Determining the Credibility of Evidence and Resources
The demand to incorporate evidence-based research findings into practice is growing with increased efforts to enhance patient safety, quality, and overall outcomes. Nursing is an ever-evolving profession, and so are patient care approaches.
Nurses must consequently grasp the reasonable scientific foundation for any patient care assistance they give. One excellent way for baccalaureate-prepared nurses to remain in their leadership positions is to incorporate evidence-based practice findings into patient care. However, before putting evidence into practice, nurses must understand how to select credible and reliable sources.
The purpose of this paper, focusing on COPD patient diagnosis, is to outline the criteria to apply in establishing the credibility of articles and websites, as well as to identify an evidence-based practice model and the systematic strategy for integrating evidence into practice.
Description of the Selected Diagnosis for which an Evidence-Based Approach may be Beneficial
Chronic pulmonary obstructive disease (COPD) is a common, preventable, and treatable condition characterized by persistent respiratory symptoms and decreased airflow. COPD is one of the leading causes of mortality worldwide, coming in third place after ischemic heart disease (first) and stroke (second) (CDC, 2020). As such, it is a huge burden that requires collaborative measures to overcome. The condition’s prevalence varies greatly based on survey methods, diagnostic criteria, and analytical procedures.
According to a 2015 systematic review of population-based research from 52 countries, the Americas had the highest COPD prevalence (15% in 2010), while Southeast Asia had the lowest (10%) (Ruvuna & Sood, 2020). COPD afflicted an estimated 299 million persons in 2015, according to the fixed ratio diagnostic criteria (Forced Expiratory Volume in One Second [FEV1] and Forced Vital Capacity [FVC]), a 44% increase from 172 million in 1990 (Ruvuna & Sood, 2020). In terms of mortality, more than 3 million people died from COPD worldwide in 2015, a 12% rise from 1990, resulting in 64 million disability-adjusted life years (Ruvuna & Sood, 2020).
The illness is also associated with a significant economic burden, with the overall cost of respiratory disease in the European Union estimated to be about 6% of total healthcare spending, with COPD accounting for 56% (38.6 billion Euros) of respiratory disease costs, and the projected direct COPD expenses in the United States estimated to be $32 billion, with indirect costs estimated to be $20.4 billion (GOLD, 2018).
The stark figures indicating the COPD burden provide sufficient incentive to seek effective evidence-based solutions to the problem. Furthermore, since the care of COPD and its exacerbations mostly depends on pharmaceutical approaches and a few non-pharmacological tactics, such as smoking cessation, more evidence is required to create new ways to curb the condition and its consequences.
Criteria for Determining Credibility of Resources
Before using evidence to guide practice, it is vital to assess whether the source is credible and delivers unbiased information. The currency, relevance, authority, accuracy, and purpose (CRAAP) formula assesses an article’s credibility.
“Currency” refers to the timelessness of the information; current sources are those published within the last five years (Kington et al., 2021). For example, any article published between 2018 and today is considered current. Embedded within each of the CRAAP attributes are questions such as how recent is the information (currency), does the information relate to the topic or answer your question (relevance), does the article include citations, or is the information supported by evidence (accuracy), what are the author’s credentials (authority), does the author appear to be trying to push an agenda or sell you something (purpose).
The majority of the sources utilized in this paper are articles, which necessitated the use of the CRAAP technique; however, websites may also be used, albeit with different criteria for determining credibility. According to the National Institutes of Health (2019), the three letters at the end of the domain name, such as “edu” (educational), “gov” (government), “org” (nonprofit), and “com” (commercial), convey important information about the credibility of a website. Websites ending in.edu and.gov are generally considered reliable; nevertheless, sites that utilize the suffixes to deceive should be avoided.
Credibility and Relevance of Evidence and Resources within the Context of the Chosen Diagnosis
Patient care relies heavily on evidence obtained from credible sources via web-based platforms. Singh, from the division of infection, immunity, and respiratory medicine at the University of Manchester, has the necessary credentials to author a medical subject, thus meeting the authority requirements. The article was published in 2021, so it is current and focuses on COPD pharmacological treatment, so it is relevant to the topic at hand.
Furthermore, Singh (2021) draws evidence from other sources in reiterating his explanation (accuracy) and aims to educate clinicians on the pharmacological treatment of stable COPD, a purpose that he accomplishes. The article is credible and can be used to draw information that informs clinical decision-making because it meets all of the CRAAP criteria.
One of the nightmares that doctors face is the treatment of COPD exacerbations both before and after hospitalization. Kopsaftis et al. (2020) published a review study to assess the influence of varying oxygen saturations in the prehospital setting on outcomes for persons with COPD exacerbations (purpose).
The article is current, having been published in 2020, relevant because it covers the issue of concern (COPD), and accurate since a large body of research backs it. In addition to being written by respiratory medicine experts from multiple medical colleges, the information from the article is credible.
Mirza and colleagues reviewed the 2018 GOLD report, covering the definition, diagnosis, and evidence-based therapy methods for COPD. The information is accurate since it can be confirmed from the original 2018 GOLD document, and it was written by authors whose names have the designation MD, signifying their expertise in medical subjects.
Furthermore, the article’s relevance (addressing the area of interest), currency (published within the last five years), and accuracy (supported by a large body of research) justify its inclusion as a source of evidence for the selected clinical diagnosis.
An Evidence-Based Practice Model to Address the Diagnosis
The ever-changing nature of nursing practice and patient care involves the development of innovative techniques for providing care while maintaining patient safety and quality. When it comes to expanding attempts to integrate innovative ways of care delivery, such as telemedicine, the Ottawa evidence-based practice model provides the greatest foundation for implementing innovations.
The use of an evidence-based practice model, in this example, the Ottawa model, gives information and direction on the process of translating research into practice (Huybrechts et al., 2021). The model is divided into six phases: setting the stage, where available resources are determined and change agents are identified; specifying the innovation, where the innovation is well articulated; assessing the innovation, where a situational assessment is conducted to determine current practice and identify barriers and facilitators; selecting and monitoring knowledge translation strategies; monitoring innovation adoption; and finally, evaluating the outcome (Huybrechts et al., 2021).
A possible innovation that might benefit from the model in the context of COPD, especially in this age of Covid19, is the telemedical approach to COPD patients. When properly utilized, the implementation process proceeds smoothly, and the objectives are inevitably fulfilled.
Conclusion
Patient treatment mostly depends on the best evidence from credible internet-based sources. A healthcare professional must thus learn how to find sources online, filter through to get credible resources, and use the evidence in practice. Baccalaureate nurses get training on determining the credibility of evidence and resources to equip them for their leadership responsibility of applying evidence into practice.
As a result, nurses often use evidence-based models to integrate evidence into practice, with Ottawa serving as an example and a framework for adopting innovations such as telemedical approaches to care for COPD patients.
References
- Global Initiative for Chronic Obstructive Lung Disease. (2018). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease 2018 Report. Goldcopd.org. https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf
- Huybrechts, I., Declercq, A., Verté, E., Raeymaeckers, P., & Anthierens, S. (2021). The building blocks of implementation frameworks and models in primary care: A narrative review. Frontiers in Public Health, 9, 675171. https://doi.org/10.3389/fpubh.2021.675171
- Kington, R. S., Arnesen, S., Chou, W.-Y. S., Curry, S. J., Lazer, D., & Villarruel, A. M. (2021). Identifying credible sources of health information in social media: Principles and attributes. NAM Perspectives, 2021. https://doi.org/10.31478/202107a
- Kopsaftis, Z., Carson-Chahhoud, K. V., Austin, M. A., & Wood-Baker, R. (2020). Oxygen therapy in the pre-hospital setting for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 1(1), CD005534. https://doi.org/10.1002/14651858.CD005534.pub3
- Mirza, S., Clay, R. D., Koslow, M. A., & Scanlon, P. D. (2018). COPD guidelines: A review of the 2018 GOLD report. Mayo Clinic Proceedings. Mayo Clinic, 93(10), 1488–1502. https://doi.org/10.1016/j.mayocp.2018.05.026
- National Institutes of Health. (2019). Finding high-quality health information on the internet. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK538539/
- Ruvuna, L., & Sood, A. (2020). Epidemiology of chronic obstructive pulmonary disease. Clinics in Chest Medicine, 41(3), 315–327. https://doi.org/10.1016/j.ccm.2020.05.002
- Singh, D. (2021). Pharmacological treatment of stable chronic obstructive pulmonary disease. Respirology (Carlton, Vic.), 26(7), 643–651. https://doi.org/10.1111/resp.14046
Assessment 2 Instructions: Determining the Credibility of Evidence and Resources
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.