Evidence-based Practice (EBP) is the use of the use of recent research findings alongside professional proficiency to direct healthcare service provision (Li et al., 2019). It is a practice that emphasizes staying informed of the changing patient needs and preferences. Factors related to improved care quality and patient safety are spearheading transformation in healthcare. EBP is the ultimate result of these factors. Nurses have become more concerned with how to move good evidence into practice to enhance positive patient outcomes. This urgent desire has led to the development of EBP models, which are frameworks that guide and aid nurses in the integration of EBP into practice. In this essay, a diagnosis that can best benefit from an evidence-based approach is presented alongside the criteria for determining the credibility of evidence and resources. The paper also analyzes the credibility of the resources relevant to the chosen clinical diagnosis and elaborates on the EBP model used to address this clinical diagnosis.
Clinical Diagnosis that Can Benefit from an Evidence-Based Approach
Chronic Kidney Disease (CKD) is characterized by kidney damage or a lower glomerular filtration rate (GFR) of less than 60 millilitres/minute per 1.73 for three months or more, according to Vaidya and Aeddula (2022). The kidney progressively loses function, eventually necessitating renal replacement therapy (RCT) (dialysis or replacement). The aetiology of CKD is multifaceted, encompassing pre-renal disease, intrinsic renal diseases, and post-renal diseases. Primary diseases causing CKD include diabetes, hypertension, primary and secondary glomerulonephritis, hereditary or cystic diseases, and chronic heart failure, which lead to reduced renal perfusion. Screening targeting individuals with a high risk of developing CKD is recommended by Kidney Disease: Improving Global Outcomes (KDIGO) (Rovin et al., 2021).
Progression of CKD is associated with several complications, including a high incidence of cardiovascular challenges, anemia, hyperlipidemia, and bone diseases (Arora, 2019). Management of these complications poses a financial burden on the patients and health systems. An evidence-based approach is essential to prevent the progression of CKD while enhancing better life standards for those already having complications. Several interventions have been suggested to manage CKD, including dietary modifications, blood pressure monitoring and control, RCT, and patient education on medication management.
Criteria for Determining Credibility of Resources
Evaluating the credibility of information sources involves a systematic process guided by the CRAAP framework (Kurpiel, 2023). The first step is to assess the currency of the source, where one considers the publication date, which is particularly crucial in dynamic fields like healthcare. The relevance of the information is then examined by examining its direct connection to the topic at hand. Evaluators consider if the evidence directly supports or undermines the assertion, ensuring its pertinence and significance in establishing the credibility and validity of the presented information. Objectivity plays a pivotal role, involving the evaluation of the balance of the presentation’s perspectives. A credible source presents both sides of the facts without bias.
Authority is a central element in the process, involving a thorough examination of the author’s educational background and professional experience (Kurpiel, 2023). Alongside this, the credibility of the publisher is considered, with a focus on established and reputable publishing firms. The accuracy of the information is ensured through the peer review process, which serves as a critical indicator of reliability and correctness. Writing quality further aligns with accuracy, indicating that a well-organized and error-free document reflects a more reliable source. Lastly, the purpose of the information is scrutinized, with an emphasis on the author’s objectivity and a warning against biases or profit-driven motives that might compromise the source’s credibility.
Analyzing the Credibility of the Relevant Resources
The articles by Vaidya and Aeddula (2022), Arora (2023), Ghelichi-Ghojogh et al. (2022), and Kovesdy (2022) are essential in addressing clinical diagnosis. These articles provide practice essentials of CKD, ranging from risk factors, epidemiology, diagnosis, pathophysiology, complications, and treatment modalities. Based on the credibility test framework described above, these sources of evidence are credible. The articles include authors’ information, including professional qualifications. The articles are also current, having been published within the last five years.
Similarly, they are relevant to the topic of discussion, addressing various facets of CKD. The objectivity of the articles has been clearly brought out at the end of each article, including the disclosures of funding agencies and the possibility of the existence of a conflict of interest. Additionally, standard cross-referencing alongside stringent peer-review standards employed by the articles shows the credibility of the sources. Based on the use of the CRAAP framework, the identified sources of evidence are deemed relevant and reliable to address the clinical diagnosis of CKD.
Evidence-Based Model Used to Address the Clinical Diagnosis
The EBP model of implementation science can be employed to address CKD. Implementation science focuses on translating evidence into real-world practice to improve patient outcomes. In this scenario, the Consolidated Framework for Implementation Research (CFIR) could be a suitable model. CFIR considers factors, otherwise called contextual factors, such as intervention characteristics, inner and outer settings, and individual characteristics to guide effective implementation (Damschroder et al., 2022). Application of CFIR to CKD involves assessing the compatibility of evidence-based interventions with the healthcare setting, understanding organizational readiness, and addressing potential barriers and facilitators. For instance, implementing dietary modifications or blood pressure control strategies necessitates aligning these interventions with the healthcare context, ensuring staff engagement, and addressing any resistance to change.
In applying CFIR to CKD management, the model helps identify key elements influencing successful implementation, such as staff training, patient education, and integrating interventions into existing workflows. By systematically considering these factors, CFIR enhances the likelihood of sustained, evidence-based practices in CKD care. This model provides a comprehensive framework for healthcare professionals to bridge the gap between research evidence and practical implementation, ensuring a more effective and patient-centered approach to managing CKD.
Conclusion
In conclusion, the essay underscores the paramount importance of EBP in healthcare, particularly in managing the complexities of CKD. The meticulous criteria for determining the credibility of resources, guided by the CRAAP framework, ensure the selection of reliable and relevant information. The articles by Vaidya and Aeddula, Arora, Ghelichi-Ghojogh, et al., and Kovesdy emerge as credible sources, meeting the stringent standards of currency, relevance, objectivity, authority, accuracy, and purpose. The adoption of the CFIR as the EBP model facilitates the seamless integration of evidence into CKD management, considering contextual factors and enhancing the likelihood of successful implementation. This approach ensures a patient-centered and effective strategy in addressing CKD, aligning with the evolving landscape of healthcare and the imperative for positive patient outcomes.
References
Arora, P. (2019, July 26). Chronic Kidney Disease: Practice Essentials, Pathophysiology, Etiology. Medscape.com. https://emedicine.medscape.com/article/238798-overview
Arora, P. (2023). Chronic Kidney Disease (CKD): Practice Essentials, Pathophysiology, Etiology. EMedicine. https://emedicine.medscape.com/article/238798-overview?form=fpf
Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022). The updated Consolidated Framework for Implementation Research is based on user feedback. Implementation Science, 17(1). https://doi.org/10.1186/s13012-022-01245-0
Ghelichi-Ghojogh, M., Fararouei, M., Seif, M., & Pakfetrat, M. (2022). Chronic kidney disease and its health-related factors: a case-control study. BMC Nephrology, 23(1). https://doi.org/10.1186/s12882-021-02655-w
Kovesdy, C. P. (2022). Epidemiology of Chronic Kidney disease: an Update 2022. Kidney International Supplements, 12(1), 7–11. https://doi.org/10.1016/j.kisu.2021.11.003
Kurpiel, S. (2023, February 17). Research Guides: Evaluating Sources: The CRAAP Test. Benedictine University; Benedictine University. https://researchguides.ben.edu/source-evaluation
Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209
Rovin, B. H., Adler, S. G., Barratt, J., Bridoux, F., Burdge, K. A., Chan, T. M., Cook, H. T., Fervenza, F. C., Gibson, K. L., Glassock, R. J., Jayne, D. R. W., Jha, V., Liew, A., Liu, Z.-H., Mejía-Vilet, J. M., Nester, C. M., Radhakrishnan, J., Rave, E. M., Reich, H. N., & Ronco, P. (2021). KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney International, 100(4), S1–S276. https://doi.org/10.1016/j.kint.2021.05.021
Vaidya, S. R., & Aeddula, N. R. (2022, October 24). Chronic renal failure. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK535404/
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