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Evidence-Based Practice in Diabetes Nursing Care
Introduction
It might be challenging at times to determine the credibility of resources, especially those from online sources. Nurses providing frontline care have an obligation to stay informed about changes in patient safety practices in their field. In order to provide the best possible evidence, evidence based practice relies on a variety of sources, but only the most reliable and credible ones should be used (National Center for Complementary and Integrative Health, n.d.). In the pre-eclampsia scenario from VilaHealth, the nurse is tasked with caring for a new patient who has been recently diagnosed. The nurse must do literature reviews in order to formulate a care plan supported by the latest scientific data.
The optimal means of treating a patient with pre-eclampsia or any other diagnosis has been the subject of numerous research studies. Therefore, if followed, these practices can greatly improve patient outcomes. Evidence-based practice in nursing is based on a systematic review of the most recent research available to inform and enhance patient care. Nurses should always look for opportunities to improve patient care and treatment.
Criteria to Determine Credibility
Web pages, scholarly articles, and hospital guidelines all need to be published within three- to five-year time frame. The healthcare sector is changing so rapidly that older reference materials quickly become outdated. The most recent research should provide the basis for evidence-based practices to improve health outcomes for patients. Web-based resources lose credibility because of the difficulty of accessing up-to-date information (Sbaffi & Rowley, 2017). It may be preferable to start by checking whether or not an organization already has a policy or protocol in place for the specific clinical problem or question at hand and then determining whether or not it is still reliable or out of date.
Journal articles are great tools for gathering information about a clinical issue, however not all published studies can be relied upon as reliable sources of information. Millions of health-related articles can be found through searches of health databases like PubMed and Medline. To narrow the search and boost trustworthiness, one should select only peer-reviewed journal publications. Evidence-based practice (EBP) should be based on the strongest available evidence, so familiarity with the various types of evidence and research is essential. A visual hierarchy of evidence is shown in the nurse research pyramid, with the least reliable evidence at the bottom and the most reliable evidence (Ingham-Broomfield, 2018).
There are seven levels of the pyramid that show the credibility of sources. Beginning with ideas and opinions at the bottom and moving up through case-controlled studies, cohort studies, randomized control trials, critically appraised individual articles, and critically appraised topics (Ingham-Broomfield, 2018). The level culminates in systematic reviews at the top, with the pyramid depicting the ascending reliability of various types of research.
Verifying the reliability of information found on the web is time-consuming and tedious. Websites with the extensions.edu,.gov, and.org are more credible compared to the.com ones. The U.S. Department of Healths National Center for Complementary and Integrative Health (n.d.) recommends asking the who, what, when, where, and why questions. One can also use other approaches to tell if what they are reading is news, advertisement, or material reviewed by academic experts. According to a systemic review by Sbaffi and Rowley (2017), quality seal of endorsement, authority of the owner, contact details, and a clear design were identified as additional elements contributing to the confidence and credibility of a website. Factors such as advertising, poor search functionality, and complicated design and layout damage the credibility of sources.
Analysis of Resources
If one intends to enhance patient outcomes through evidence-based practice, they can do so more methodically by using the criteria outlined above. In the VilaHealth case, the nurses list of resources must be checked for reliability and credibility. Despite being a reliable resource, the hospital protocols is nearly outdated. To determine whether the protocol is still credible, it may be necessary to review more recent studies.
Four online materials were also retrieved by the nurse which need to be reviewed. The first source, I Am the Face of Preeclampsia is a blog just since it has a.com domain, thus not credible for use. The page on pre-eclampsia on Wikipedia is also not a reliable resource. Wikipedia has a.com domain, therefore being susceptible to editing by anyone on the internet. Additionally, the article on WebMD is not a reliable source either. This is a.com website that has not been peer reviewed and has numerous adverts, so while it may be useful for some broad understanding, it is not reliable. The last online based resource, Everything You Need to Know About Preeclampsia, is also a.com site. Due to the lack of peer review, this resource cannot be considered a reliable source for evidence-based practice.
Four additional sources from the Capella library are included to simulate the collection found in a hospital or clinic setting. The first one, titled About Pre-Eclampsia and Eclampsia, comes from the National Institutes of Healths (NIH).gov website. References are included, and the document was published in 2018, both of which add credibility to the document. The following article is Elevated Risk of Preeclampsia in Pregnant Women With Depression: Depression or Antidepressants?
Even if it was published in a reputable journal, the material is outdated and should be disregarded as unreliable. The next article, Inflammatory Markers and Preeclampsia: A Systematic Review, is a reliable resource. It is the most credible piece of evidence because it is a systematic review published in 2018 in a reputable peer-reviewed publication. This articles final bibliographical reference comes from the Mayo Clinics official.org website. It is an authoritative source dated 2018 and produced by Mayo clinic which is a reputable organization.
Incorporating Credible Evidence
The use of an EBP model is often helpful in facilitating the incorporation of reliable evidence into practice. Using a methodical framework, an EBP model integrates scientific results into clinical practice while measuring their effect on patient outcomes. Like evidence-based practice, the lowa Model, a popular technique for implementing EBP, is regularly revised to account for developments in healthcare and incorporate the best available research (Hanrahan et al., 2019). The nurse in the VilaHealth scenario could benefit from using an EBP model to organize the findings, develop a care plan, and/or adjust the current hospital policy.
Conclusion
While all nurses should be familiar with the importance of EBP in enhancing patient outcomes, few have received formal education on how to implement it. The process of figuring out whether sources of information and methodologies are reliable might be challenging. Many healthcare settings provide obstacles to EBP implementation. With a rising number of baccalaureate-prepared nurses, it is imperative that this transition be facilitated in clinical practice to ensure the best possible outcomes for patients.
References
Hanrahan, K., Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and evidence-based practice application. Journal of pediatric nursing, 48(3), 121-122. Web.
Ingham-Broomfield, R. (2018). A nurses guide to the hierarchy of research designs and evidence. Australian Journal of Advanced Nursing, 33(3), 38-43. Web.
National Center for Complementary and Integrative Health. (n.d.). Finding and evaluating online resources. Web.
Sbaffi, L., & Rowley, J. (2017). Trust and credibility in web-based health information: a review and agenda for future research. Journal of medical Internet research, 19(6), e7579. Web.
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