Homework answers / question archive / THE INSTRUCTIONS AND THE SCENARIO IS BOLDED OUT PLEASE FOLLOW ALL INSTRUCTIONS I WILL ADD ADDITIONAL TEMPLATES AND MY PREVIOUS SCORE TO SEE WHAT THE INSTRUCTOR IS LOOKING FOR!!!!!!!!!!! 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

THE INSTRUCTIONS AND THE SCENARIO IS BOLDED OUT PLEASE FOLLOW ALL INSTRUCTIONS I WILL ADD ADDITIONAL TEMPLATES AND MY PREVIOUS SCORE TO SEE WHAT THE INSTRUCTOR IS LOOKING FOR!!!!!!!!!!! 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

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THE INSTRUCTIONS AND THE SCENARIO IS BOLDED OUT PLEASE FOLLOW ALL INSTRUCTIONS I WILL ADD ADDITIONAL TEMPLATES AND MY PREVIOUS SCORE TO SEE WHAT THE INSTRUCTOR IS LOOKING FOR!!!!!!!!!!!

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.

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.

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.

DEMONSTRATION OF PROFICIENCY

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.
  • Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis.
• 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.
  • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

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 for researching and completing this assessment:

• 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.

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 you identified in the first assessment, you may want to begin your literature and evidence search from the databases that 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.
• Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis.
  • 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.

SUBMISSION 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.

EVIDENCE-BASED PRACTICE 1 Evidence-Based Practice Case Study Erik Hovsepyan Capella University April 27, 2021 Evidence-Based Practice Case Study Introduction EVIDENCE-BASED PRACTICE 2 Evidence-Based Practice (EBP) is a methodology designed for a harmonized clinical practice within the healthcare system. It is an approach that focuses on the combination of the usage of the best evidence from scientific research, personal knowledge, and experience. The practice illustrates that a healthcare provider committed to the application of EBP should combine the use of these three strategies whenever attending to a patient ("Current resources for evidencebased practice, November 2020," n.d.). However, the pieces of evidence applicable here, vary from one expertise to another due to the variation in the selection and usage of the available research study at their disposal. EBP is, therefore, an important approach for every clinical officer. If utilized properly, EBP can play a critical role in the instilling confidence to the practitioner. This can, however, only happen in case the practitioner has confidence on the evidence and uses it as it ought to when serving patients. Evidence-Based Practice EBP is always not a simple approach because it requires a lot of commitments. For EBP to be implemented well, the nurses and other clinical officers have to gather the information for their use. In gathering this information, there are specified given sources where the Evidence can be obtained. These include systematic reviews, clinical cohort study, clinical practice trials, and Randomized control trials. The clinical expertise in health needs to ensure that they locate and identify credible and scholarly resources available to sharpen their reasoning and judgment skills during practice throughout the process of establishing the information for evidence-based practice (Fiset et al. 2017). The levels for evidential-based practice are different in the level of information that they contain. This information can be taken as filtered information and unfiltered information based on their different sources. The Evidence that is required here is majorly published in a variety of EVIDENCE-BASED PRACTICE 3 documents regarded as their sources. These include academic publications and scientific journals. Other sources include books, conference proceedings, websites, and news reports. The two outstanding sources that are majorly considerable by the practicing officers are academic publications and journals. The credibility in journals and academic writing is considered high quality due to their independent and peer review processes as indicated by Fiset et al. ( 2017.) Discussion In the determination of the credibility of a resource, especially when it comes to journals and academic writings, several considerations are taken into account to mention a few. The level of evidence is one very important method of determining the credibility of a source. It uses a pyramid to determine and establish the quality of the evidence provided when doing the evidence translation while considering the evidence on top. In the evidence pyramid, the information is regarded as filtered and unfiltered information (Sutton, et al., 2020). The filtered information contained systematic reviews, critically appraised topics, evidence synthesis, and article synthesis. The other pyramid component is a section for unfiltered information containing casecontrolled trials, cohort studies, randomized control trials, and background information sometimes referred to as an expert opinion. According to Mackey and Bassendowski (2017), another way that a researcher can establish the credibility of the sources is whether the information available therein is up to date and whether the sources cited in them present the latest data and evidence. For example, suppose in the journal there are no expert reviews or other relevant declaration sources. In that case, the reader cannot assume the source has information based on the best available evidence. In the Villa health Scenario where the nurses are interested in establishing evidence on the effects of the sodium chloride on suction patients, it is important to note the existing practicing EVIDENCE-BASED PRACTICE 4 procedure and relate it to the presenting pieces evidence to do an investigation. It is common for the nurses to put between 3 and 10 ml of the sodium chloride into the patient’s endotracheal tube so as to assist in the loosening of the thin secretions. This is a recommended procedure because it assists in the lubrication of the sanction catheter and the eventual stimulation of the cough. However, presenting research evidence is contradictory and indicates that the practice is not 100% safe since it might have certain adverse effects such as the impairment of the alveoli capillary oxygen exchange, hence leading to the decrease in oxygen saturation. Worse still; the procedure can also contribute to the dislodging of the bacterial colonies, increasing the rates of respiration in the patients. The practicing officers are aware that it releases the pain from the normal practice, but there is evidence of adverse outcomes from the research evidence-based literature. This case is a clinical safety issue that requires highly organized evidence-based research so that safe practice is designed. In this evidence Based research, the researcher will be required to do their researcher on medical journals and search for the current resources for evidence based practice to consult experts and determine the fate of practice (Mackey & Bassendowski, 2017). Websites such as the US National Library of Medicine National Institute of Health that has the current resources for Evidence-Based practice and many other websites will offer information about the issue at question. Through thorough research on current health research journals, their research, and laboratory test information obtained, the research team can publish An Evidence-Based Practice. Conclusion In conclusion, credible evidence is important for the derivation of the EBP because, without evidence to be approved, there cannot be a demand for Evidence-Based Practice. The credible and reliable evidence acquired from medical articles and documents in journals, websites, and books EVIDENCE-BASED PRACTICE 5 are very important when blended with the research question to conclude the proper practice to be taken. EVIDENCE-BASED PRACTICE 6 References Fiset, V. J., Graham, I. D., & Davies, B. L. (2017). Evidence-based practice in clinical nursing education: A scoping review. Journal of Nursing Education, 56(9), 534-541. Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. McGowan, B. S. (2019). Reimagining information literacy instruction in an evidence-based practice nursing course for undergraduate students. Journal of the Medical Library Association: JMLA, 107(4), 572. Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3(1), 1-10. Assessment 2 Instructions: Determining the Credibility of ... Course Navigation ! # Tutorials 4/29/21, 1:30 PM Alexandra Duke Support Log Out FACULTY ! " Alexandra Duke 1199 COACH ! Assessment 2 Instructions: Determining the Credibility of Evidence and Resources Print 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. 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. 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. Demonstration of Proficiency 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. Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis. 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. Communicate using writing that is clear, logical, and professional with correct grammar and spelling https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_305019_1&content_id=_9751960_1 Page 1 of 3 Assessment 2 Instructions: Determining the Credibility of ... 4/29/21, 1:30 PM using current APA style. 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 for researching and completing this assessment: The specific diagnosis 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. 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 you identified in the first assessment, you may want to begin your literature and evidence search from the databases that 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. https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_305019_1&content_id=_9751960_1 Page 2 of 3 Assessment 2 Instructions: Determining the Credibility of ... 4/29/21, 1:30 PM 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. Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis. 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. Submission 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. SCORING GUIDE Use the scoring guide to understand how your assessment will be evaluated. VIEW SCORING GUIDE $ https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_305019_1&content_id=_9751960_1 Page 3 of 3 AACN1903_291-300 16/7/08 09:05 PM Page 291 AACN Advanced Critical Care Volume 19, Number 3, pp.291–300 © 2008, AACN Selecting a Model for Evidence-Based Practice Changes A Practical Approach Anna Gawlinski, DNSc, RN, FAAN Dana Rutledge, PhD, RN ABSTRACT Evidence-based practice models have been developed to help nurses move evidence into practice. Use of these models leads to an organized approach to evidence-based practice, prevents incomplete implementation, and can maximize use of nursing time and resources. No one model of evidence-based practice is actors related to patient safety, quality, and F evidence-based practice (EBP) are driving changes in healthcare. Nurses are interested in how to move good evidence into practice to optimize patients’ outcomes; thus, nurses may benefit from understanding more about EBP models. These models have been developed to help nurses conceptualize moving evidence into practice. They can assist nurses in focusing efforts derived either from clinical problems or from “good ideas” toward actual implementation in a specific practice setting. Use of EBP models leads to systematic approaches to EBP, prevents incomplete implementation, promotes timely evaluation, and maximizes use of time and resources. This article describes a systematic process for organizations to use as a template for choosing an EBP nursing model. Strategies for involving staff nurses and clinical and administrative leaders are discussed. Finally, a summary of key EBP nursing models is presented. Creating Structures or Forums for Discussions The first step in selecting a model is to establish a structure or a forum in which presenta- present that meets the needs of all nursing environments. This article outlines a systematic process that can be used by organizations to select an evidence-based practice model that best meets the needs of their institution. Keywords: evidence-based practice models, evidence-based practice, models tions and discussions can occur about various EBP models, their advantages and disadvantages, and their applicability to organizational needs. Several possible strategies include: • use of an existing nursing research committee in which selection of an EBP model is added to annual goals and activities; • formation of an EBP council, with an initial task of selecting an EBP model; • appointment of a task force charged with selecting an EBP model; • use of an educational event to increase knowledge about EBP models while facilitating the selection of a model appropriate for the organization; and • use of a focus group process to select an EBP model consistent with the philosophy, vision, and mission of the organization.1 Anna Gawlinski is Director, Evidence-Based Practice, and Adjunct Professor, Ronald Reagan University of California, Los Angeles Medical Center & University of California, Los Angeles School of Nursing, 757 Westwood Plaza, Los Angeles, CA 90095 (agawlinski@mednet.ucla.edu). Dana Rutledge is Professor, Department of Nursing, California State University Fullerton; and Nursing Research Facilitator, Saint Joseph Hospital, Irvine, California. 291 AACN1903_291-300 16/7/08 09:05 PM Page 292 G AW L I N S K I A N D R U T L E D G E AACN Advanced Critical Care Any of these strategies could help “set the stage” for an organization to choose an EBP model. For example, the authors used an existing nursing research committee/council to begin the process of selecting an EBP model in 2 different settings. In a third hospital, a multidisciplinary EBP council took on the task of selecting an EBP model. Regardless of the structure or the forum used, a thoughtful and systematic process is helpful. Composition of the Committee or the Group The second step to identifying an EBP model is to carefully consider appropriate members of the committee or the group. Administrative and clinical leaders such as nurse managers, clinical nurse specialists, and nurse educators should be represented, as should interested staff nurses. Staff nurses who are clinical resources in their units, share an interest in improving patient care, or are curious about research are likely members. The educational level of the committee members should reflect that of nurses within the department or the institution and will most commonly include nurses with associate, bachelor’s, and master’s degrees. In addition, members should represent the various clinical units/departments or specialties within the institution. Involvement of persons with special expertise in research or EBP, such as a nurse researcher or faculty member from a local unit, hospital, or school of nursing, may be especially helpful. These persons may be internal or external to the organization and have valuable expertise in EBP nursing models. They can function as active members or as consultants. A librarian member may also be useful in retrieving needed publications to evaluate selected models. The evaluation process and the number of EBP models that are considered can influence the desirable number of committee members. For example, at one institution (a university academic hospital), the nursing research council selected 7 EBP nursing models for review and evaluation. Table 1 lists the models and shows the criteria used to evaluate them. These 7 models were chosen for evaluation either because they were commonly mentioned in publications about EBP nursing models or because they were identified by committee members. At another institution (a community hospital), the nursing research council selected 4 EBP nursing models to eval- uate on the basis of council members’ knowledge of the models’ utility and potential fit with the organization. Involvement of all committee members in the evaluation process is vital. Using a process where 2 or 3 persons volunteer to review and present 1 to 2 EBP nursing models can get all members involved. Staff nurses can be paired with administrative or clinical leaders in teams of 2 to 3 persons. All committee members can then participate in the process of evaluating models by attending presentations about each model and actively participating in discussions. By having small groups present each model, the workload is divided among group members. The more people involved in the process, the greater the need for coordination and oversight by the chairperson. Organizing the First Meeting Once the group has been selected, the next step is to organize the first meeting so that clear communication about the roles and responsibilities of team members can occur. The chairperson or the leader can survey the group members to determine the optimal date, time, and comfortable location for this meeting. Because of the nature of the work involved in selecting a model, 2 hours is an optimal duration for meetings. An agenda should accompany the meeting invitations and initially will include items such as discussions of the purpose and goals of the committee and the roles and responsibilities of committee members (Table 2). Providing a brief reading assignment that gives an overview of EBP models and should be completed before the first meeting is advisable. The chairperson can request committee members who are already knowledgeable about EBP models to highlight parts of the reading assignment at the first meeting to promote discussion. The chairperson should also collaborate with unit leaders to ensure that staff nurses have appropriate release time for meetings. Roles and Responsibilities of Committee or Members At the first meeting, roles and responsibilities of the members for reviewing, presenting, and evaluating each EBP model should be addressed. Assignments and due dates are determined to ensure steady progress. For example, a member can elect to work in a small group to review the literature on an EBP 292 AACN1903_291-300 16/7/08 09:05 PM Page 293 V O L U M E 1 9 • N U M B E R 3 • J U LY – S E P T E M B E R 2 0 0 8 SELECTING A MODEL FOR EBP CHANGES Table 1: Evaluation Criteria and Scoring for 7 Models of Evidence-Based Practice Changesa Evaluation Criteria for EBP Model Purpose of Project: Evaluation and selection of an EBP model for the Nursing Department of Ronald Reagan University of California, Los Angeles Medical Center. 1. Search, retrieve, and synthesize the current literature describing EBP models to help staff nurses use EBP concepts and apply them in clinical practice. 2. Recommend the adoption of a specific EBP model for use by UCLA nurses. Scoring system: 0 not present; 1 present/yes; 2 highly present/yes Criteria Models 1. Concepts and organization of model are clear and concise 2. Diagrammatic representation of the model allows quick assimilation of concepts and organizes the steps in the process of EBP changes 3. The model is comprehensive from beginning stages through implementation and evaluation of outcomes 4. The model is easy to use when concepts are applied to direct EBP changes and practice issues in clinical settings 5. The model is general and can be applied to various populations of patients, EBP projects, and department initiatives and programs 6. The model can be easily applied to typical practice issues as evidenced with practice scenario or in published literature Total Comments EBP Model: Strengths: Weaknesses: EBP Model: Strengths: Weaknesses: EBP Model: Strengths: Weaknesses: EBP Model: Strengths: Weaknesses: EBP Model: Strengths: Weaknesses: a Used with permission from the Evidence-Based Practice Program, Nursing Department at Ronald Reagan University of California, Los Angeles Medical Center, Los Angeles, California. 293 AACN1903_291-300 16/7/08 09:05 PM Page 294 G AW L I N S K I A N D R U T L E D G E AACN Advanced Critical Care Table 2: Example of Agenda Items for the First Evidence-Based Practice Committee or Group Meeting Welcome and introduce members Review agenda Discuss the goals of the committee Discuss roles and responsibilities of committee members Select models for evaluation Discuss the process for presenting and evaluating evidence-based practice models Make assignments and schedule Identify resources and forms Identify strategies to communicate ongoing committee work to the department Open discussion of other items Plan for next meeting model. Work teams should be assigned a presentation date to present details of the reviewed EBP model to committee members. Presentations of each EBP model may take 30 to 45 minutes and might include information on the history and development of the EBP model (who, what, when, where, and how), revision of the model over time, overall concepts in the EBP model, the process and flow of the EBP model, and publications describing how the model guided EBP changes in other facilities. Each presentation of an EBP model can be followed by 10 or 15 minutes for group members to raise questions and discuss specific aspects of the EBP model. After the presentation and discussion, group members could review an example of how the EBP model might be applied in a realistic practice scenario that requires consideration of a practice change (Table 3). Group members could then use the EBP model under discussion to address the practice issue. Depending on the group’s size, this work can be done in small groups, with each small group slated to report back to the larger group its opinion about how the model “worked.” It is recommended that groups break into smaller groups of 2 or 3 persons to “rate” the models’ applicability on the basis of predetermined criteria (Table 4). Criteria for evaluating the applicability of the EBP model should include clarity of the EBP model concepts and diagrammatic representation, applicability of the EBP model to clinical practice issues for diverse patient care situations in the institution, ease and user-friendliness of the EBP model, and the ability of the EBP model to provide direction for all phases of the EBP process. Table 1 shows an example of an evaluation tool that can be used by committee members when reviewing each EBP model. After the evaluation instrument is administered and scored, committee members can compare and contrast the ratings, strengths, and weaknesses for addressing the practice scenarios, and potential adoption by the institution for each model is reviewed. The use of a structured process provides members with little or no background in evaluating an EBP model to learn about EBP models and have greater participation and support in the evaluation process. The link of the EBP model to practice is clear when the practice scenario is used. Members increase their knowledge and skills in using EBP models for practice changes and become champions for the adoption of a model within the organization. Finally, the ongoing work of the committee should be communicated through forums such as mass e-mails, newsletters, posters, nursing grand rounds, and other continuing education programs. Such communication helps disseminate the process used in selecting a model for the organization, while inviting others to participate via comments and feedback. Summary of Selected EBP Nursing Models A number of EBP models have been developed; many appear very different from each other. Some of these models are more useful in some contexts than others, and each has advantages and disadvantages. The following steps or phases are common to most models: • Identification of a clinical problem or potential problem • Gathering of best evidence • Critical appraisal and evaluation of evidence; when appropriate, determination of a potential change in practice • Implementation of the practice change • Evaluation of practice change outcomes, both in terms of adherence to processes and planned outcomes (eg, clinical, fiscal, administrative) 294 AACN1903_291-300 16/7/08 09:05 PM Page 295 V O L U M E 1 9 • N U M B E R 3 • J U LY – S E P T E M B E R 2 0 0 8 SELECTING A MODEL FOR EBP CHANGES Table 3: Sample Practice Scenario for Evaluating Applicability of Models for EvidenceBased Practice Changesa Scenario for Application of Evidence-Based Practice Nursing Models Note: The following scenario includes selected literature on the subject for the purpose of providing a clinical practice issue for use when applying EBP models. The following does not include an extensive or integrated review of the literature on the subject. Clinical Issue Suctioning patients who have endotracheal and tracheal tubes is a frequent and important nursing intervention. These tubes interrupt the normal mucociliary system and can result in a patient’s inability to mobilize and expectorate secretions).13 Suctioning is an intervention that has beneficial effects such as removal of secretions, maintenance of airway patency, and promotion of optimal ventilation and oxygenation.13 It is common practice for nurses and other healthcare providers to instill 3 to 10 mL of sodium chloride in the endotracheal or tracheal tubes before suctioning.14 The action of sodium chloride is believed to loosen and thin secretions, stimulate a cough, and lubricate the suction catheter.13,15,16 Research and Evidence-Based Literature Results of research on the benefits of sodium chloride instillation have been inconclusive.13,17–23 In fact, studies indicate that this practice may result in the following adverse outcomes: • • • • Interferes with the alveolar-capillary oxygen exchange, causing a decrease in oxygen saturation, Increases rate of respiration, Increases the risk of infection by dislodging significantly more bacterial colonies, and Increases intracranial pressure.13,19,21,22 Furthermore, patients can panic or feel as though they are drowning during routine instillation of sodium chloride via endotracheal or tracheal tubes.24 Research results indicate that mucus and sodium chloride solution are immiscible.13,17 Therefore, it is unlikely that instillation of sodium chloride loosens secretions and aids in the expectoration of airway secretions.13 The application of heat and humidification to the airway and the use of sodium chloride nebulizers are effective in thinning secretions and promoting airway clearance.13,23 Nursing Staff and EBP Process The nurses in your unit have recently heard a lecture presenting the lack of evidence supporting the routine use of instillation of sodium chloride before suctioning patients with endotracheal and tracheal tubes and the potential deleterious effects. They are questioning this practice and come to you as the unit manager or the clinical nurse specialist to help them with considering a change in this practice. Reflect on this EBP model to guide you through the steps to help your staff with this EBP change project. a Used with permission from the Evidence-Based Practice Program, Nursing Department, Ronald Reagan University of California, Los Angeles Medical Center, Los Angeles, California. Table 4: Criteria for Evaluation of Evidence-Based Practice Models to Meet Institutional Needs Concepts and organization of the model are clear and concise Diagrammatic representation of the model allows quick assimilation of concepts and organizes the steps in the process of EBP changes Model is comprehensive from beginning stages to implementation and evaluation of outcomes Model is easy to use when concepts are applied to direct EBP changes and practice issues in clinical settings Model is general and can be applied to various populations of patients, EBP projects, and department initiatives and programs Model can be easily applied to typical practice issues as evidenced with practice scenario or in the published literature Abbreviation: EBP, evidence-based practice. 295 AACN1903_291-300 16/7/08 09:05 PM Page 296 G AW L I N S K I A N D R U T L E D G E AACN Advanced Critical Care Table 5: Selected Evidence-Based Practice Nursing Models and Key Components Emphasis Stages/ phases Iowa Model3 Stetler’s Model2 Organizational process At individual nurse or organizational level 1 Trigger: Problem 1 Preparation or new knowledge 2 Validation 2 Organizational 3 Comparative priority? evaluation 3 Team formation 4 Decision making 4 Evidence gathered 5 Translation/ application 5 Research base critiqued and 6 Evaluation synthesized 6 Sufficient? 7 Pilot change 8 Decision? 9 Widespread implementation with continual monitoring of outcomes Rosswurm and Larrabee’s Model4 Johns Hopkins Nursing Model5 Organizational process Organizational process ACE Star Model of Knowledge Transformation6 Knowledge transformation 1 Assess need for change in practice 1 Practice question identified 1 Knowledge discovery 2 Link problem interventions and outcomes 2 Evidence gathered 2 Evidence summary 3 Synthesize best evidence 3 Translation: Plan, implement, evaluate, and communicate 3 Translation into practice recommendations 4 Design practice change 4 Integration into practice 5 Implement and evaluate change in practice 5 Evaluation 6 Integrate and maintain 10 Dissemination of results The following paragraphs describe several EBP models that are often considered for use in hospitals (Tables 5 and 6). These models were selected on the basis of the following criteria: (1) they commonly appear in nursing publications about EBP models; (2) published reports support their use to guide EBP changes in the clinical setting; (3) institutions (hospitals or schools of nursing) use the model; and (4) the models are intended to be used by nurses as they set out to find and use evidence to enhance patients’ or organizations’ outcomes. Table 5 describes selected EBP models that have specific steps or phases to guide the EBP process. Table 6 identifies key components of EBP models that do not have specific steps or phases but help describe and conceptualize the many variables and interactions that occur when making EBP practice changes. One of the oldest models that has recently been revised to include EBP outcomes is Stetler’s EBP model.2 This model is one of the few that does not focus entirely on formal changes led by nurses in organizational settings, suggesting use by individual nurses as well. Developed as a model for nurses within an East Coast hospital, Stetler’s model promotes use of both internal (eg, data from quality improvement, operational, or evaluation projects) and external (primary research evidence and consensus of national experts) evidence. Stetler’s model consists of 5 phases, ranging from searching for evidence about a clinical problem to formal and/or informal evaluations. Decision making about whether a practice change should be made includes consideration of substantiating evidence, setting fit, feasibility, and current practice. Developed as a model to promote quality care, the Iowa model of EBP has been used in multiple academic and clinical settings.3 This model melds quality improvement with research utilization in an algorithm that nurses find intuitively understandable. Unique to the Iowa model is the concept of “triggers” of EBP. Evidence-based practice may be spurred by a clinical problem or by knowledge coming from 296 AACN1903_291-300 16/7/08 09:05 PM Page 297 V O L U M E 1 9 • N U M B E R 3 • J U LY – S E P T E M B E R 2 0 0 8 SELECTING A MODEL FOR EBP CHANGES Table 6: Select Evidence-Based Practice Frameworks ARCC Model7–9 PARIHS Framework10,11 Key focus Organization of department or unit Understanding key components of EBP Key concepts EBP mentor—an individual who has expert knowledge and skills in EBP and the passion to help others practice daily from an evidence base Evidence Major proposition The development of APNs and other nurses as EBP mentors facilitates an organizational culture change toward evidence-based care Practice changes are most likely when they are based upon robust evidence, conducted in a context “friendly” to change, and facilitated well Utility—practical implications Need to… Need to… • assess and organize culture and readiness for EBP • critically appraise evidence • identify strengths and major barriers to EBP implementation • implement ARCC strategies • develop and use EBP mentors • interactive EBP skill-building workshop Context Facilitation • thoroughly understand the practice arena before implementing a change • make a strategic plan for facilitation of any practice change— from development to implementation and evaluation • make EBP rounds and form journal clubs • implement EBP • improve patient, nurse, and system outcomes Abbreviations: ARCC, Advancing Research and Clinical Practice through Close Collaboration; EBP, evidence-based practice; PARIHS, Promoting Action on Research Implementation in Health Services. outside an organization. Either of these triggers can set an EBP project into motion. Thereafter, the model delineates 3 key decision points during the process of making a practice change: (1) Is there an institutional reason to focus on this problem or use this knowledge? (2) Is there a sufficient research base? (3) Is the change appropriate for adoption in practice? At 2 of these points, users must focus on the realities within an organizational context; the third point infers the possibility that evidence is not sufficient and thus that a research study may be needed or other evidence sought. Rosswurm and Larrabee4 developed a 6-step model for change in EBP that aims for integration of EBP into a care delivery system. The initial need for change is determined by comparing internal data such as quality indicators with data from outside the organization. When possible, this problem is linked to standard interventions and outcomes. Research and contextual evidence are sought to solve the problem and combined with clinical judgment. With sufficient evidence, a practice protocol is developed and a pilot test done to determine effects on outcomes. With widespread implementation, both processes (eg, staff adherence to the change) and clinical outcomes are evaluated. The practice change is maintained by using theoretically derived diffusion strategies. The Johns Hopkins Nursing EBP model was developed in collaboration with the Johns Hopkins Hospital and the Johns Hopkins University School of Nursing.5 To ensure that current research findings were incorporated into patient care, nursing administrative leaders from Johns Hopkins Hospital developed a model for the department of nursing. The resulting model addressed the following 3 297 AACN1903_291-300 16/7/08 09:05 PM Page 298 G AW L I N S K I A N D R U T L E D G E AACN Advanced Critical Care domains of professional nursing: nursing practice, education, and research. The model incorporates use of available evidence as a core component for decision making within these domains. Guidelines for the model reflect the “PET” process, an acronym that stands for practice question, evidence, and translation. First, a team identifies an important practice question. The team gathers evidence by reviewing literature, rates the evidence, and makes recommendations for changes in processes of care or systems. The last phase is the translation in which a plan of action is developed and implemented and outcomes are evaluated and communicated.5 The ACE Star Model of Knowledge Transformation aims to promote EBP by depicting knowledge types (from research to integrative reviews to translation) as necessary precursors to practice integration.6 This model does not discuss use of nonresearch evidence. The 5 major stages of knowledge transformation are (1) knowledge discovery, (2) evidence summary, (3) translation into practice recommendations, (4) integration into practice, and (5) evaluation. The goal of the process is knowledge transformation, defined as “the conversion of research findings from primary research results, through a series of stages and forms, to impact on health outcomes by way of [evidence-based] care.”6 Another EBP model that is considered a “mentorship” model is the Advancing Research and Clinical Practice through Close Collaboration model. This EBP model resembles an organizational plan for a department of EBP. The model focuses on establishing relationships across systems to bring experienced researchers together with clinicians to integrate research and clinical practice more fully.7 Originally an organizational model for linkages between a college of nursing and a medical center, the model relies heavily on EBP mentors, ideally advanced practice nurses, with in-depth knowledge of EBP and expert clinical and group facilitation skills.7–9 This model may be most useful in academic settings with formal linkages between nursing education and practice in which APNs are abundant. Out of the British system comes the Promoting Action on Research Implementation in Health Services framework,10,11 which is “useful as a heuristic device to help make sense of the many variables and interactions that take place in practice.”12(pS1) This intuitive model aids in understanding the key components of EBP: evidence, context, and facilitation. The model aims to represent the complexity of making practice changes on the basis of evidence. The key proposition in the model is that “the nature of the evidence, the quality of the context, and the type of facilitation all impact simultaneously on whether implementation is successful.”11(p178) Further understanding of the relationships among evidence, context, and facilitation is needed to maximize EBP. This model, though very useful as a theoretical explanation, has not been documented as useful in driving projects within organizations. Selection of EBP Model for the Institution After evaluation of each of the EBP models, committee members should be able to narrow the selection of these models to 1 or 2 models. This can be done by selecting the top 2 models with the highest scores on the evaluation tool and by discussions that facilitate group consensus. If 2 models score similarly on the evaluation tool, having members discuss general advantages and disadvantages of each of the models can help delineate the model that “fits” the needs of the organization best. For example, the group members might discuss advantages and disadvantages of the models reviewed and make the final selection on the basis of (1) how easy the EBP model was to understand and whether it would guide users in the EBP process; (2) appropriate direction by the model for the conduct of research when evidence is insufficient to support a practice change; (3) the flow of steps in the model is similar to the flow of practice algorithms for staff; and (4) decision points in the EBP model would provide users with opportunities for thoughtful reflection and decision making. To maximize leadership buy-in, nurse managers, administrators, and clinical leaders who are not part of the selection committee should also be included in the evaluation and selection process. This can be accomplished by having members of the nursing research committee attend leadership meetings to present either the final model or the final 2 models determined by the selection committee. Leadership members can then participate in the exercise of evaluating and scoring the final model(s) by using the practice scenario. The management group can then discuss the results, 298 AACN1903_291-300 16/7/08 09:05 PM Page 299 V O L U M E 1 9 • N U M B E R 3 • J U LY – S E P T E M B E R 2 0 0 8 SELECTING A MODEL FOR EBP CHANGES advantages, and disadvantages, and make final recommendation for adoption. Including broader nursing leadership representation in the selection of an EBP model would build consensus and promote support of the adopted model. If the initial committee is having trouble making a decision, leadership input can help break a tie or may result in new insights as to why one model might fit better than another. Dissemination and Integration of the Selected Model Once the model is chosen, the committee can brainstorm strategies to promote its dissemination and use. Educational sessions that are planned should use active participation of learners to enable participants to increase their knowledge and skills in using the model to answer clinically important questions that require evidence-based solutions. Several strategies can be used for dissemination and integration of the selected model: • Incorporating a class about EBP and the selected model into the new graduate orientation or residency program. This ensures that each new employee has basic knowledge about the use of the selected model. • Add content about use of the EBP model in preceptor development programs. Preceptors are often clinical leaders in their respective units. Enhancing their knowledge and skills about EBP models can increase the likelihood that preceptors will serve as agents of change and champions of EBP within their clinical areas. • Incorporate education and skill building on use of the selected EBP model into the annual skills laboratories or competency forums. This strategy ensures wider dissemination of the selected model and aids in establishing baseline knowledge and skills for all nurses throughout the organization. • Conduct nursing grand rounds on the selected model, with examples of use of the model in clinical practice. Grand rounds can provide a forum for more in-depth knowledge and skill building with respect to use of the model. Examples of how the model can be used to answer important clinical practice questions can also be presented and discussed. Feedback can be obtained from the grand rounds participants about the clarity and feasibility of using the model for the EBP process. Ideas can be elicited from the • • • • • participants about strategies to overcome challenges to using the model. Provide EBP programs for the nursing leadership group. The program should introduce this group to more extensive concepts of the model, involve them in several examples of how to use the model for both administrative and clinical changes, and discuss their role in increasing use of the model in their respective areas. The infrastructures available to facilitate use of the model should also be discussed. Implement special “train-the-trainer” EBP development programs. Content about various innovative methods to teach others about the model should be included, along with a general discussion of the structure, concepts, and processes of the model. Include content in institution-sponsored research and EBP conferences by selecting programs that increase participants’ knowledge and skill building relative to the use of the model for EBP practice changes. Integrate the selected EBP model into the curriculum of any existing EBP immersion programs, such as an EBP internship or fellowship programs. Encourage members of the nursing research committee/council to brainstorm additional ideas that work best in their respective units, institution, and nursing culture. Members can examine what educational programs and forums already exist that could be used to disseminate and integrate the model in the organization. Summary Using a model for EBP change will assist nursing departments to better focus their limited fiscal and personnel resources on critical EBP activities. This article described structures and processes that institutions could use to facilitate choosing a model for EBP change that fits their practice setting and guides efforts in making EBP changes. References 299 1. Rempher KJ. Putting theory into practice: six steps to success. Am Nurs Today. 2006;11:41–42. 2. Stetler CB. Updating the Stetler model of research utilization to facilitate evidence-based practice. Nurs Outlook. 2001;49(6):272–279. 3. Titler MG, Kleiber C, SteelmanVJ, et al. The Iowa model of evidence-based practice to promote quality care. Crit Care Nurs Clin North Am. 2001;13(4):497–509. 4. Rosswurm MA, Larrabee JH. A model for change to evidence-based practice. IMAGE. 1999;31(4):317–322. AACN1903_291-300 16/7/08 09:05 PM Page 300 G AW L I N S K I A N D R U T L E D G E AACN Advanced Critical Care 5. Newhouse R, Dearholt S, Poe S, Pugh LC, White KM. Evidence-based practice: a practical approach to implementation. J Nurs Adm. 2005;35:35–40. 6. Academic Center for Evidence-Based Practice, The University of Texas Health Science Center at San Antonio. The ACE: learn about EBP page. http://www.acestar .uthscsa.edu/Learn_model.htm. Accessed November 30, 2007. 7. Ciliska D, DiCenso A, Melnyk BM, Stetler CB. Using models and strategies for evidence-based practice. In: Melnyk BM, Fineout-Overhold E, eds. Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. Philadelphia: Lippincott Williams & Wilkins; 2005:185–219. 8. Fineout-Overhold E, Melnyk BM, Schultz A. Transforming health care from the inside out: advancing evidencebased practice in the 21st century. J Prof Nurs. 2005;21 (6):335–344. 9. Melnyk BM, Fineout-Overhold E, Stone P, Ackerman M. Evidence-based practice: the past, the present, and recommendations for the millennium. Pediatr Nurs. 2000; 26:77–80. 10. Kitson A, Harvey G, McCormack B. Enabling the implementation of evidence-based practice: a conceptual framework. Qual Health Care. 1998;7:149–158. 11. Rycroft-Malone J, Kitson A, Harvey G, et al. Ingredients for change: revisiting a conceptual framework. Qual Saf Health Care. 2002;11:174–180. 12. Kitson A. What influences the use of research in clinical practice? Nurs Res. 2007;56(4)(suppl):S1–S3. 13. Taylor-Piliae RE. Establishing evidence-based practice: issues and implications in critical care nursing. Intensive Crit Care Nurs. 1998;14(1):30–37. 14. Ackerman MH. The use of bolus normal saline instillations in artificial airways: is it useful or necessary. Heart Lung. 1985;14(5):505–506. 15. Raymond SJ. Normal saline instillation before suctioning: helpful or harmful? A review of the literature. Am J Crit Care. 1995;4(4):267–271. 16. Wood CJ. Endotracheal suctioning: a literature review. Intensive Crit Care Nurs. 1998;14(3):124–136. 17. Demers RS, Saklad M. Minimizing the harmful effects of mechanical aspiration. Heart Lung. 1973;2(4): 542–545. 18. Hanley MV, Rudd T, Butter J. What happens to intratracheal saline instillations? Am Rev Respir Dis. 1978;117 (4)(suppl):124–124. 19. Bostick J, Wendelgass ST. Normal saline instillation as part of the suctioning procedure: effects on PaO2 and amount of secretions. Heart Lung. 1987;16(5): 532–537. 20. Gray JE, MacIntyre NR, Kronenberger WG. The effects of bolus normal-saline instillation in conjunction with endotracheal suctioning. Respir Care. 1990;35(8): 785–790. 21. Ackerman MH. The effect of saline lavage prior to suctioning. Am J Crit Care. 1993;2(4):326–330. 22. Hagler DA, Traver GA. Endotracheal saline and suction catheters: sources of lower airway contamination. Am J Crit Care. 1994;3(6):444–447. 23. Williams R, Rankin N, Smith T, Galler D, Seakins P. Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med. 1996;24(11):1920–1929. 24. Jablonski RA. If ventilator patients could talk. RN. 1995; 58(2):32–34. 300 5/6/2021 Capella University Scoring Guide Tool NURS-FPX4030 u02a1 - Determining the Credibility of Evidence and Resources Learner: Erik , Hovsepyan OVERALL COMMENTS Hi Erik– Thank you for your efforts. However, I am not confident that you discussed and demonstrated how to determine the credibility of evidence and resources using the example of a new graduate nurse who was unfamiliar with the diagnosis of preeclampsia from the Villa Health scenario. I am not confident that you are becoming more aware of the importance of integrating the best available evidence for the purposes of enhancing clinical reasoning and judgment skills when making decisions. Please see below comments. Warmly, Dr. Duke RUBRICS https://scoringguide.capella.edu/grading-web/gradingdetails 1/12 5/6/2021 Capella University Scoring Guide Tool CRITERIA 1 Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach. COMPETENCY Plan care based on the best available evidence. NON_PERFORMANCE: Does not identify a quality or safety issue, or a chosen diagnosis, that could benefit from an evidencebased approach. BASIC: Identifies a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach. PROFICIENT: Describes a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach. DISTINGUISHED: Describes a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach. Provides a specific rationale for the importance or benefit of applying an evidence-based approach. Comments: Hi Erik– I do not see where you describe the Villa Health dx using an EBP approach. I also do not see where you provided specific rationales for the importance or benefits of the specified approach. https://scoringguide.capella.edu/grading-web/gradingdetails 2/12 5/6/2021 Capella University Scoring Guide Tool CRITERIA 2 Explain criteria that should be considered when determining credibility of resources such as journal articles and websites. COMPETENCY Analyze the relevance and potential effectiveness of evidence when making a decision. NON_PERFORMANCE: Does not list criteria that should be considered when determining credibility of resources such as journal articles and websites. BASIC: Lists criteria that should be considered when determining credibility of resources such as journal articles and websites. PROFICIENT: Explains criteria that should be considered when determining credibility of resources such as journal articles and websites. DISTINGUISHED: Explains criteria that should be considered when determining credibility of resources such as journal articles and websites. Notes one or more ways the criteria could be applied to a specific resource. Comments: Hi Erik– I do not see where explained the criteria that should be considered when determining credibility of resources. Please discuss explicit evidence-based criteria. https://scoringguide.capella.edu/grading-web/gradingdetails 3/12 5/6/2021 Capella University Scoring Guide Tool CRITERIA 3 Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis. COMPETENCY Analyze the relevance and potential effectiveness of evidence when making a decision. NON_PERFORMANCE: Does not describe the credibility or relevance of evidence or resources. BASIC: Describes the credibility or relevance of evidence or resources, but does not offer a complete analysis. The specific context of a quality or safety issue, or a chosen diagnosis may be unclear as well. PROFICIENT: Analyzes the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis. DISTINGUISHED: Analyzes the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis. Additionally, identifies the most useful evidence or resource based upon the analysis. Comments: Hi Erik– Because you did not discuss the appropriate dx or criteria, you were not able to effectively analyze the credibility and relevance of evidence and resources within the context of the Villa Health scenario. https://scoringguide.capella.edu/grading-web/gradingdetails 4/12 5/6/2021 Capella University Scoring Guide Tool CRITERIA 4 Explain the importance of incorporating credible evidence into an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis. COMPETENCY Apply an evidence-based practice model to address a practice issue. NON_PERFORMANCE: Does not identify an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis. BASIC: Identified an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis, but does not explain the model or the importance of incorporating credible evidence. PROFICIENT: Explains the importance of incorporating credible evidence into an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis. DISTINGUISHED: Explains the importance of incorporating credible evidence into an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis. Notes specific examples of how the model could help improve the chosen issue or diagnosis. Comments: Hi Erik– I do not see where you explained the importance of incorporating credible evidence into a specific evidencebased practice model. https://scoringguide.capella.edu/grading-web/gradingdetails 5/12 5/6/2021 Capella University Scoring Guide Tool CRITERIA 5 Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. COMPETENCY Apply professional, scholarly communication strategies to lead practice changes based on evidence. NON_PERFORMANCE: Does not organize content for ideas. Lacks logical flow and smooth transitions. BASIC: Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling. PROFICIENT: Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. DISTINGUISHED: Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors. Comments: Hi Erik– The assessment was not organized to reflect expected criteria. https://scoringguide.capella.edu/grading-web/gradingdetails 6/12 5/6/2021 Capella University Scoring Guide Tool CRITERIA 6 Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. COMPETENCY Apply professional, scholarly communication strategies to lead practice changes based on evidence. NON_PERFORMANCE: Does not apply APA formatting to headings, intext citations, and references. Does not use quotes or paraphrase correctly. BASIC: Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes and/or paraphrasing. PROFICIENT: Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. DISTINGUISHED: Exhibits strict and flawless adherence to APA formatting of headings, intext citations, and references. Quotes and paraphrases correctly. Comments: Hi Erik– There were no APA formatting errors noted in the paper. Supplemental Feedback https://scoringguide.capella.edu/grading-web/gradingdetails 7/12 5/6/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 1 Purpose Compose a text that articulates meaning relevant to the main topic, scope, and purpose of the prompt BEGINNING: This text is unrelated to the assignment prompt. DEVELOPING: This text is related to the assignment prompt but does not demonstrate an understanding of the main topic, scope, and purpose. SKILLED: This text responds to the assignment prompt and appropriately addresses the main topic, scope, and purpose. ADVANCED: This text presents a focused response to the assignment prompt and demonstrates a thorough understanding of the main topic, scope, and purpose. Comments: https://scoringguide.capella.edu/grading-web/gradingdetails 8/12 5/6/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 2 Organization Develop text using organization, structure, and transitions that demonstrate understanding of relationship between main and subtopics BEGINNING: This text does not include a thesis statement and is organized inappropriately for the assignment. DEVELOPING: The thesis statement in this text is unclear and/or the text is presented in paragraphs with unclear main idea(s) and/or transitional phrases. SKILLED: This text includes a thesis statement and is organized into paragraphs, with clear main ideas and effective transitional phrases. ADVANCED: This text reflects a strong thesis statement. Additionally, this text is organized with skillful transitions into paragraphs with clear main ideas, sufficient evidence, analysis, and linking information. Comments: https://scoringguide.capella.edu/grading-web/gradingdetails 9/12 5/6/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 3 Evidence Integrate into text appropriate use of scholarly sources and evidence BEGINNING: This text included plagiarized information. DEVELOPING: This text lacks synthesis of information from sources and/or the credibility of the sources is questionable, with many flaws in APA citation style. SKILLED: The included evidence was integrated and synthesized from outside sources, most of which are scholarly, with minimal flaws in APA citation style. ADVANCED: The evidence in this text was integrated and synthesized from credible, scholarly, and professionally sound sources, with minimal flaws in APA citation style. Comments: https://scoringguide.capella.edu/grading-web/gradingdetails 10/12 5/6/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 4 Tone Apply in text the standard writing conventions for the discipline, including structure, voice, person and tone BEGINNING: Text uses language inappropriate for the intended audience. DEVELOPING: This text does not meet writing conventions for the discipline and lacks appropriate voice, person, and/or tone for the intended audience. SKILLED: This text meets writing conventions for the discipline and there were minimal issues in appropriate use of voice, person, or tone for the intended audience. ADVANCED: This text exhibits strict adherence to writing conventions for the discipline and uses appropriate voice, person, and tone for the intended audience. Comments: https://scoringguide.capella.edu/grading-web/gradingdetails 11/12 5/6/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 5 Sentence Structure Produce text with minimal grammar, usage, spelling, and mechanical errors BEGINNING: Text meaning is unclear due to errors in sentence structure, grammar, usage, word choice, spelling, or mechanics in 75% or more of text. DEVELOPING: Text meaning is interrupted due to sentence structure, grammar, usage, word choice, spelling, or mechanical errors in 25%-75% or more of text. SKILLED: Text conveys clear meaning with minimal issues in grammar, usage, word choice, spelling, or mechanical errors in 10%-25% of text. ADVANCED: Text complexity and concision conveys clear meaning, with grammar, usage, word choice, spelling, or mechanical errors in 10% or less of text. Comments: https://scoringguide.capella.edu/grading-web/gradingdetails 12/12