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A scientific approach to problem-solving implies testing hypotheses and observing results since tested and proven knowledge can be considered credible. In a healthcare setting, such knowledge is referred to as evidence-based practice (EBP). According to Bianchi et al. (2018), EBP is “the use of current best evidence in making decisions about the care of individual patients” (p. 919). EBP is central in the scenario provided by Vila Health – it pictures a newly trained nurse experiencing doubts in selecting EBP sources due to working on a specific diagnosis for the first time in her clinical experience. Her patient, a 25-year-old pregnant woman, was brought into the ER with significant heartburn and swelling in her hands and feet. The attending physician diagnosed pre-eclampsia, and the nurse was tasked with developing an appropriate care plan for the patient. In this context, the current research paper will first analyze the credibility criteria of EBP sources in general, then focus on EBP sources particularly useful for the chosen issue, and, finally, elaborate on the importance of the EBP model application with the selection of a specific model for the chosen issue.
Diagnoses based on EBP imply a thorough evaluation of the sources’ credibility prior to their implementation. One of the possible ways to assess credibility is by applying the RADAR framework. The abbreviation stands for five evaluation criteria such as rationale, authority, date, accuracy, and relevance (Loyola Marymount University, 2022). Firstly, every source is made to serve a specific purpose; thus, analyzing it in terms of the author’s intent, potential bias, and objectivity proves to be a reliable filter. Secondly, EBP can vary significantly based on the author’s experience and knowledge; this is why their authority should not be disregarded. Thirdly, research in the medical field is in constant motion – new theories, points of view, and evidence might provide a more efficient solution compared to the old approach. Therefore, the date of research rightfully belongs among the indicators of credibility. Fourthly, accuracy is essential because errors and misconceptions distort a line of reasoning and might prove fatal in the case of clinical practice. Finally, the relevance criterium ensures the use of appropriate and pertinent information.
In the context of the discussed scenario, RADAR was used to identify five credible online sources that can provide relevant information regarding CAD. The NIH website (https://www.ncbi.nlm.nih.gov/) represents the National Library of Medicine’s database. ScienceDirect (https://www.sciencedirect.com/) is another example of a comprehensive medical research database. Regarding the scholarly journals, The International Journal of Obstetrics & Gynaecology, the American Journal of Obstetrics and Gynecology, and the Journal of Reproductive Immunology are devoted to the topics of obstetrics, which include associated complications, such as pre-eclampsia.
The mentioned sources were chosen due to the EBP research possibilities and search utility they provide. First, NIH has access to a vast database of medical science and statistical pieces of research as a governmental website. For instance, the article by Burton et al. (2019) that summarizes new approaches to pre-eclampsia treatment was located with the help of the NIH search tool. Second, the ScienceDirect website has implemented a sophisticated and precise search tool, allowing for complex search specification options. For example, it was used to locate the article by Rolnik et al. (2022) that discusses the use of aspirin in preventing pre-eclampsia complications. Meanwhile, mentioned scholarly journals display an ongoing and constantly updating showcase of research on the scenario topic, which includes EBP reports and recent research findings. Overall, these sources make scholarly articles easy to find, study and use accordingly for a confident EBP implementation.
To further simplify and generalize the EBP application, professionals in the healthcare field have developed various EBP models that aid in implementing EBP. These models represent organized step-by-step guides that help integrate current and relevant research into clinical practice with the aim of creating the best patient care practices. Apart from assisting nurses in EBP integration, EBP models optimize the time and resources required in the process and help secure the complete implementation of associated projects.
In the context of the scenario issue, Stetler’s EBP model fits the most due to various reasons. The given scenario has several critical features that have to be considered, such as the need to learn and obtain experience from the new nurse’s perspective and the responsibility for two lives instead of one due to the patient’s condition. In other words, the model should encourage the nurse to apply her critical thinking in information processing and learning, simultaneously focusing on a patient-centered approach to treatment. Conveniently, Stetler’s model fulfills both requirements set by the chosen scenario. According to Christenbery (2017), this model allows practitioners to critically assess the way EBP can be implemented into clinical practice to foster patient-centered care. Specifically, it is designed to facilitate critical thinking regarding the integration of available research findings and promotes the use of EBP as an ongoing practice, presenting an excellent opportunity for the nurse to study. Additionally, it helps reduce errors in decision-making by categorizing the obtained evidence, ultimately resulting in outstanding patient care.
References
Bianchi, M., Bagnasco, A., Bressan, V., Barisone, M., Timmins, F., Rossi, S., Pellegrini, R., Aleo, G. & Sasso, L. (2018). A review of the role of nurse leadership in promoting and sustaining evidence‐based practice. Journal of Nursing Management, 26(8), 918-932. Web.
Christenbery, T. (2017). Evidence-based practice in nursing: Foundations, skills, and roles [Course handout]. Springer Publishing Company.
Burton, G. J., Redman, C. W., Roberts, J. M., & Moffett, A. (2019). Pre-eclampsia: pathophysiology and clinical implications. BMJ, 366. Web.
Loyola Marymount University. (2022). Evaluating sources: Using the RADAR framework. Web.
Rolnik, D. L., Nicolaides, K. H., & Poon, L. C. (2022). Prevention of preeclampsia with aspirin. American journal of obstetrics and gynecology, 226(2), S1108-S1119. Web.
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