Description
Develop a 2-4 page scholarly paper in which you describe the diagnosis you researched for the previous assessment, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.
Diagnoses:
Congestive Heart Failure (CHF): A chronic condition in which the heart doesn’t pumpblood as well as it should:
o Interventions: Diuretics, ACE inhibitors, beta-blockers, fluid restriction, daily weight monitoring, and patient education on symptom management.
o Keywords: Left-sided heart failure, right-sided heart failure, ejection fraction, cardiomyopathy, edema.
……………………………………………………………………………………………………
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 diagnosis for this assessment. Your initial identification of resources should be of resources that will best help address the presented diagnosis you selected. Since 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.
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 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 chosen diagnosis.
This is where you are selecting the specific resources to help address the diagnosis you selected for the first assessment.
Identify the Evidence-Based Practice model and explain the importance of incorporating credible evidence into the EBP model used to address a chosen diagnosis. Review the literature below and choose the appropriate model for your diagnosis.
……………………………………………………………………………………….
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
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Appendix: Evidence-Based Practice Models
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Nurses and other healthcare professionals have developed several evidence-based practice (EBP)
models that aid in the implementation of EBP. These models serve as organizing guides that
integrate the most current research to create best patient care practices. In addition to helping
nurses integrate credible evidence into practice, EBP models help assure complete
implementation of EBP projects and optimize the use of nurses’ time and healthcare resources.
No single EBP model can meet the needs of every organization and every patient situation.
Therefore, we are providing model definitions, essential steps, salient points, and information
resources for the models to help readers identify the EBP model that best fits their current,
specific EBP needs.
Model Definition
Essential Steps
Salient Point
Iowa Model of EBP (Titler et al., 2001). The
1. Identify either a “problem-focused trigger”
• Recom
Iowa Model focuses on the entire healthcare
or “knowledge-focused trigger” that will
organi
system (e.g., patient, practitioner,
generate the need for a practice change.
• Uses p
infrastructure) to implement and guide practice
2. Determine whether the “trigger” is a
solvin
decisions based on best available research and
healthcare organization priority.
to EBP
evidence.
3. Reflect a team’s topic of interest and include
• Detail
interested stakeholders. The team will
(see C
search, appraise, and synthesize literature
decisio
related to the topic.
• Clearl
4. Evaluate the availability and merit (e.g.,
points
level of evidence, quality of evidence) of
throug
evidence. If evidence availability and merit
• Empha
are lacking, conduct research.
projec
5. If credible and reliable evidence is available,
system
pilot the practice change.
• Design
6. Appraise pilot for level of success. If pilot is
collab
successful, disseminate findings within the
• Has su
organization and implement recommended
change into practice.
Stetler Model (Ciliska et al., 2011; Stetler,
Steps in this model are referred to as phases.
• Design
2001). The Stetler Model enables practitioners
thinkin
to assess how research findings and other
Phase I. Preparation: Identify a priority need.
of rese
Model Definition
pertinent evidence are implemented in clinical
practice. The model examines how to use
evidence to create change that fosters patientcentered care.
Essential Steps
Salient Point
Identify the purpose of the EBP project, context in
• Promo
which the project will occur, and relevant sources of
as an o
evidence.
• Helps
decisio
Phase II. Validation: Assess sources of evidence for
• Allow
level and overall quality. Determine whether source
eviden
has merit and goodness of fit and whether to accept
researc
or reject the evidence in relation to project purpose.
organi
• Empha
Phase III. Comparative Evaluation/Decision
practit
Making: Evidence findings are logically
groups
summarized and similarities and differences among
stakeh
sources of evidence are evaluated. Determine
whether it is acceptable and feasible to apply
summation of findings to practice.
Phase IV. Translation/Application: Develop the
“how to’s” for implementation of summarized
findings. Identify practice implications that justify
application of findings for change.
Phase V. Evaluation: Identify expected outcomes of
the project and determine whether the goals
of EBP were successfully achieved.
Ottawa Model of Research Use (Graham & The model is composed of three phases: (a) Assess
Logan, 2004 Graham et al., 2006). The
barriers and supports. (b) Monitor intervention and
Ottawa Model is an interactive model that
extent of use. (c) Evaluate outcomes. Subsumed
depicts research as a dynamic process of
under the three phases are six designated primary
interconnected decisions made and actions
elements that must be considered when integrating
taken by stakeholders.
research into practice:
I.
Assess barriers and supports:
1.
Evidence-based innovation: Clearly
identify what the innovation is and
what the implementation will
involve.
2.
Potential adopters: Identify potential
adopters with characteristics that
could influence the adoption of the
innovation (see Rogers’ Change
Theory in Chapter 7).
3.
The practice environment: Identify
leaders, formal and informal, who
can inspire change. Assess
environment for needed resources.
•
•
•
Patien
model
health
primar
The m
level e
the en
organi
The pr
model
and ev
Model Definition
Essential Steps
Salient Point
II.
Monitor intervention and extent of use:
1.
Implementation of intervention
strategies: Select appropriate
strategies to increase awareness of
implementation and provide
necessary education and training for
conducting the implementation.
2.
Adoption of innovation: Determine
the extent of adoption of
implementation.
III.
Evaluate outcomes:
1.
Evaluate the impact of innovation on
patients, practitioners, stakeholders,
and healthcare organization.
Promoting Action on Research
1. Evidence: Search for and identify the best
• Explic
Implementation in Health Services
available evidence from research, clinician
factor
(PARiHS) Framework (Rycroft-Malone,
experience, patient values, organization data,
researc
2004). The PARiHS Framework provides a
and information.
• Does n
method to implement research into practice
2. Context: This is the local environment
new k
by exploring the interactions among three key
where the practice change will occur.
• Focus
elements: (a) evidence, (b) context, and (c)
Adoption of practice change is dependent on
than sy
facilitation.
contextual features such as organizational
• Codifi
culture and level of acceptance, leadership
and no
investment, and evaluation of desired
practit
outcomes.
source
3. Facilitation: Organizational participants use
their knowledge and skills to foster
implementation of practice change.
ACE (Academic Center for Evidence-Based Five Stages:
• Focus
Practice) Star Model of Knowledge
1. Discovery: This stage involves searching for
of EBP
Transformation© (Kring, 2008; Stevens,
new knowledge found in traditional
• Includ
2004). As a framework, the ACE Star Model
quantitative and qualitative methodologies.
eviden
aids in systematically integrating best evidence
2. Evidence Summary: The primary task is to
• Primar
into practice. The model has five major stages
synthesize the body of research knowledge
knowl
that depict forms of knowledge in relative
into a meaningful statement of evidence for
• Does n
sequence. Research moves through the cycles to
a given topic. This is a knowledgenonres
combine with other forms of knowledge before
generating stage, which occurs
values
integration into practice occurs.
simultaneously with new findings that may
experi
arise from the synthesis.
• Identif
3. Translation: The aim of translation is to
adopti
provide clinicians with a practice document
(e.g., clinical practice guideline) derived
from the synthesis and summation of
research findings.
Model Definition
Essential Steps
Salient Point
4. Integration: Practitioner and healthcare
organization practices are changed through
formal and informal channels.
5. Evaluation: An array of EBP outcomes are
evaluated on impact, quality, and
satisfaction.
Advancing Research and Clinical Practice
1. Assess the healthcare organization for
• Promo
Through Close Collaboration
readiness for change and implantation
advanc
(ARCC) (Melnyk & Fineout-Overholt, 2015).
of EBP project.
direct
2. Identify potential and actual barriers to and
• Identif
facilitators of EBP project.
stakeh
3. Identify EBP champions to work with direct
suppor
care nurses or specific clinical units.
• Cogni
4. Implement evidence into practice.
underp
5. Evaluate EBP outcomes.
• Empha
organi
identif
barrier
• Encom
values
eviden
Johns Hopkins Nursing Evidence-Based
1. Practice Question: Using a team approach,
• Empha
Practice Model (JHNEBP) (Newhouse,
the EBP question is identified.
• Well-d
Dearholt, Poe, Pugh, & White, 2007).
2. Evidence: The team searches, appraises,
provid
The JHNEBP Model applies a problem-solving
rates the strength of evidence, describes
questio
approach to clinical decision making. The
quality of evidence, and makes a practice
eviden
model is designed to meet the EBP needs of
recommendation on the strength of evidence.
apprai
direct care nurses using an uncomplicated three3. Translation: In this stage, feasibility is
forms
step process referred to as PET: (a) Practice
determined, an action plan is created, and
Question, (b) Evidence, and (c) Translation.
change is implemented and evaluated.
Findings are presented to the healthcare
organization and broader nursing
community.
Knowledge-to-Action (KTA) Process
Phases:
• Adapt
Framework (Graham et al., 2006).
1. Identify problems that need to be addressed
individ
The KTA is a model of knowledge creation and
and begin searching for evidence and
health
knowledge integration.
research about the identified problem.
• Is grou
2. Adapt the knowledge use to a local context.
theory
3. Identify barriers to use of knowledge.
adapta
4. Select, adapt, and implement interventions.
setting
5. Monitor the use of implanted knowledge.
• Breaks
6. Evaluate outcomes related to knowledge use.
proces
7. Sustain appropriate knowledge use.
section
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