For this assessment, you may choose from the following options as the context for the quality or safety issue or chosen diagnosis/health issue for researching and completing this assessment: • The specific diagnosis/health issue you identified in your previous assessment. • The simulation Vila Health: Determining the Credibility of Evidence.

Analyzing the Credibility and Relevance of the Evidence within the Context of the Issue

The nurse arrived at multiple online websites and articles that they reported reviewing to understand more about preventing pressure ulcers and ensuring maintenance of skin integrity for the patient. Sources identified from the nurse’s search history showed that they arrived at moderately credible sources. The first article was from MedicalNews Today, whereby the author had submitted their excerpt to be reviewed by a medical officer. However, it did not comprehensively review the subject topic, and the depth of knowledge was relatively shallow, suggesting that it was targeted at the general public. Additionally, there were plenty of advertisements on the website.

An article from Mayo Clinic and Medscape were found to be credible sources. Their website addresses ended with .org. Medscape provides references, and the content is cited throughout. These two websites had limited advertisements and were powered by credible organizations that command authority in medicine. Other sources in the organization’s online library were mostly credible. The articles were peer-reviewed, current, relevant, and unbiased. These included unfiltered sources such as randomized control studies and filtered information like systematic reviews. The sources adequately covered the topic and provided evidence-based insights toward informed nursing care for patients at risk of impaired skin integrity (“Evidence-based practice for nursing: Evaluating the evidence”, n.d.).

Incorporating Credible Evidence into EBP models

EBP models were developed to provide a framework for nurses interested in adopting EBP toward optimizing patient care. These models guide approaches to EBP through directing strategic implementation, proper evaluation, and appropriate resource use. Therefore, nursing and medical research evidence are continually adopted into evidence-based decision-making in nursing care. An example of an EBP model is the Johns Hopkins Nursing Evidence-Based Practice Model. The model is clinician-focused and allows the timely and suitable adoption of current knowledge and best practices into patient care. The model has three steps: identification of the EBP question, sourcing and reviewing the available evidence, and translating feasible evidence into consideration. The research question in the identified case scenario is the need to conduct a driven program toward preventing and managing the risk of impaired skin integrity of the immobilized spinal injury patient. Adoption of the PICO question format can be implemented in the evidence-reviewing phase to ensure that the key articles relating to pressure ulcer incidence, risk factors, comparison of nursing interventions, best practices, and their safety are accessed (Anicoche, 2021).

Evidence revealed from reviewed sources through the Johns Hopkins EBP model will offer suitable interventions to prevent or manage the identified nursing diagnosis for spinal injury patients. Possible prevention interventions include developing an optimal patient repositioning schedule, risk and skin assessment, appropriate bed positioning to prevent shear, and padding and pillows to reduce pressure. Treatment interventions include appropriate wound dressings, nutritional assessment, wound debridement, and the use of biological agents (Atkinson & Cullum, 2018). Findings from the exercise should be suitably communicated to all members of the unit through a continuous medical education activity to increase the competence of the entire team in risk assessment and beginning nursing interventions for patients at risk of impaired skin integrity.

Conclusion

The inclusion of EBP in nursing practice helps to incorporate current, real-time, and data-based insights toward decision-making in nursing care. Nurses who adopt EBP stay updated about medical protocols for care, evaluate research, and make nursing decisions that uphold practice core principles of medical practice: autonomy, beneficence, non-maleficence, and justice. Scientific evidence shows that immobilized patients, like those with spinal cord injuries, have the highest risk of altered skin integrity and the development of pressure sores. These skin changes contribute to the risk of iatrogenic infections and reduced range of movement and function. Interventions to ensure skin integrity and prevent pressure ulcers require understanding evidence-based best practices to promote positive outcomes. Evidence-based practice models are instrumental in providing a framework for conceptualizing evidence into practice. The Johns Hopkins EBP model is one such model implemented to the effect.

References

Anicoche, M. L. (2021). The Johns Hopkins Evidence-Based Practice (EBP) Model: Weinberg Peri