Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

  • Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
  • Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
  • Review and download the Critical Appraisal Tool      Worksheet Template provided in the Resources.

(Evidence-Based Project)

Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer-reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 2-3 page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

Types of Study Designs: https://www.youtube.com/watch?v=PzEyl-VrhKU

Levels of Evidence video:  https://www.youtube.com/watch?v=tqQ94s-3dCc

Reliability and Validity video:  https://www.youtube.com/watch?v=9ltvDNAsO-I

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)

· Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733

image1.emf

Evaluation Table

Use this document to complete the
evaluation table
requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

American Journal of Infection Control 48 (2020) 940−947

Contents lists available at ScienceDirect

American Journal of Infection Control

journal homepage: www.ajicjournal.org

State of the Science Review

Notice to comply: A systematic review of clinician compliance with
guidelines surrounding acute hospital-based infection management

Kendall E. McKenzie MEng a,*, Maria E. Mayorga PhD b, Kristen E. Miller MSPH, DrPH c, Nishant Singh BS b,
Ryan C. Arnold MD d, Santiago Romero-Brufau MD e,f

a Department of Design, North Carolina State University, Raleigh, NC
b Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC
c MedStar Institute for Innovation, MedStar Health, Washington, DC
d Department of Emergency Medicine, Cottage Health System, Santa Ynez, CA
e Department of Medicine, Mayo Clinic, Rochester, MN
f Department of Biostatistics. Harvard T.H. Chan School of Public Health, Boston, MA

Key Words:

* Address correspondence to Kendall E. McKenzie M
Carolina State University, 50 Pullen Road, Raleigh, NC 276

E-mail address: [email protected] (K.E. McKenzie)
Conflicts of interest: None to report.
Funding: This work was supported by the N

(IIS1522072, IIS1522106, IIS1522107, IIS1833538).

https://doi.org/10.1016/j.ajic.2020.02.006
0196-6553/© 2020 Association for Professionals in Infect

Purpose: To identify and characterize studies evaluating clinician compliance with infection-related guide-
lines, and to explore trends in guideline design and implementation strategies.
Data sources: PubMed database, April 2017. Followed the PRISMA Statement for systematic reviews.
Study selection: Scope was limited to studies reporting compliance with guidelines pertaining to the preven-
tion, detection, and/or treatment of acute hospital-based infections. Initial search (1,499 titles) was reduced
to 49 selected articles.
Data extraction: Extracted publication and guideline characteristics, outcome measures reported, and any
results related to clinician compliance. Primary summary measures were frequencies and distributions of
characteristics. Interventions that led to improved compliance results were analyzed to identify trends in
guideline design and implementation.
Results of data synthesis: Of the 49 selected studies, 18 (37%), 13 (27%), and 10 (20%) focused on sepsis,
pneumonia, and general infection, respectively. Six (12%), 17 (35%), and 26 (53%) studies assessed local,
national, and international guidelines, respectively. Twenty studies (41%) reported 1-instance compliance
results, 28 studies (57%) reported 2-instance compliance results (either before-and-after studies or control
group studies), and 1 study (2%) described compliance qualitatively. Average absolute change in

ww.sciencedirect.com

Journal of Hospital Infection 91 (2015) 202e210

Available online at w

Journal of Hospital Infection

journal homepage: www.elsevierheal th.com/journals / jh in

Review

Applying psychological frameworks of behaviour
change to improve healthcare worker hand hygiene:
a systematic review

J.A. Srigley a,*, K. Corace b, D.P. Hargadon a, D. Yu a, T. MacDonald c,
L. Fabrigar c, G. Garber a

a Public Health Ontario, Toronto, Ontario, Canada
bUniversity of Ottawa, University of Ottawa Institute of Mental Health Research, Ottawa Hospital Research Institute, Ottawa,
Ontario, Canada
cDepartment of Psychology, Queen’s University, Kingston, ON, Canada

A R T I C L E I N F O

Article history:
Received 12 April 2015
Accepted 27 June 2015
Available online 4 August 2015

Keywords:
Behaviour
Hand hygiene
Psychology

* Corresponding author. Address: BC Childre
V6H 2N9. Tel.: þ1 604 875 2305.

E-mail address: [email protected]

http://dx.doi.org/10.1016/j.jhin.2015.06.019
0195-6701/Crown Copyright ª 2015 Published

S U M M A R Y

Background: Despite the importance of hand hygiene in preventing transmission of
healthcare-associated infections, compliance rates are suboptimal. Hand hygiene is a
complex behaviour and psychological frameworks are promising tools to influence
healthcare worker (HCW) behaviour.
Aim: (i) To review the effectiveness of interventions based on psychological theories of
behaviour change to improve HCW hand hygiene compliance; (ii) to determine which
frameworks have been used to predict HCW hand hygiene compliance.
Methods: Multiple databases and reference lists of included studies were searched for
studies that applied psychological theories to improve and/or predict HCW hand hygiene.
All steps in selection, data extraction, and quality assessment were performed indepen-
dently by two reviewers.
Findings: The search yielded 918 citations; seven met eligibility criteria. Four studies
evaluated hand hygiene interventions based on psychological frameworks. Interventions
were informed by goal setting, control theory, operant learning, positive reinforcement,
change theory, the theory of planned behaviour, and the transtheoretical model. Three
predictive studies employed the theory of planned behaviour, the transtheoretical model,
and the theoretical domains framework. Interventions to improve hand hygiene adherence
demonstrated efficacy but studies were at moderate to high risk of bias. For many studies,
it was unclear how theories of behaviour change were used to inform the interventions.
Predictive studies had mixed results.
Conclusion: Behaviour change theory is a promising tool for improving hand hygiene;
however, these theories have not been exte

American Journal of Infection Control 48 (2020) 940−947

Contents lists available at ScienceDirect

American Journal of Infection Control

journal homepage: www.ajicjournal.org

State of the Science Review

Notice to comply: A systematic review of clinician compliance with
guidelines surrounding acute hospital-based infection management

Kendall E. McKenzie MEng a,*, Maria E. Mayorga PhD b, Kristen E. Miller MSPH, DrPH c, Nishant Singh BS b,
Ryan C. Arnold MD d, Santiago Romero-Brufau MD e,f

a Department of Design, North Carolina State University, Raleigh, NC
b Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC
c MedStar Institute for Innovation, MedStar Health, Washington, DC
d Department of Emergency Medicine, Cottage Health System, Santa Ynez, CA
e Department of Medicine, Mayo Clinic, Rochester, MN
f Department of Biostatistics. Harvard T.H. Chan School of Public Health, Boston, MA

Key Words:

* Address correspondence to Kendall E. McKenzie M
Carolina State University, 50 Pullen Road, Raleigh, NC 276

E-mail address: [email protected] (K.E. McKenzie)
Conflicts of interest: None to report.
Funding: This work was supported by the N

(IIS1522072, IIS1522106, IIS1522107, IIS1833538).

https://doi.org/10.1016/j.ajic.2020.02.006
0196-6553/© 2020 Association for Professionals in Infect

Purpose: To identify and characterize studies evaluating clinician compliance with infection-related guide-
lines, and to explore trends in guideline design and implementation strategies.
Data sources: PubMed database, April 2017. Followed the PRISMA Statement for systematic reviews.
Study selection: Scope was limited to studies reporting compliance with guidelines pertaining to the preven-
tion, detection, and/or treatment of acute hospital-based infections. Initial search (1,499 titles) was reduced
to 49 selected articles.
Data extraction: Extracted publication and guideline characteristics, outcome measures reported, and any
results related to clinician compliance. Primary summary measures were frequencies and distributions of
characteristics. Interventions that led to improved compliance results were analyzed to identify trends in
guideline design and implementation.
Results of data synthesis: Of the 49 selected studies, 18 (37%), 13 (27%), and 10 (20%) focused on sepsis,
pneumonia, and general infection, respectively. Six (12%), 17 (35%), and 26 (53%) studies assessed local,
national, and international guidelines, respectively. Twenty studies (41%) reported 1-instance compliance
results, 28 studies (57%) reported 2-instance compliance results (either before-and-after studies or control
group studies), and 1 study (2%) described compliance qualitatively. Average absolute change in

Aires KF, Barlem JGT, Souza CS de et al. Contribuição da carga de trabalho para a ocorrência…

English/Portuguese

J Nurs UFPE on line., Recife, 10(12):4572-80, Dec., 2016 4572

ISSN: 1981-8963 ISSN: 1981-8963 DOI: 10.5205/reuol.9978-88449-6-ED1012201619

CONTRIBUTION OF THE WORK LOAD TO THE OCCURRENCE OF MEDICATION
ERRORS IN NURSING

CONTRIBUIÇÃO DA CARGA DE TRABALHO PARA A OCORRÊNCIA DE ERROS DE MEDICAÇÃO
NA ENFERMAGEM

CONTRIBUCIÓN DE LA CARGA DE TRABAJO PARA LA OCURRENCIA DE ERRORES DE MEDICACIÓN EN
LA ENFERMERÍA

Ketri Fagondes Aires1, Jamila Geri Tomaschewski Barlem2, Catharine Silva de Souza3, Laurelize Pereira

Rocha4, Deciane Pintanela de Carvalho5, Carolina Domingues Hirsch6

ABSTRACT

Objective: to analyze the contribution levels of the workload for the occurrence of medication errors in
nursing. Method: this is an exploratory-descriptive study with a quantitative approach, conducted with 49
nurses in a public hospital in the South of Brazil, using an instrument built and validated by the authors of the
research. Data were analyzed by descriptive and inferential statistics. Results: most participants had
experienced some medication error in their work unit, with dose errors being the most frequent and the
number of staff contributing to the occurrence of medication errors. Conclusion: the study facilitated the
recognition of elements of the workload that contribute to the occurrence of medication errors in nursing,
which may support the construction of strategies necessary to minimize the occurrence of medication errors

and patient safety. Descriptors: Workload; Nursing; Patient Safety; Medication Errors.

RESUMO

Objetivo: analisar os níveis de contribuição da carga de trabalho para a ocorrência de erros de medicação na
enfermagem. Método: estudo exploratório-descritivo, de abordagem quantitativa, realizado com 49
enfermeiros em um hospital público do Sul do Brasil, mediante aplicação de um instrumento construído e
validado pelos autores da pesquisa. Os dados foram analisados a partir de estatística descritiva e inferencial.
Resultados: a maioria dos participantes já vivenciou algum tipo de erro de medicação em sua unidade de
trabalho, sendo os erros de dose os mais frequentes e o quantitativo de pessoal o fator que mais contribui
para ocorrência de erros de medicação. Conclusão: o estudo oportunizou o reconhecimento de elementos da
carga de trabalho que contribuem para a ocorrência de erros de medicação na enfermagem, o que poderá
subsidiar a construção das estratégias necessárias para a minimização da ocorrência dos erros de medicação e
segurança do paciente. Descritores: Carga de Trabalho; Enfermagem; Segurança do Paciente; Erros de

Medicação.

RESUMEN

Objetivo: analizar los niveles

International Journal of

Environmental Research

and Public Health

Review

Hand Hygiene Teaching Strategies among Nursing
Staff: A Systematic Review

María B. Martos-Cabrera 1, Emilio Mota-Romero 1 , Raúl Martos-García 1,2 ,
José L. Gómez-Urquiza 3, Nora Suleiman-Martos 4,* , Luis Albendín-García 1,3 and
Guillermo A. Cañadas-De la Fuente 3

1 Andalusian Health Service, Avenida del Sur N. 11, 18014 Granada, Spain
2 Red Cross School of Nursing, University of Sevilla, Avenida la Cruz Roja N. 1, 41009 Sevilla, Spain
3 Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
4 Faculty of Health Sciences, University of Granada, Calle Cortadura Del Valle S.N., 51001 Ceuta, Spain
* Correspondence: [email protected]; Tel.: +34-958-248-047

Received: 12 July 2019; Accepted: 18 August 2019; Published: 22 August 2019
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Abstract: Background: Patient safety is a priority of any healthcare system, and one of the most
effective measures is hand hygiene. For this, it is important that health staff have correct adherence and
perform the technique properly. Otherwise, the incidence of nosocomial infections can increase, with
consequent complications. The aim here was to analyze hand hygiene training and the effectiveness
of different methods and educational strategies among nurses and whether they maintained correct
adherence over time. Methods: A systematic review was conducted in the sources CINAHL
(Cumulative Index to Nursing and Allied Health Literature), Dialnet, Lilacs (Latin American and
Caribbean Health Sciences Literature), ProQuest (Proquest Health and Medical Complete), Medline,
SciELO (Scientific Electronic Library Online), and Scopus. The search equation with Medical Subject
Headings (MeSH) descriptors was “Nurs* AND (handwashing OR hand hygiene) AND clinical
trial”. The review was performed following the recommendations of the guidelines of the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: n = 17
clinical trials were included, with a total of 5747 nurses and nursing students. Strategies such as
reminder sounds, practical simulations, videos, and audiovisual media improved handwashing
compliance. Adherence overtime increased by up to 60%. The greatest effectiveness was related to the
use of povidone–iodine, which reduced colony formation compared Hand hygiene teaching strategies
among nursing staff: a systematic review to soap. Conclusions: The strategies that go beyond teaching
techniques such as lectures may be more effective at increasing hand hygiene compliance. Combined
approaches to learning/instruction improve user satisfaction by enabling self-management, flexibility,
and repetition.

Keywords: hand hygiene; handwashi

Full APA formatted citation of selected article.

Article #1

Article #2

Article #3

Article #4


Evidence Level *

(I, II, or III)



Conceptual Framework

Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**

Design/Method

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

Sample/Setting

The number and characteristics of

patients, attrition rate, etc.

Major Variables Studied

List and define dependent and independent variables

Measurement

Identify primary statistics used to answer clinical questions (You need to list the actual tests done).

Data Analysis Statistical or

Qualitative findings

(You need to enter the actual numbers determined by the statistical tests or qualitative data).

Findings and Recommendations

General findings and recommendations of the research


Appraisal and Study Quality

Describe the general worth of this research to practice.

What are the strengths and limitations of study?

What are the risks associated with implementation of the suggested practices or processes detailed in the research?

What is the feasibility of use in your practice?

Key findings