Locating Credible Databases and Research

Evidence-based practice is the widely recommended strategy for improving patient safety, quality of healthcare delivery, and achieving desired patient outcomes (Chien, 2019). It is defined as an approach in medical care that employs the most current research to improve patient safety and cost-effective quality of care. Impaired skin integrity is a common nursing diagnosis in practice. Pressure ulcers occur when there is an injury to the skin and underlying tissues arising from constant pressure, friction, or shear. Its pathogenesis involves tissue ischemia, reduced nutritional and oxygen supply, and tissue necrosis (Bhattacharya & Mishra, 2015). Immobilized patients, such as those with spinal fractures, are at an increased risk of developing pressure ulcers. Existing evidence shows that continuing medical education and training among nurses can enhance their competence in reducing the incidence of pressure ulcers (Getie et al., 2020). Impaired wound integrity is a significant nursing care concern. It could result in a prolonged treatment course, a high biomedical care burden, and sanctions in reimbursements from health insurers.

In this assessment, it is considered that the new nurse assigned a patient with a spinal fracture. The nurse immediately identifies the risk of the patient developing pressure ulcers and makes a nursing diagnosis of the risk of impaired skin integrity. As the nurse’s first assignment, she is not competent enough to implement evidence-based nursing interventions for this patient. As a senior nurse, my role is to identify and employ effective communication strategies to encourage less experienced nurses to conduct proper research on their patients’ diagnoses. Recommended guidelines and criteria for the appropriate evaluation of credible scientific sources will be identified, and a list of such sources will be described.

Effective Communication Strategies

The Institute of Medicine recommends lifelong learning for the nursing profession (Qalehsari et al., 2017). According to Mlambo et al. (2021), nurses report that supervision, team briefings, mentoring programs, and observations are fundamental to learning on the job. Effective communication channels and the development of meaningful relationships at work is fundamental and a prerequisite to lifelong learning (Qalehsari et al., 2017). A baccalaureate nurse is expected to have strong communication and leadership skills and, therefore, provide oversight in the strategic implementation of programs like evidence-based nursing practice. These skills include active listening, appropriate non-verbal cues, proper verbal communication, and strong competence in written nurse-to-nurse communication. The nurse will receive tips on verifying website addresses, which addresses are credible (like .gov), examples of databases, and how to conduct a search.

Formal mentorship between experienced nurses and newly trained nurses helps build confidence, provide guidance, and promote commitment. Strategies for encouraging diagnosis-based research include group work, lectures, practicum work, online modules, and simulations (Horntvedt et al., 2018). These strategies are effective in integrating evidence-based practice into nursing care. Nurse mentors can also use clinical aids such as the Practice Nurse Postcard tool to communicate current evidence-based interventions for specific patient ailments (Dadich & Hosseinzadeh, 2016). A nurse evidence-based practice mentor will ensure that a section at the floor nursing station is availed and dedicated to nursing research. Multiple computers with internet access and already logged on to the identified databases in this assessment will be provided

Sites to Conduct Research

Finding credible reference resources may be challenging as there is a wide range of information online. Adoption of the CRAAP test is one suitable method to evaluate content. The acronym stands for Currency, Relevance, Authority, Accuracy, and Purpose (Central Michigan University, 2020). While it is unlikely to encounter information that fails the CRAAP test in the databases accessed through an approved database, questionable information may arise from peers or personal experiences. Therefore, it is fundamental for nurses to understand what constitutes a credible source and where it can be accessed. Using approved databases accessed through institutional log-in portals is also fundamental to ensuring that only credible reference materials are accessed and adopted in evidence-based practice.

Identification of Five Sources

Application of the CRAAP test in evaluating research sources accessed through the internet established the following five credible sources suitable for EBP on management and prevention of impaired skin integrity as a nursing diagnosis. They include the PubMed website supported by the National Library of Medicine, the Journal of Wound, Ostomy and Continence Nursing, the BMC Nursing Journal published by BioMed Central, the Scopus database powered by Elsevier publishing, and the CINAHL Database run by EBSCO. Peer-reviewed articles from these sources provide current, relevant, scientific, and sound information that is accurate, centered around the main research objective fronted by the authors, and makes conclusions that reconcile with the primary objectives. These sources satisfactorily fulfill the criteria provided by the CRAAP test and are, therefore, credible to be used as suitable reference materials.

The Rationale for Applying the Identified Sources

The sources identified provided access to peer-reviewed, full-text articles from top-notch health and nursing journals. These sources contain both published primary studies and systematic reviews. Although high-quality randomized control studies provide the foundation of new and developing knowledge, reviewing them entirely is an enormous effort. Systematic reviews consolidate studies from more than one high-quality study and summarize the different findings in a single report. Therefore, most systematic reviews address narrow questions and are suitable for nursing diagnoses in this assessment scenario. Identified major databases help limit such irrelevant and impractical articles. These databases and journals are usually current on evidence-based practice research to manage and prevent impaired skin integrity, specifically pressure ulcers. These databases make credible articles easy to locate and at an affordable cost. Further, nurses should be encouraged to have patience and practice using these databases and articles frequently. Consequently, this will give them the technical know-how to quickly identify credible sources and eliminate unsuitable reference material.

Conclusion

The paradigm shift in the planning and implementation of nursing care is a notable change in current nursing practice. Adoption of evidence-based nursing practice empowers nurses through mentored partnerships to improve their critical thinking, adopt research findings into practice, and have interprofessional collaborations toward best practices. The initial nurse mentor, Florence Nightingale, laid the foundation of evidence-based practice in clinical decision-making. However, the first step is the proper identification of credible resources.

Nurse mentors using effective communication strategies are, therefore, instrumental in evidence-based practice. Transformational leadership has been associated with positive outcomes in patient safety. Therefore, more transformative nurse leaders could play a critical role in determining the success of evidence-based practice. As a baccalaureate nurse leader, I am responsible for training the next cohort of competent nurses. Accordingly, this can be achieved through supporting evidence-based practice mentorship, ensuring appropriate feedback, and providing guidance, information, time, and other resources, such as the CRAAP approach to encourage evidence-based care for patients. As a result, this will ensure that their involvement and competence are continually enhanced and align with the unit’s quality goals.

References

Bhattacharya, S., & Mishra, R. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India, 48(1), 4. https://doi.org/10.4103/0970-0358.155260

Central Michigan University. (2020). Website research: CRAAP test.

https://libguides.cmich.edu/web_research/craap

Chien, L. Y. (2019). Evidence-Based Practice and Nursing Research. The Journal of Nursing Research, 27(4), e29. https://doi.org/10.1097/JNR.0000000000000346

Dadich, A., & Hosseinzadeh, H. (2016). Communication channels to promote evidence-based practice: A survey of primary care clinicians to determine perceived effects. Health Research Policy and Systems, 14(1), 1–12. https://doi.org/10.1186/S12961-016-0134-Z/TABLES/2

Getie, A., Baylie, A., Bante, A., Geda, B., & Mesfin, F. (2020). Pressure ulcer prevention practices and associated factors among nurses in public hospitals of Harari regional state and Dire Dawa city administration, Eastern Ethiopia. PLOS ONE, 15(12), e0243875. https://doi.org/10.1371/JOURNAL.PONE.0243875

Horntvedt, M. E. T., Nordsteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: A thematic literature review. BMC Medical Education, 18(1), 1–11. https://doi.org/10.1186/S12909-018-1278-Z/TABLES/3

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a meta synthesis of the literature. BMC Nursing, 20(1), 1–13. https://doi.org/10.1186/S12912-021-00579-2/TABLES/4

Qalehsari, M. Q., Khaghanizadeh, M., & Ebadi, A. (2017). Lifelong learning strategies in nursing: A systematic review. Electronic Physician, 9(10), 5541. https://doi.org/10.19082/5541Create a 2-4 page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP.

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Question

The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

Locating Credible Databases and Research

For this assessment:

Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario or clinical practice issue/diagnosis and describe to which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the workplace to complete this research and how you would access the desired, relevant research within research databases or other online sources.
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 communication strategies to encourage nurses to research the diagnosis/practice issue, as well as strategies to collaborate with the nurses to access resources.
Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis/health care issue within the context of a specific health care setting.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis/practice issue.
Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis/health care issue.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis/practice issue, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.

Scenario

You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane Library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments, and you have all participated in shift reports. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse in finding research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.

You may choose the diagnosis for the patient in this scenario or the health care issue/diagnosis of your choice. Or you may choose something you would find interesting to research or that applies to a clinical problem/diagnosis you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, journal article, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.

Create a 2-4 page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP.

For this assessment:

Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario or clinical practice issue/diagnosis and describe to which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the work place to complete this research and how you would access the desired, relevant research within research databases or other online sources.
Be sure to address the following in this assessment, which correspond 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.

Scenario

You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.

You may choose the diagnosis for the patient in this scenario or health care issue/diagnosis of your choice. Or you may choose something you would find interesting to research or that applies to a clinical problem/diagnosis you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, journal article, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.