NUR 550 Topic 4 Assignment: Critical Appraisal of Research

Sample Answer for NUR 550 Topic 4 Assignment: Critical Appraisal of Research Included After Question

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.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

 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.

The Assignment (Evidence-Based Project)

Part 3A: 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 1-2-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.

BY DAY 7 OF WEEK 7

Submit Part 3A and 3B of your Evidence-Based Project.

SUBMISSION INFORMATION

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A Sample Answer For the Assignment: NUR 550 Topic 4 Assignment: Critical Appraisal of Research

Title: NUR 550 Topic 4 Assignment: Critical Appraisal of Research

Identifying the Phenomenon

The article by Rankin et al., (2018) was selected for this assignment. The research focused on human experiences within a natural setting. The phenomenon was the barriers and facilitators to taking self-management of diabetes in pre-adolescent children suffering from diabetes type 1. The researchers conducted interviews in the doctor’s office where the participants were encouraged to share their experiences related to self-management tasks related to diabetes type 1. The study was conducted in the natural setting of the participants in that data was obtained in their usual environment. There was also the use of simulations such as drawing to increase the depth of the information that was obtained in the study.

The phenomenon under investigation in the research by Rankin et al., (2018) is relevant to nursing. It explores the patient-related factors that influence the utilization of self-care tasks in the management of diabetes. It also provides insights into the barriers and enablers to the use of self-care tasks by pre-adolescents for the management of diabetes. The information from the article enables nurses and other healthcare providers to identify effective interventions that can enhance the utilization of self-care management techniques in pre-adolescents with diabetes.

Structuring the Study

The research by Rankin et al., (2018) did not explicitly state the research question. However, it can be inferred from the aim of the research to have been; what are the barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes? It can be seen from this question that the researchers specified the distinct process that was under investigation. They identified the focus of the study to be on the perceived barriers and facilitators by the participants. The study also identified the context of the research. It can be seen from the research question that the study targeted pre-adolescents with diabetes mellitus type 1. It also identified the nature of tasks that the target population are expected to engage in the management of diabetes mellitus type 1. Accordingly, the researchers were interested in the self-management tasks for diabetes mellitus type 1. The choice of qualitative method that was utilized in the selected study fitted with the research question. As seen in the study by Rankin et al., (2018), its main aim was to identify barriers and facilitators to self-management tasks for diabetes type 1 in pre-adolescents. The barriers and facilitators could only be identified through unstructured interviews that enabled the participants to express their experiences in detail. The approach to data analysis such as inductive, thematic approach was also appropriate due to its ability to provide a generalized view of the experiences of the participants.

Researchers Perspectives and Sample Selection

The biases of the researchers were reported. They included the use of a homogenous sample and small sample size. The researchers concluded that these factors are likely to influence the reliability, generalizability, and dependability of the reported findings. The researchers also provided structure of ideas that reflected their beliefs. For example, they expressed the fact that the incorporation of health information technologies into self-management tasks would address some of the barriers that were identified in the research. It can also be seen in the study that the sample selection utilized by the researchers lives in the phenomenon of interest. The participants were selected based on an inclusion criterion, which included being on treatment due to diabetes mellitus type 1 and willingness to participate in the research.

Data Collection

The methods of data collection that were utilized in the study by Rankin et al., (2018) were stated clearly. They included the use of unstructured interviews where participatory activities were utilized to prompt discussions. The interviews lasted for an average of 45 minutes and were digitally recorded and transcribed in entirety. There is the evidence that participant consent was an integral part of the data collection process. The parents or guardians and pre-adolescents were given consent forms to demonstrate their voluntary participation in the research.

Data Analysis

The dimensions of data analysis that were utilized in the research by Rankin et al., (2018) can be identified and followed logically. They included data analysis by two analysts, independent data analysis that was followed by joint discussions, development of a coding framework, and thematic analysis using NVIVO software. The researchers painted a clear picture of the participants’ reality. They used direct quotations of their descriptions to increase the readers’ understanding of these experiences. The interpretation of the researchers also captured the meaning of the participants. They utilized the data to come up with shared meanings by the participants concerning their subjective barriers and facilitators on self-management tasks in diabetes. The interpretation of the interpretation of the researchers was however not confirmed by other professionals.

Describing the Findings

The researchers provided an explicit analysis of their findings. They provided themes that represented the shared meanings of the participants’ experiences. They also gave examples of the direct quotations of the participants’ narratives about their experiences. They also compared the different subjective experiences to increase the understanding of the readers concerning the experiences. The researchers linked their findings to existing literature. There was an extensive analysis of the similarities and differences in the findings in the study and those reported by other scholars. This analysis provided insights into areas of further research on the topic.

NUR 550 Topic 4 Assignment: Critical Appraisal of Research References

Rankin, D., Harden, J., Barnard, K., Bath, L., Noyes, K., Stephen, J., & Lawton, J. (2018). Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study. BMC endocrine disorders, 18(1), 1-9.

NUR 550 Topic 4 Assignment: Critical Appraisal of Research

A Sample Answer 2 For the Assignment: NUR 550 Topic 4 Assignment: Critical Appraisal of Research

Title: NUR 550 Topic 4 Assignment: Critical Appraisal of Research

The burden of CLABSI is high and this compromises the quality of care delivered to the patients admitted in the hospitals. Therefore, there is need to explore the evidence-based practices that can be used to reduce the health issue especially in the ICU. The purpose of this study is to appraise the evidences provided on the various measures of responding to the CLABSI in the inpatient units.

Evaluation Table

 

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
	Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400	Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007	Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4	Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473
Evidence Level *(I, II, or III)	III	I	I	II
Conceptual FrameworkDescribe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	The conceptual framework not indicated	No conceptual or theoretical framework indicated.	No theoretical framework defined	No theoretical framework defined.
Design/MethodDescribe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	The study involved a systematic review and meta-analysis conducted in conformity to the PRISMA and MOOSE guidelines. Sources from the various databases including MEDLINE, CINAHL, EMBASE, Scopus and Cochrane were involved. Only studies that involved randomized trials, and quasi experiment on the effect of CHG bathing versus non-CHG bathing in preventing CLABSI among the adult populations were included.	The study involved a non-randomized clinical trial. The study focused on the patients admitted in the ICU in the University Hospital Zurich with the cases of CLABSI analyzed after the implementation of CHG bathe.	The study involved a wedged cluster-randomized design conducted in four sequences. The indices of CLABSI among the patients undergoing the CHG bathing were analyzed before and after the implementation of bath protocol in the hospital.	The study involved cross-sectional survey where the target population were given questions to indicate their level of knowledge and awareness on CHG bathing.
Sample/Setting  The number and characteristics of patients, attrition rate, etc.	Data were obtained from reputable journal sources and covered studies conducted in clinical setting. The sample population was 22,850 patients with 8% attrition rate.	The study was conducted in an ICU setting. The sample population was 5008 patients.  All participants were included. The attrition rate was 0%.	The study was conducted in the university hospital setting. The total sample population was 1640. All the participants were included in the study. Attrition rate was 0%.	The study was conducted in healthcare setting. A total of 335 nurses were included in the study. The attrition rate was 0%.
Major Variables Studied  List and define dependent and independent variables	The major variables were CHG bath and risk for CLABSI.The dependent variable was CHG baths while the independent variable was the risk of CLABSI.	The major variables were daily CHG bathe and CLABSI incidences.The predictor variable included the daily chlorhexidine bathing in ICU and while the outcome variable was risk of CLABSI.	The variables were CHG bath and CLABSI rates.The dependent variable was CHG bathing while the independent variable was CLABSI rates.	The variables were knowledge and attitude towards CHG bath and the CLABSI rates. The dependent variable was knowledge, attitude and practice among nurses while the outcome variable was CLABSI rates.
Measurement  Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The DerSimonian average intervention was used in estimating the average intervention effect. The logistic regression model was used in estimating the relationship between the dependent (predictor) and the outcome variable.	The statistics conducted included multivariable regression analysis, odd ratio, and descriptive statistics.	The primary statistics used included descriptive statistics and linear regression model.	Chis-square and t-test were used.
Data Analysis Statistical orQualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The data analysis was quantitative based. The risk for CLABSI infections reduced the incidence of CLABSI by about 40%. The effect of the CHG bath was significant (0.67, 95% CI: 0.53–0.85).	The study was quantitative based. Multivariate analysis indicated that the intervention was significant (OR 0.47, 95% CI 0.26e0.84, P¼0.011).	The study findings indicated that the number of healthcare providers correctly identifying facts about CHG bathing increased, from 31.11 to 50.0% (χ2 = 9.32, p = .002).	Majority of nurses, with frequencies ranging from 70.7% to 90.1% were aware of the CLABSI prevention guidelines. Nursing workshops and courses (67.3%) was the main source of information CLABSIs prevention, followed by guidelines (42.7%), and internet (30.7%).
Findings and Recommendations  General findings and recommendations of the research	CHG bathing can help in reducing the risks of CLABSI among the patients admitted in hospitals. Therefore, healthcare institutions should adopt CHG bathing.	CHG bathing can help reduce the risk of CLABSI in the ICU unit. Therefore, healthcare institutions should adopt CHG bathing.	Educating the healthcare providers on the CHG bathing improves its implementation and reduce the risk for CLABSI. Therefore, healthcare institutions should adopt CHG bathing.	Improved knowledge on CLABSI prevention helps in enhancing adherence to infection prevention protocols. Therefore, healthcare institutions should adopt CHG bathing.
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?	The study involved a large sample population and the data covered were appropriate. On the other hand, the main weakness is that the study was based on adult populations alone and so cannot be inferred to children.However, the findings from the study can be used in reducing CLABSI among the adults.	The study’s setting was appropriate and could provide reliable answers to the research question. On the other hand, the weakness of the study was monocentric and did not monitor the intervention and this could bias the findings. However, the results from the study are feasible.	The study recruited adequate sample population. On the other hand, the weakness was that the CHG bathing processes were not standardized and this could affect the outcome recorded.The findings from the study are feasible for clinical practice.	The study covered various aspects influencing CLABSI prevention measures. The statistical tests were appropriate. On the other hand, the main weakness was lack of standard method for measuring attitude and level of knowledge.The findings from the study are feasible and can be used for clinical practice.
Key findings	CHG bathing reduces the risk for CLABI.	CHG bathing reduces the CLABSI.	There is a need to educate ICU nursing on CHG bathing protocols.	There is need to increase education programs on reducing CLABSI.
Outcomes	Reduced CLABSI	Reduced cases of CLABSI among the ICU patients.	Increased awareness on CHG bathing	Increased knowledge on CLABSI prevention.
General Notes/Comments	Healthcare institution should implement the CHG baths among other interventions to reduce CLABSI.	The use of CHG bath can be used to reduce the risks for CLABSI among patients in ICU.	Healthcare institutions should have standard guidelines for CHG bathing.	Educating the nurses on CLABSI prevention measures allows them to implement to protocols accordingly.

 

Critical Appraisal of Research

The studies reviewed explored the best practices that can be used to reduce the incidences of CLABSI among the patients in ICU.  Nosocomial infections are common among the patients on catheters and those on central lines. Furthermore, the studies indicate that the risk of CLABSI increases with the prolonged hospital stay (Afonso et al., 2016). The healthcare providers have the responsibility to ensure that they engage the right interventions and only discharge the patients when they are ready. As a result, there is need to monitor and ensure safe practices and reduce the risk of the patients contracting CLABSI. The use of CHG bathing has been proven effective in reducing the risks for CLABSI (Reynolds et al., 2021). However, variations in the protocols for the CHG bathing procedure among the healthcare institutions remain a major concern. Therefore, there is need for standardizing the procedures and creating awareness so that all the nurses are aware of what they should do as they interact with the patients.

The study by Esposito et al. (2017) indicated a gap in the knowledge and practice of the CHG prevention measures by the nurses in the ICU units. Also, the study indicates variations in the attitudes of the nurses towards the clinical practice and this affects the level of its implementation in the healthcare settings. Therefore, there is a need to create awareness and let the nurses understand the importance and the procedures involved in the CHG bathing as part of preventing the CLABSI. Besides, there should be guidelines published and that are readily available to ensure standardized safety protocols in the ICU units. The burden of CLABSI is high and this needs that adequate and prompt interventions must be developed to curb the health menace. The guidelines should be made available to all inpatient units. Thirdly, there is a need to conduct regular trainings on the CLABSI prevention measures to ensure that all the nurses have updated information on how to respond to the CLABSI.

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Finally, there is enough evidence from the analysis that CHG bathing can reduce CLABSI. Though, future studies should be conducted to explore other alternative methods that can be used alongside the intervention especially among children. In addition, having a standard protocol for CHG bathing will means that all people will be aware of what they should do to prevent CLABSI.

NUR 550 Topic 4 Assignment: Critical Appraisal of Research References

Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400

Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473

Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4

Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007