Assessment 2

Determining the Credibility of Evidence and Resources

Instructions-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.

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.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated

Determining the Credibility of Evidence and Resources Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
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.

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.

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.

 

Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6-year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with the father of Robby, her firstborn. She indicates “pretty serious partying” with the likely father of the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per week, plus intermittent methamphetamine use.Which clinical information would be most critical for you to collect in the first visit?What are the greatest risk factors for substance use disorder for this patient?Which harm reduction strategies would you recommend?Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient.   (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies? 

Original Work, No Plagiarism, Cite and Reference

Hugo is a graduate student working on a research study that is seeking to explore the efficacy of a new medicine for the prevention of chemotherapy-induced peripheral neuropathy.  As part of his duties, he is asked to make himself available during participant recruitment to clarify any questions that the recruitment personnel or the participants may have. On one of these occasions, a research nurse named Phoebe is obtaining informed consent from a young adult named Simon. 

The informed consent form includes information on the purpose of the study, a double-blinded, randomized intervention trial to test the efficacy of a medicine for the prevention of chemotherapy-induced peripheral neuropathy.  The form explains the risks and benefits of participation at length, including the anticipated side effects of the new medicine. 

The benefits are thought to outweigh the risks.  The participants in the treatment arm of the study may benefit from the medicine's hypothesized prevention of chemotherapy-induced peripheral neuropathy. Participants in both groups will receive close monitoring of neuropathy symptoms and evidence-based care while being in the study. Finally, the form explains that the information collected may help to lead to the discovery of an agent that may reduce chemotherapy-induced peripheral neuropathy, of which there are currently no none effective preventative treatments. 

As Phoebe is reviewing the informed consent form, Simon appears somewhat uncomfortable and apprehensive. Hugo thinks that his response may be related to the surroundings and/or situation. They are sitting in the exam room shortly after Simon learned of the treatment options for advanced stage colorectal cancer and the doctor left without answering all of his questions. Simon also has additional oncology appointments shortly after the consent discussion. 

Hugo is also struck by Simon's interaction with Phoebe. He nods and his occasional brief responses sound more like someone receiving a set of instructions than an indication of understanding.

During the time it takes to complete the informed consent form, which is quite lengthy, Hugo begins to wonder whether Simon truly understands the research study and his part in it.  Hugo also questions whether Simon understands what randomization is and how this technique will affect him as a research participant. Hugo is distracted from his thoughts by movement from across the room. Simon is ready to place his signature on the informed consent form. He seems to be eager to do so. The form states that study subjects have the right to refuse to participate and that they may withdraw at any time, but Hugo begins to question whether Simon truly has a choice in giving his consent. Do the benefits from this study, overwhelm any concerns he may feel regarding being in the study?

Hugo is unsure how to address his discomfort with the informed consent process that he has just witnessed and he begins to deliberate about what course of action he should take to address his concerns.

Discussion Questions:

1. How could the informed consent form or the process of obtaining informed consent be modified to address Hugo's concerns?

2. What types of questions or techniques could have Phoebe provided to assess Simon's understanding of the study?

3. How would you describe “randomization” to a prospective study participant?

4. How would you respond to a participant who says “can we skip the rest of this and sign the form” during the informed consent discussion?

 

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