Determining the Credibility of Evidence and Resources Paper

Determining the Credibility of Evidence and Resources Paper

 NURS FPX 4030 Assessment 2: Determining the Credibility of Evidence and Resources

Determining the Credibility of Evidence and Resources is important to assess the trustworthiness of the information presented in these resources. Their trustworthiness determines their applicability to practice and influencing decision-making. Less credible sources make clinical arguments less powerful. Credible information is used by a clinician at the point of care to provide evidence-based care. A scenario is given of a new nurse who is tending to a post-operative patient on day 2. He notes that the incision site is swollen and reddish. He is concerned that this might be an intermediate complication of the surgery. However, he is unsure of what diagnosis to make. The purpose of this paper is fourfold: to describe this patient safety issue, to establish a criterion for assessing the credibility of resources that would be sued to answer this safety issue, and adopt an EBP model to justify the process of utilizing resource’s information, explain their credibility.

The Chosen Diagnosis

The hypothetical patient has abdominal surgery three days ago. On postop day 2, the nurses note redness and swelling at the incision site. The patient’s temperature is within the normal limits and there is no purulent discharge from the site. The nurse suspects a diagnosis of surgical site and infection as his medical diagnosis. He is, however, unsure and would like to research further and establish this diagnosis in this patient for more evidence-based care planning. His suspected diagnosis would benefit from evidence-based practice.

Evidence-based practice uses the best available practice evidence to influence practice and clinical decision-making (Abu-Baker et al., 2021). This nurse requires to make the best clinical decision for this patient but is unable to establish for sure if the patient is developing a surgical site infection. Surgical site infections are among the major causes of patient safety risks in hospitals (Liu et al., 2018). Other causes include but are not limited to injuries, falls, and medication errors. This nurse requires to apply EBP, in this case, to promote patient safety and keep up to date with current practices and be ready for similar situations in the future in his practice.

Criteria for Credibility

There is no standard method or criteria for assessing the credibility of online information including articles and websites. Various methods and criteria have been used in different settings. The CRAAP Test is a method that has been in use and taught by many institutions for establishing resource credibility (Garcia et al., 2018). The CRAAP is an acronym that stands for currency, relevance, authority, accuracy, and purposes. Under currency, this criterion assesses for timeliness of the information. Information published in the past five years is deemed current (Kurpiel, 2022). Under relevance, the CRAAP test assesses the importance of the resource’s information in answering the clinical issue. This includes the appropriateness of the level of information, the relation to the clinical issues, and the intended audience in the resource.

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Authority criterion is used to determine the author, the educational qualification, the relevant professional levels, and their credentials. For websites, the uniform resource locater (URL) a link is important. Website URLs ending with .gov, .edu, and .org will be more authoritative for the case diagnosis above (Mazer et al., 2021). Accuracy assesses for reliability, truthfulness, and content correctness of the resources (Kurpiel, 2022). The level of evidence in the hierarchy of evidence will be an important indicator of the accuracy of the resource findings. The purpose of the resource is also important in the CRAAP test. Religious expert opinions would serve are ranked differently from systematic reviews on a credibility scale because of different purposes.

Applying this criterion is simpler. For every resource of information, the researcher would ask themselves when was the resource published, whether is it relevant to answer my clinical question, who published the information, how accurate are the findings, and what was the resource meant to achieve? This applies to websites, articles, books, and even online media such as YouTube videos. Therefore, the CRAAP criterion is useful during the critical appraisal in the EBP cycle. When assessing a website, for example, for credibility, the researcher will find the title of the page and its relevance to the issue at hand, the publisher of the website, its website name (an example is cdc.gov), the year the content was published, and the purpose of the content (Kurpiel, 2022). In so doing they will have assessed the currency, relevance, authority, accuracy, and purpose. Sometimes, the source may lack the actual human author and the corporate author such as CDC will have an impact on the credibility of the resource (Lenaerts et al., 2020). For articles, the journal database may be important for credibility assessment.

The credibility of Selected Evidence Resources

I identified three resources to solve the nurse’s diagnosis issue in the clinical scenario described earlier. Three resources were identified, all journal articles by McLean et al. (2021) Mengesha et al.(2020), and Sajun et al. (2020). Using the CRAAP test, all these sources are current because they were published in the past two years. They are relevant to answering the clinical issues but the source by Mengesha et al. (2020) is more credible because it addresses the issues specific to nurses. All the sources are authoritative because they were authored by a healthcare professional but the source by Mengesha et al. (2020) is the most authoritative because it was authored by nurses. The three sources are accurate because the authors are experts in various clinical fields. The by Mengesha et al. (2020) still stands out as the most purposeful source for this clinical issue because it intended to answer the diagnosis of SSIs besides explaining the factors that affect this diagnosis among nurses. The information from all the sources is contributory and useful the source by Mengesha et al. (2020) is the most credible source based on the CRAAP test analysis.

Evidence-Based Practice Model and Importance of Incorporating Credible Evidence

Various EBP models exist for use among healthcare professionals. For this clinical issue, the Johns Hopkins Nursing Evidence-based Practice Model was selected for the process of researching the nursing diagnosis for the nurse in the case scenario (Vera, 2022). In the Johns Hopkins Nursing Evidence-based Practice Model, the practitioner enters into a cycle involving clinical inquiry, research, implementation of best practices, evaluation this the outcomes, and reflection on the outcomes (Dang et al., 2022). The research phase involves alternating between learning and practice through the formulation of practice questions, acquisition of evidence, and translation of the evidence into practice. This model will improve the nurse’s learning and practice through knowledge acquisition from the best sources.

Following the sequential stages in the model, the nurse will gain the best practices leading to a best practice environment. The model requires constant reflection at every stage thus an important quality assurance for decisions made. The nurse will make his decision based on the acquired information and will have to constantly reflect on the outcomes of the decisions made in the care of the patient. It will important for the nurse to incorporate credible evidence while using this model because the outcomes of his care plans and implementations depend on the accuracy of the information. His patient education will also depend on the credibility of the information he knows about the issue (Lenaerts et al., 2020). Therefore, he will need the most credible evidence to educate and influence the patient to increase their participation, experience, and satisfaction. This will lead to quality in healthcare. Implementing the credible will make his care reliable and valid per the CRAAP test criteria. The safety of the patient will depend on his decision

Conclusion

Evidence-based practice will be the best method for the nurse to make the best decisions and practices. The CRAAP test offers the criteria for assessing the credibility of the information by assessing for currency, relevance, authority, accuracy, and purpose of the resources. The presented three sources will be all valid for application into practice by the nurse but one source will be the most credible because it intended to answer the issue specifically among nurses thus purposeful and most credible. John Hopkins’s EBP model will beys suffice his process of diagnosis research.

References

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: a cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1), 13. https://doi.org/10.1186/s12912-020-00522-x

Dang, D., Dearholt, S., & Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins nursing evidence-based practice: Model and guidelines (4th ed.). SIGMA Theta Tau International. https://www.hopkinsmedicine.org/evidence-based-practice/ijhn_2017_ebp.html

Garcia, M., Daugherty, C., Ben Khallouq, B., & Maugans, T. (2018). Critical assessment of pediatric neurosurgery patient/parent educational information obtained via the Internet. Journal of Neurosurgery. Pediatrics, 21(5), 535–541. https://doi.org/10.3171/2017.10.PEDS17177

Kurpiel, S. (2022, April 13). Research guides: Evaluating sources: The CRAAP test. https://researchguides.ben.edu/c.php?g=261612&p=2441794

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

Liu, Z., Dumville, J. C., Norman, G., Westby, M. J., Blazeby, J., McFarlane, E., Welton, N. J., O’Connor, L., Cawthorne, J., George, R. P., Crosbie, E. J., Rithalia, A. D., & Cheng, H.-Y. (2018). Intraoperative interventions for preventing surgical site infection: an overview of Cochrane Reviews. The Cochrane Library, 2018(2). https://doi.org/10.1002/14651858.cd012653.pub2

Mazer, A. J., Mazer, M. A., & Meisenberg, B. R. (2021). Teaching deliberation and restraint in interpreting a tempest of COVID-19 “information.” ATS Scholar, 2(2), 163–167. https://doi.org/10.34197/ats-scholar.2020-0160CM

McLean, K. A., Mountain, K. E., Shaw, C. A., Drake, T. M., Pius, R., Knight, S. R., Fairfield, C. J., Sgrò, A., Bouamrane, M., Cambridge, W. A., Lyons, M., Riad, A., Skipworth, R. J. E., Wigmore, S. J., Potter, M. A., Harrison, E. M., & TWIST Collaborators. (2021). Remote diagnosis of surgical-site infection using a mobile digital intervention: a randomized controlled trial in emergency surgery patients. NPJ Digital Medicine, 4. https://doi.org/10.1038/s41746-021-00526-0

Mengesha, A., Tewfik, N., Argaw, Z., Beletew, B., & Wudu, M. (2020). The practice of and associated factors regarding prevention of surgical site infection among nurses working in the surgical units of public hospitals in Addis Ababa city, Ethiopia: A cross-sectional study. PloS One, 15(4), e0231270. https://doi.org/10.1371/journal.pone.0231270

Sajun, S. Z., Albutt, K., Moosajee, U. S., Drevin, G., Mukhopadhyay, S., & Samad, L. (2020). Self-Diagnosis of Surgical Site Infections: Lessons from a tertiary care center in Karachi, Pakistan. Pakistan Journal of Medical Sciences Quarterly, 36(1), S55–S60. https://doi.org/10.12669/pjms.36.ICON-Suppl.1716

Vera, D. (2022, February 1). 2022 EBP Models and Tools. Hopkinsmedicine.org. https://www.hopkinsmedicine.org/evidence-based-practice/ijhn_2017_ebp.html

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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.
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.
o 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.
o 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.
o 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.
o Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
o 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.
o 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.
o 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.
o Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
o Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Determining the Credibility of Evidence and Resources Scoring Guide

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CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.	Does not describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.	Lists a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.	Describes a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.	Describes a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach. Provides a specific rationale for the importance or benefit of applying an evidence-based approach. Uses literature to support discussion.
Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.	Does not explain criteria that should be considered when determining credibility of resources such as journal articles and websites.	Lists criteria that should be considered when determining credibility of resources such as journal articles and websites.	Explains criteria that should be considered when determining credibility of resources such as journal articles and websites.	Explains criteria that should be considered when determining credibility of resources such as journal articles and websites. Notes one or more ways the criteria could be applied to a specific resource.
Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.	Does not analyze the credibility or relevance of evidence or resources.	Describes the credibility or relevance of evidence or resources, but does not offer a complete analysis. The specific context of a quality or safety issue, or a chosen diagnosis may be unclear as well.	Analyzes the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.	Analyzes the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis. Additionally, identifies the most useful evidence or resource based upon the analysis.
Identify an evidence-based practice model (such as John Hopkins, Stetler, Iowa, 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.	Does not identify an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis/health care issue.	Identifies an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis/health care issue. Does not explain the model or the importance of incorporating credible evidence.	Identifies an evidence-based practice model and explains the importance of incorporating credible evidence into an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis/health care issue.	Explains the importance of incorporating credible evidence into an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis/health care issue. Notes specific examples of how the model could help improve the chosen issue or diagnosis/health care issue.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.	Does not organize content for ideas. Lacks logical flow and smooth transitions.	Attempts to organize content with some logical flow and smooth transitions. Contains several errors in grammar/punctuation, word choice, and spelling.	Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.	Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.	Does not apply APA formatting to headings, intext citations, and references. Does not use quotes or paraphrase correctly.	Attempts to apply APA formatting to in-text citations, headings and references incorrectly, detracting noticeably from the content. Inconsistently uses headings, quotes and/or paraphrasing.	Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.	Exhibits strict and flawless adherence to APA formatting of headings, intext citations, and references. Quotes and paraphrases correctly.