NURS 4030 Assessment 2: Portfolio Prompt Paper

NURS 4030 Assessment 2: Portfolio Prompt Paper

 

 

Evidence-Based Practice: Credibility of Evidence

Patient safety concerns arise from medical devices, surgical procedures, infections, antibiotic resistance, and falls. The Patient Safety Component (PSC) by the National Healthcare Safety Network (NHSN) focuses on measures to improve the safety of the patient from risks that arise from the above elements of patient safety (Centers for Disease Control and Prevention, 2021). My chosen clinical issue of interest concerns falls among residents in long-term care (LTC) facilities. Falls and fall-related injuries among residents in the LTCs contribute to significant mortality and morbidity among the victims.

Various fall prevention strategies have been used by LTCs to improve patient safety. However, falls still occur. Interventions that were used a decade ago may not be in use because the latest evidence has provided new insights into practice. To enhance these new insights into practice, the pieces of research evidence need to be credible and authoritative enough to change practice. The purpose of this paper is to elaborate on my clinical issues of interest and select credible evidence sources to provide answers to the issue using the John Hopkins Model.

Clinical Issues

Falls among patients in LTCs can be prevented by using technology, among other strategies. From the global perspective, falls come second to road traffic accidents as one of the leading causes of unintentional injuries. As individuals age, the frequency of falls rises due to increased risks such as degenerative diseases, cognitive problems, and increased fragility. Use of walking aids, previous fall history, and physical disability are some of the strongest predictors of falls. Among residents in LTCs, the older adults form a larger percentage and have most of these predicts. Effective fall prevention can save the individual as well as the health system significant cost of healthcare. Various technologies have been used to detect, recognize, and prevent falls among patients in hospitals.

Wearable technology is a technology that has been utilized in healthcare for different purposes. In this clinical issue, I aim to ascertain the benefit of wearable technology over other fall prevention methods. Wearable devices use various technology concepts such as gyroscopes, barometers, and accelerometers, either singly or in combination, to achieve their functions. Understanding the benefits and applicability of this intervention in health prevention would benefit from an evidence-based approach. Using the John Hopkins Model, the acquisition of evidence – the third step – requires the formation of the research question. In this case, my PICO question stated: among elderly patients in long-term care facilities, does the use of wearable technology have better fall prevention outcomes than other types of technologies?

Evidence

There are various ways to ascertain the credibility of the evidence during the evaluation phase of EBP. The credibility of the evidence is the trustworthiness of the information (Lund et al., 2021). Several criteria have been used to assess the credibility and quality of the information provided by online health information websites and journals. Currently, there is no unanimously and standardly agreed-on criterion or tool for credibility assessment of health information. In this evaluation, my criterion for assessing credibility encompasses timeliness, author information, source of the information (Lenaerts et al., 2020), methodology, and evidence level (Melnyk & Fineout-Overholt, 2018), and relevance of language used for the audience intended. Two journal articles were selected to answer the research question formulated.

According to a study by Warrington et al. (2021), wearable technology offers a low cost and more accurate ways of fall detection, alerting, and prevention. This piece of evidence is credible because it meets my criterion aforementioned. The authors are health professionals with command of the knowledge in the healthcare field as presented in the author information section of the article. The study was published in 2021 – a year ago – making the information timely, more accurate, and up to date. The article was retrieved from Cochrane liberal, a renowned journal library for health-related journal articles and other publications. This study is a systematic review study and thus has a high quality of evidence because it synthesizes pieces of information from many primary sources and focuses on one topic. The information in this piece of evidence is presented logically with conventional headings and subheadings and in medical language. This presentation makes it credible because the audience is familiar with the format and thus trustable. The authors presented the process of coming up with the research findings.

The second study by Pang et al. (2019) found that wearable devices are cost-effective and can be used for long-term monitoring of older adults at risk of falls. This study reviewed and analyzed nine studies from their literature search results. The applicability of wearable devices was also reported in preventing near falls and promoting other activities of daily living. These findings are credible because the article meets the aforementioned criteria. The findings are current because the study was carried out and published in the past five years.  The authors’ expertise and knowledge are relevant to the content of the article, and the publishing journal is reputable and relevant – the journal of geriatric physical therapy. The systematic presentation of the information and the language used is relevant to the intended audience – health professionals. Therefore, these two pieces of evidence are credible because they meet various aspects of different criteria for credibility assessment.

Evidence-based Model and Importance of Credible Evidence

In this evidence-based process, the Johns Hopkins Nursing Evidence-based Practice: Model has been used. In this model, the process of EBP includes practice questions, evidence, and translation (Dang & Dearholt, 2019). The practice question helps in clinical inquiry and the selection of relevant evidence. The evidence phase involves evaluating the sources and pieces of evidence and summarizing and consolidating this evidence to meaningfully guide practice implementation. In the process, credible evidence has been obtained to answer the research question. Credible evidence is crucial because it helps approach patient more effectively (Roth-Cohen et al., 2021), improves health professionals’ health preventive behaviors, and prevent misinformation to patients by enabling them to provide evidence-based patient education (Amit Aharon et al., 2020; Budin, 2018). Credible evidence is therefore useful to the health care provider as well as the patients.

Conclusion

Evidence credibility is yet to be standardized. Various tools have been used by various scholars but vary slightly in criteria. However, some concepts cut across most of these tolls and have been applied in this project to provide credible answers to my research question. My clinical issue of interest was the use of wearable devices to prevent falls. The Johns Hopkins EBP model guided the process of evidence acquisition. Two high-level pieces of evidence were selected and used to answer the research question. These articles provided credible evidence because their findings were timely, provided by provided authors, sourced from reputable journals, published recently, and relayed in a systematic scholarly manner.

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References

Amit Aharon, A., Ruban, A., & Dubovi, I. (2020). Knowledge and information credibility evaluation strategies regarding COVID-19: A cross-sectional study. Nursing Outlook, 69(1), 22–31. https://doi.org/10.1016/j.outlook.2020.09.001

Budin, W. C. (2018). Credible evidence for practice. The Journal of Perinatal Education, 27(4), 187–189. https://doi.org/10.1891/1058-1243.27.4.187

Centers for Disease Control and Prevention. (2021, December 15). Patient safety component (PSC). Cdc.Gov. https://www.cdc.gov/nhsn/psc/index.html

Dang, D., & Dearholt, S. (2019). Johns Hopkins nursing evidence-based practice: Model and guidelines (3rd ed.). SIGMA Theta Tau International.

Lenaerts, G., Bekkering, G. E., Goossens, M., De Coninck, L., Delvaux, N., Cordyn, S., Adriaenssens, J., & Vankrunkelsven, P. (2020). Tools to assess the trustworthiness of evidence-based point-of-care information for health care professionals: Systematic review. Journal of Medical Internet Research, 22(1), e15415. https://doi.org/10.2196/15415

Lund, H., Juhl, C. B., Nørgaard, B., Draborg, E., Henriksen, M., Andreasen, J., Christensen, R., Nasser, M., Ciliska, D., Clarke, M., Tugwell, P., Martin, J., Blaine, C., Brunnhuber, K., Robinson, K. A., & Evidence-Based Research Network. (2021). Evidence-Based Research Series-Paper 2 : Using an Evidence-Based Research approach before a new study is conducted to ensure value. Journal of Clinical Epidemiology, 129, 158–166. https://doi.org/10.1016/j.jclinepi.2020.07.019

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Lippincott Williams and Wilkins.

Pang, I., Okubo, Y., Sturnieks, D., Lord, S. R., & Brodie, M. A. (2019). Detection of near falls using wearable devices: A systematic review. Journal of Geriatric Physical Therapy (2001), 42(1), 48–56. https://doi.org/10.1519/jpt.0000000000000181

Roth-Cohen, O., Levy, S., & Zigdon, A. (2021). The mediated role of credibility on information sources and patient awareness toward patient rights. International Journal of Environmental Research and Public Health, 18(16), 8628. https://doi.org/10.3390/ijerph18168628

Warrington, D. J., Shortis, E. J., & Whittaker, P. J. (2021). Are wearable devices effective for preventing and detecting falls: an umbrella review (a review of systematic reviews). BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-12169-7

Instructions for NURS 4030 Assessment 2

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.

Introduction

The goal of using evidence-based research findings is to enhance 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 health care 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 makes 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 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 judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care 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

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 growth 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 upon 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 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.

• 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 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 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 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 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; contains 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.