Awadh, H., Chaftari, A. M., Khalil, M., Fares, J., Jiang, Y., Deeba, R., Ali, S., Hachem, R., & Raad, I. I. (2021). Management of enterococcal central line-associated bloodstream infections in patients with cancer. BMC Infectious Diseases, 21(1), 1–7. https://doi.org/10.1186/s12879-021-06328-9

Buetti, N., Marschall, J., Drees, M., Fakih, M. G., Hadaway, L., Maragakis, L. L., Monsees, E., Novosad, S., O’Grady, N. P., Rupp, M. E., Wolf, J., Yokoe, D., & Mermel, L. A. (2022). Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update. Infection Control and Hospital Epidemiology, 43(5), 553–569. https://doi.org/10.1017/ice.2022.87

CDC.gov. (2023). Bloodstream Infection Event Central Line-Associated Bloodstream Infection and Non-central Line-Associated Bloodstream Infection. https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf

Cullen, L., Hanrahan, K., Edmonds, S. W., Reisinger, H. S., & Wagner, M. (2022). Iowa Implementation for Sustainability Framework. Implementation Science, 17(1), 1–20. https://doi.org/10.1186/s13012-021-01157-5

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

Haddadin, Y., Annamaraju, P., & Regunath, H. (2022). Central Line Associated Blood Stream Infections. https://www.ncbi.nlm.nih.gov/books/NBK430891/

Larsen, E. N., Gavin, N., Marsh, N., Rickard, C. M., Runnegar, N., & Webster, J. (2019). A systematic review of central-line-associated bloodstream infection (CLABSI) diagnostic reliability and error. Infection Control and Hospital Epidemiology, 40(10), 1100–1106. https://doi.org/10.1017/ice.2019.205

Park, S., Moon, S., Pai, H., & Kim, B. (2020). Appropriate duration of peripherally inserted central catheter maintenance to prevent central line-associated bloodstream infection. PLoS ONE, 15(6 June), 1–11. https://doi.org/10.1371/journal.pone.0234966

Selby, L. M., Rupp, M. E., & Cawcutt, K. A. (2021). Prevention of Central-Line Associated Bloodstream Infections: 2021 Update. Infectious Disease Clinics of North America, 35(4), 841–856. https://doi.org/10.1016/

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Develop a 2-4 page scholarly paper in which you describe a quality or safety issue or a chosen diagnosis, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.

Determining the Credibility of Evidence and Resources

Introduction
The goal of using evidence-based research findings is to enhance the safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon 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. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in healthcare transformation, baccalaureate-prepared nurses are expanding, taking on leadership roles that include 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 the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.

It would be an excellent choice to complete the Vila Health Determining the Credibility of Evidence activity prior to 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 be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgment skills. When reliable and relevant evidence-based findings are utilized, outcomes for patients, health care systems, and nursing practice 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
The purpose of this analysis is to better understand what constitutes credibility of journal articles as well as 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 evidence-based templates is growing. This type of 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 as well as 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 done within the context of your chosen scenario for this assessment. For example, if you choose 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, if you are locating resources to help provide evidence-based care for the diagnosis/health care issue you identified in the first assessment, you may want to begin your literature and evidence search from the databases that were identified. 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, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will 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 that should be considered when determining the credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue or a chosen diagnosis.
This is where you are selecting 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 used to address a quality or safety issue, or a chosen diagnosis/health care issue. Review the literature below and choose 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 writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
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 successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Explain criteria that should be considered when determining the credibility of resources such as journal articles and websites.
Analyze the credibility and relevance of evidence and resources within the context of 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 used 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.