Introduction

Locating and determining the quality of credible resources by a baccalaureate-prepared nurse is vital for improving clinical reasoning and judgement skills. The patients of anxiety and depression are increasing rapidly in the United States. According to Anxiety and Depression Association of the US (AADA), such mental disorders are affecting more than 40 million adults(Melnyk, 2018). Selecting evidence-based practices for the treatment and diagnosis of depression in older adults is challenging for baccalaureate-prepared nurses in hospital settings. There are several factors nurses have to consider to determine the credibility of an evidence-based research. Unfortunately, not every information resource nurses access online is credible. The purpose of this report is to enable healthcare researchers and nurses to better equip themselves with the awareness and evaluation skills of an evidence-based research to improve patient care and safety. 

Establishing the Criteria for Determining Credibility

Selecting EBPs for Treatment of Depression in Older Adults helps to understand the rules of evidence-based practices and how they can benefit nurses to improve their outcomes. Several factors should be considered to identify which EBPs are available online for older adults facing depression and anxiety disorders. These resources should be interpreted and evaluated correctly to improve the interventions against depressive symptoms. For example, effective treatments include psychotherapy, antidepressant medications, and collaborative and integrated medical healthcare. This is the reason a junior nurse must learn effective treatments to reduce depression severity in patients; credible research and interventions can help to reduce such symptoms in patients up to 80% (Yancey, 2019). 

Since Quality research his conducted by referring to peer-reviewed journals, care should be taken not to include materials older than five years. Moreover, while choose credible websites for research on depressive symptoms and interventions (evidence-based), healthcare professionals should only consult websites with extension that are regarded as credible government resources online. Blog posts and individual articles are not credible resources; neither Wikipedia nor any other encyclopaedia can be considered as a credible source for researchers. Moreover, nurses should refrain from consulting commercial and profit-oriented websites with .com domains because information in those websites is not proven by researchers. This shows that nurses should always use credible scholarly resources while aiming to enhance their knowledge about diagnosis and treatment of depression and anxiety. 

NURS FPX 4030 Assessment 2 Determining the Credibility of Evidence and Resources JJ

There are several credible websites, journals, and government and company resources available on the Internet to find evidence-based researches related to anxiety and depression. Such sources are often peer-reviewed and published after careful scrutiny and checking by renowned scholars and professors. In addition to finding scholarly journals, it is vital that nurses should only access resources published within the last five years (Zheng, 2018). The newer the resource, the latest the information published in it. 

Determining the credibility of an online resource is easy when researchers utilize the CRAAP method or test. For instance, CRAAP test ensures that the sources selected are not more than five years old. Moreover, it also ensures that the information published in those journals and websites is valid and relevant to the topic researched. It should also meet the criteria of honesty including usefulness and acceptability to influence positive outcomes (Yancey, 2019). Therefore, while evaluating the criteria for credible resourcesselected for the diagnosis of depressive symptoms and treatments, a research published by a psychotherapy professor or expert will be considered more useful compared to a medical student with no practical experience. 

Applying the Evidence-Based Practice Model

Evidence-based practices possess strong scientific proof of producing positive outcomes for certain types of disorders. Other researches without the evidence may also be useful for nurses treating or dealing with depression patients, however, these researches cannot produce stronger outcomes due to lack of evidence. This implies that with EBPs, nurses can successfully reduce depression symptoms in patients, improve their overall mental health, and improve body functioning and performance. (Skaggs, 2018). The selection of an EPB depends on the problems faced by the older adults and the outcomes they desire to live a healthy life. For example, doctors think that both psychotherapy and medications can reduce depressive symptoms. However, if the severity of depression in older adults is higher, then considering their private history and other health conditions, the choice of one of these methods could be done. 

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In routine mental healthcare treatments, psychotherapy is considered as the best model or practice performed under the guidance of skilled professionals. It helps depression patients to openly speak about their experiences. Psychotherapist can be doctors, social workers, counselors, or philanthropists. In addition to psychotherapy, the Iowa Model has also been introduced in nursing practices that focuses on the use of research with evidence. Developed in 1994, the Iowa model can be implemented in seven steps. The first step involves selection of topic for evidence-based research. The second step contains forming a team for development and evaluation of the evidence-based practice. The team should follow written policies and guidelines with proper interaction with members (Melnyk, 2018). The third step involves evidence retrieval that involves a brainstorming session to identify the available resources and key terms to guide the search of evidence. For example, evidence can be retrieved using several online databases such as Cinahl and Web of Science. To ensure the best care standards, researchers should refer to the Quality Improvement and Innovation Partnership (QIIP). 

The fourth step in the Iowa model involves grading the evidence to address the quality areas of the individual research to measure the strength of the evidence. Qualitative data is vital for a thorough understanding of a phenomenon. Using the inductive reasoning, the researchers develop a theory and also use quantitative data based on the process of induction (LoBiondo-Wood, 2021). The research questions influence the research methodology selected as researchers aim to address the areas of effectiveness, appropriateness, and feasibility. 

The fifth step involves developing an evidence-based practice standard after careful critique of the literature. Guideliens are created for the depression patients’ group to support the evidence-based practices. The sixth step involves implementing EBPs when it is written as a policy or a guideline. The final steps involve evaluation of this practice to measure its value and contribution. The evaluation should show how the EBP has affected patient care. This model can be successfully applied to treat depression and anxiety in patients with the incorporation of the evidence into the model. Therefore, using the Iowa model ensures that no low-quality treatments are utilized in the hospital settings and the EBPs are backed by a solid research to help nurses find the best medications for patients. 

The Five Credible Resources for Effective Diagnosis

The CRAAP test is a useful tool that nurses and medical healthcare professionals apply to identify and explore the best relevant resources and find a relevant evidence-based solution for treating depression. Through this test, nurses were confident that they could find at least five credible online resources to solve their problem. These resources are as follows: “Journal of Depression and Anxiety”, “The American Journal of Psychiatry”, “ClinMed International Library”, “Open Journal of Depression and Anxiety”, and “Wiley Online Library.

 These resources are based on their usefulness to the nurses and patients. Out of these five sources, three will be selected that will accurately help to address the issue of depression and anxiety in the patient. 

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Analysis of Credibility and the Importance of Credible Evidence

Many researchers have been published to find the differences in treatment preferences between clients who read credible information compared to those who read non-credible information. The EBP is considered as a staple in the field of healthcare that allows therapists to only used treatments backed by evidences (Kim, 2019). Cognitive Behavioral Therapy (CBT) and Behavioral Activation (BA) are considered are considered useful techniques by the American Psychological Association (APA) to treat depression patients (Backwater, 2017). However, some of the medical treatments are potentially harmful for patients despite having well-established evidence. This shows that the evidence-based model shows that level of clinical and nursing expertise to treat depressive patients. The APA describes that most treatments are effective when professionals are responsive to patient’s specific needs and personalities. A study by Ellis, (2019) shows that patients who participate actively in decision making show improved outcomes and show deeper satisfaction. Therefore, CBT and BA are considered as the gold standards of psychotherapy and are preferred by more than 80% of the patients compared to medication (Ellis, 2019). Therefore, nurses and psychotherapists are encouraged to incorporate the evidence-based practices for achieving the best patient care outcomes. 

Moreover, according to Estabrooks (2018), a randomized control trial is also a gold standard of psychotherapy that helps to assess the effectiveness of a medical treatment for depression or any other disease. This process allows people to use a random intervention or method to treat depression and provide stronger proof of evidence compared to other studies. Moreover, randomized control trial is also performed by Quasi experiments (Ellis, 2019). This type of study is also effective to suggest a vital intervention. Therefore, the decision to apply an evidence-based practice on depression patients depends on their needs, readiness, selection of the right EBP, and assessing the competency of the hospital to apply the specific EBP. Hence, reliable evidence-based information always helps to improve the knowledge of professionals and provide better ways to improve overall outcomes. 

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Conclusion

The goal of achieving the best outcomes related to treatment of depression in older patients depends on using the right evidence-based practices that are backed up by credible and reliable information. The EBP models and interventions such as psychotherapy and medication can improve patient’s wellbeing; however, the professionals must know where to obtain the best evidence-based resources and how to evaluate them. Using the Iowa technique is useful that has allowed evaluation of the most credible resources to incorporate into patient care. 

References 

Ellis, P. (2019). Evidence-based practice in nursing. Learning Matters.

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Iowa Model Collaborative, Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., 

McCarthy, A. M., … & Authored on behalf of the Iowa Model Collaborative. (2017). Iowa model of evidence‐based practice: Revisions and validation. Worldviews on Evidence‐Based Nursing, 14(3), 175-182.

Kim, J. S., Gu, M. O., & Chang, H. (2019). Effects of an evidence-based practice education 

program using multifaceted interventions: a quasi-experimental study with undergraduate nursing students. BMC medical education, 19(1), 1-10.

LoBiondo-Wood, G., Faan, P. R., Haber, J., &Faan, P. R. (2021). Nursing Research E-Book: 

Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

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Melnyk, B. M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Van Dromme, L., & Thomas, 

B. K. (2018). Outcomes from the first helenefuld health trust national institute for evidence‐based practice in nursing and healthcare invitational expert forum. Worldviews on Evidence‐Based Nursing, 15(1), 5-15.

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Yancey, N. R. (2019). Evidence-Based Practice in Nursing for Teaching-Learning: But Is It 

Really Nursing?. Nursing science quarterly, 32(1), 25-28.

Zheng, X., & Deng, Y. (2018). Dependence assessment in human reliability analysis based on 

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