Determining the Credibility of Evidence and Resources for Hospital-Acquired Pneumonia

 

Hospital-acquired pneumonia (HAP) is a prevalent issue within healthcare settings, posing significant risks to patient health and increasing the burden on healthcare systems (Baker & Quinn, 2018). The choice to focus on HAP is due to its high incidence and the potential for evidence-based practice (EBP) to significantly impact patient outcomes and healthcare efficiency. The Knowledge-to-Action (KTA) framework is a useful approach in guiding EBP, as it emphasizes the importance of translating research evidence into practical application for improved patient care (Ten, 2022). Determining the credibility of evidence and resources for understanding HAP diagnosis and management requires a careful evaluation of several factors. These factors include the publication source, the quality of the research methodology, and the relevance and applicability of the evidence to the specific hospital context. Peer-reviewed journal articles represent a reliable source of information, as they undergo a rigorous evaluation process by experts in the field (Glanville et al., 2019). Furthermore, the Cochrane Library, a reputable source of systematic reviews and clinical guidelines, can provide valuable insights into the diagnosis and management of HAP (Negrini et al., 2018).

Applying an evidence-based approach to HAP diagnosis and management is essential to ensure the most effective and efficient care for patients. Utilizing credible resources and evidence allows healthcare professionals to develop and implement best practice guidelines, which can lead to improved patient outcomes and reduced healthcare costs (Ten, 2022). Additionally, evidence-based practice can help identify knowledge gaps and areas where further research is needed, promoting continuous learning and improvement within the healthcare field (Torres et al., 2023). The literature supports the importance of using an evidence-based approach to address HAP. For instance, Baker and Quinn (2018) demonstrated the high incidence of HAP in the United States and emphasized the need for effective prevention strategies. Moreover, studies such as those by Jitmuang et al. (2022) and Kim et al. (2022) provide valuable insights into diagnostic tools and risk factors associated with HAP, informing healthcare professionals on how to better identify and manage the condition. Furthermore, the KTA framework, as described by Ten (2022), offers a structured approach to incorporating evidence into practice, highlighting the importance of translating research findings into actionable interventions for improved patient care.

Guidance for Determining the Credibility of Information Sources

In determining the credibility of resources for understanding HAP diagnosis, several criteria should be considered. According to Ten (2022), these include evaluating the publication source, assessing the quality of the research methodology, and considering the relevance and applicability of the evidence to the specific hospital context. Peer-reviewed journal articles represent a reliable source of information, as they undergo a rigorous evaluation process by experts in the field (Glanville et al., 2019). The Cochrane Library is an example of a database that is well-known for reputable systematic reviews and clinical guidelines that can provide valuable insights into the diagnosis and management of HAP (Negrini et al., 2018). To evaluate the publication source, new nurses should look for articles published in well-established, reputable journals with a high impact factor. According to Negrini et al. (2018), the impact factor is a measure of the frequency with which the average article in a journal has been cited in a particular year and is an indicator of the journal's quality and influence in the field. Additionally, new nurses should consider the affiliations and credentials of the authors, ensuring that they have relevant expertise and experience in the subject matter.

Assessing the quality of the research methodology involves examining the study design, sample size, data collection methods, and statistical analysis (Ten, 2022). New nurses should look for studies with well-defined objectives, clear inclusion and exclusion criteria, and a detailed description of the methods used. High-quality studies will typically have an appropriate sample size, a robust data collection process, and a thorough statistical analysis that addresses potential biases and confounding factors. For example, a randomized controlled trial (RCT) is considered the gold standard in research design, as it minimizes bias and allows for causal inference (Glanville et al., 2019). Considering the relevance and applicability of the evidence to the specific hospital context is crucial for new nurses learning how to diagnose HAP (Nowak & Zasowska, 2018). The evidence should be pertinent to the patient population and the setting in which the new nurses are working. For instance, a study conducted in a pediatric intensive care unit may not be directly applicable to the adult population or a general medical ward. Moreover, new nurses should consider the timeliness of the research, as more recent studies may provide updated information on diagnostic criteria, risk factors, and management strategies for hospital-acquired pneumonia.

Analysis of the Credibility of Recommended Sources of Information

To help new nurses in the diagnosis of HAP, it is important to utilize credible and relevant evidence from these recommended resources. For instance, the study by Baker and Quinn (2018) offers valuable insights into the incidence of non-ventilator hospital-acquired pneumonia in the United States, providing context to the prevalence of HAP. This article is credible because it is published in the American Journal of Infection Control, a reputable peer-reviewed journal in the field of infection prevention and control. The authors also utilize a large sample size and employ rigorous statistical methods, ensuring the reliability of their findings. Additionally, Jitmuang et al. (2022) discuss the use of a multiplex pneumonia panel for diagnosing HAP and ventilator-associated pneumonia in the era of emerging antimicrobial resistance, providing a potentially useful diagnostic tool for new nurses to consider. The credibility of this article is supported by its publication in Frontiers in Cellular and Infection Microbiology, a respected peer-reviewed journal. Moreover, the authors describe the diagnostic accuracy and potential clinical implications of the multiplex pneumonia panel in detail, offering valuable information for new nurses.

Furthermore, the comprehensive risk assessment for HAP by Kim et al. (2022) identifies sociodemographic, clinical, and hospital environmental factors associated with HAP incidence, assisting new nurses in recognizing patients at higher risk for developing HAP. This article is credible due to its publication in BMC Pulmonary Medicine, a well-regarded peer-reviewed journal. The study utilizes a large sample size and controls for potential confounding factors, enhancing the validity of their findings. Of these resources, the study by Kim et al. (2022) is the most useful for new nurses in diagnosing and learning more about HAP because it provides a comprehensive analysis of risk factors associated with the condition. Understanding these risk factors can assist new nurses in identifying patients at increased risk for HAP, allowing for more targeted diagnostic efforts and interventions. Additionally, the multiplex pneumonia panel discussed by Jitmuang et al. (2022) serves as a valuable diagnostic resource when used in conjunction with the risk factors identified by Kim et al. (2022).

Applicability of the Knowledge-to-Action Framework for Evidence-Based Diagnosis of Hospital-Acquired Pneumonia

The KTA framework is an EBP model that emphasizes the importance of incorporating credible evidence into practice to address the diagnosis of HAP (Ten, 2022). The KTA model consists of two main components: knowledge creation and the action cycle. Knowledge creation involves synthesizing evidence from research, while the action cycle focuses on adapting and implementing this evidence into practice, evaluating the outcomes, and sustaining the practice change (Torres et al., 2023). By incorporating credible evidence into the KTA framework, new nurses can enhance their decision-making process in identifying and managing HAP. For example, the findings from Kim et al.'s (2022) study on risk factors associated with HAP incidence can be incorporated into the knowledge-creation phase of the KTA framework. New nurses can use this evidence to identify patients at a higher risk for HAP and prioritize their monitoring and diagnostic efforts accordingly. In the action cycle, new nurses can adapt this evidence to their specific hospital context and implement targeted screening and prevention strategies for high-risk patients, such as more frequent assessment of respiratory status, strict hand hygiene protocols, and optimizing oral care.

Another example is the incorporation of the multiplex pneumonia panel for diagnosing HAP, as discussed by Jitmuang et al. (2022). By integrating this diagnostic tool into the knowledge creation phase of the KTA framework, new nurses can stay up-to-date with the latest diagnostic technologies for HAP. During the action cycle, new nurses can work with their healthcare team to implement the use of the multiplex pneumonia panel in their hospital setting, evaluate its effectiveness in diagnosing HAP, and make necessary adjustments to improve patient care. Incorporating credible evidence into the KTA framework not only helps improve the diagnosis of HAP but also promotes a culture of evidence-based practice among new nurses. This fosters continuous learning, critical thinking, and the adaptation of research findings to address the ever-changing challenges in healthcare. Ultimately, using the KTA framework to guide evidence-based diagnosis of HAP empowers new nurses to provide high-quality patient care, leading to improved patient outcomes and overall healthcare efficiency. In conclusion, addressing the diagnosis of hospital-acquired pneumonia in the healthcare setting among new nurses requires a solid foundation of credible evidence and a framework for translating this evidence into practice. New nurses can enhance their understanding of HAP diagnosis, identification, and management by applying the Knowledge-to-Action framework and utilizing resources such as peer-reviewed journal articles located in the hospital's library. This evidence-based approach will eventually result in better patient outcomes and more efficiency in the healthcare system.

References

Baker, D., & Quinn, B. (2018). Hospital-acquired pneumonia prevention initiative-2: Incidence of non-ventilator hospital-acquired pneumonia in the United States. American Journal of Infection Control, 46(1), 2–7. https://doi.org/10.1016/j.ajic.2017.08.036

Glanville, J., Dooley, G., Wisniewski, S., Foxlee, R., & Noel‐Storr, A. (2019). Development of a search filter to identify reports of controlled clinical trials within CINAHL Plus. Health Information and Libraries Journal, 36(1), 73–90. https://doi.org/10.1111/hir.12251

Jitmuang, A., Puttinad, S., Hemvimol, S., Pansasiri, S., & Horthongkham, N. (2022). A multiplex pneumonia panel for diagnosis of hospital-acquired and ventilator-associated pneumonia in the era of emerging antimicrobial resistance. Frontiers in Cellular and Infection Microbiology, 12, 977320–977320. https://doi.org/10.3389/fcimb.2022.977320

Kim, B.-G., Kang, M., Lim, J., Lee, J., Kang, D., Kim, M., … Jeon, K. (2022). Comprehensive risk assessment for hospital-acquired pneumonia: Sociodemographic, clinical, and hospital environmental factors associated with the incidence of hospital-acquired pneumonia. BMC Pulmonary Medicine, 22(1), 21–21. https://doi.org/10.1186/s12890-021-01816-9

Negrini, S., Arienti, C., Gimigliano, F., Grubišić, F., Howe, T., Ilieva, E., … Kiekens, C. (2018). Cochrane rehabilitation: Organization and functioning. American Journal of Physical Medicine & Rehabilitation, 97(1), 68–71. https://doi.org/10.1097/PHM.0000000000000832

Nowak, P. J., & Zasowska A. (2018). Pneumonia in palliative care patients, part 1 – principles of diagnosis and treatment, hospital-acquired pneumonia, and community-acquired pneumonia. Medycyna Paliatywna, 10(4), 159–175. https://doi.org/10.5114/pm.2018.83271

Ten, W. (2022). Assisting nurses with evidence-based practice: A case for the knowledge-to-action framework. Health SA Gesondheid, 27(7), 2118–2118. https://doi.org/10.4102/hsag.v27i0.2118

Torres, C. P., Mendes, F. J., & Barbieri-Figueiredo, M. (2023). Use of “The Knowledge-to-Action Framework” for the implementation of evidence-based nursing in child and family care: Study protocol. PloS One, 18(3), e0283656–e0283656. https://doi.org/10.1371/journal.pone.0283656