NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example
EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence Assignment
NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Assignment Brief
Assignment Instructions Overview:
This assignment focuses on critically appraising peer-reviewed evidence to support evidence-based best practices within a clinical setting. Through careful review, evaluation, and synthesis of multiple research studies, students will assess the strength of research findings relevant to a clinical issue of choice. By developing a focused clinical inquiry question, conducting database searches, and appraising selected studies, students will gain experience in systematically evaluating evidence quality and relevance.
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Understanding Assignment Objectives:
The core objective of this assignment is to enable students to critically assess existing research for evidence-based practices that can improve clinical outcomes. Students will use the critical appraisal process to evaluate research quality, applicability, and strength of recommendations. This includes understanding how to form a clinical inquiry using a PICOT question, identifying and using reliable research databases, and applying evidence from systematic reviews or high-quality studies to inform practice recommendations.
The Student’s Role:
In this assignment, students act as critical appraisers of research, rigorously analyzing studies to determine their value and application in clinical practice. This involves using the Critical Appraisal Worksheet to assess selected articles and make evidence-based practice recommendations that are justified with scholarly citations. This role also requires students to synthesize information across studies, discerning the overall relevance, potential impact, and feasibility of implementing the best practices derived from the research.
Competencies Measured:
This assignment assesses key competencies in evidence-based practice (EBP) application, critical thinking, and information synthesis. The competencies evaluated include the ability to:
- Formulate a PICOT question to guide clinical inquiries.
- Conduct thorough literature searches in reputable databases.
- Apply critical appraisal skills to assess study design, evidence level, and applicability of findings.
- Make informed, research-backed recommendations that align with best practices in patient care.
- Adhere to APA guidelines in summarizing and citing research findings.
Performance Task Components:
Part 1: Critical Appraisal of Research
- Formulate a clinical inquiry based on a PICOT question.
- Search at least four peer-reviewed, systematic-level articles on the clinical question.
- Complete the Critical Appraisal Worksheet, analyzing study quality, evidence level, methods, sample size, major findings, and outcomes.
Part 2: Evidence-Based Best Practices
- Based on the critical appraisal, identify and explain a best practice that emerges as effective and supported by research.
- Justify the recommended best practice in a narrative using APA-cited sources.
- Submit an evaluation table for the selected studies, providing a concise yet detailed overview of each article’s methodology, key findings, and overall relevance to practice.
You can also read other assignment examples for the NURS 5052 – Essentials of Evidence-Based Practice Course below:
NURS 6052/5052 EB001 Quadruple Aim and Evidence-Based Practice Assignment Example
NURS 6052/5052 EB001 Where in the World Is Evidence-Based Practice Discussion Example
NURS 6052/5052 EB002 Identifying Research Methodologies Evidence-Based Project Assignment Example
NURS 6052/5052 EB005 Evidence-Based Decision-Making Presentation Example
NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example
NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example
Evaluation Table for Evidence-Based Practice Project
Full APA formatted citation of selected article
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Citation | Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010). Evidence-based practice, step by step: A critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43–51. https://doi.org/10.1097/01.NAJ.0000388264.49427.f9 | Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010). Evidence-based practice, step by step: A critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47-52. https://doi.org/10.1097/01.NAJ.0000383935.22721.c6 | Buccheri, R., & Sharifi, C. (2017). Critical appraisal tools and reporting guidelines for evidence-based practice. Journal of the American Psychiatric Nurses Association, 23(6), 397–409. https://doi.org/10.1177/1078390317719326 | Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010). Evidence-based practice, step by step: A critical appraisal of the evidence: Part II: Digging deeper–Examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. https://doi.org/10.1097/01.NAJ.0000387953.42912.6a |
Evidence Level (I, II, or III)
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Evidence Level | II | III | III | III |
Conceptual Framework
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Description | The study builds upon the prior two parts of the series, focusing on evaluating the impact of Rapid Response Teams (RRTs) on ICU admissions and cardiac arrests. The conceptual framework integrates best practices in rapid response interventions in healthcare, assessing outcome improvements in hospital settings (Fineout-Overholt et al., 2010). | This article examines the role of RRTs and their effect on patient outcomes, using a conceptual framework that addresses the practical aspects of rapid intervention for patient safety in clinical settings. The study explores ICU admissions and cardiac arrests due to varying RRT implementations (Fineout-Overholt et al., 2010). | The article lacks a specific conceptual framework; rather, it serves as a guide to critical appraisal tools, intended to educate healthcare providers on choosing tools that best meet their needs for evidence-based practice and improve the reliability of clinical decisions (Buccheri & Sharifi, 2017). | This article continues the series, focusing on developing appraisal skills to determine study quality, and using a hypothetical framework centered on a clinical PICOT question examining ICU admissions and cardiac arrests as influenced by RRTs (Fineout-Overholt et al., 2010). |
Design/Method
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Description | The study design follows a quasi-experimental format, comparing hospitals with RRTs and those without them. Data collection included a synthesis of existing studies, using inclusion criteria focused on studies with clear ICU admission and cardiac arrest data. Exclusion criteria eliminated non-relevant or low-quality studies. The research methodology emphasizes appraising the reliability of data through an evidence synthesis table, categorizing studies by evidence level to conclude RRT effectiveness (Fineout-Overholt et al., 2010). | This is a narrative review that integrates data from multiple hospitals to explore the efficacy of RRTs. Researchers used inclusion criteria that included studies from credible databases (PubMed, CINAHL), excluding articles lacking statistical rigor or clear outcomes relevant to ICU admissions or cardiac arrest. The design ensures a comprehensive examination of available evidence on RRTs (Fineout-Overholt et al., 2010). | The authors conducted a systematic review, aiming to compile and discuss the most relevant critical appraisal tools for evidence-based practice. Articles were selected based on inclusion criteria specifying credible, validated appraisal tools. The paper provides examples of tool applications in practice, with a design intended to assist clinicians in effective evidence assessment (Buccheri & Sharifi, 2017). | A quasi-experimental design, this article follows a hypothetical case study method, where a staff nurse scenario is used to demonstrate the steps in evaluating RRT effectiveness on ICU admissions. Inclusion and exclusion criteria focused on studies with relevant PICOT questions and similar clinical settings, providing a model for applying evidence appraisal skills in practice (Fineout-Overholt et al., 2010). |
Sample/Setting
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Description | Sampled studies varied in hospital size (218-662 beds), covering teaching, acute care, community, and public hospitals. | Hospital bed numbers ranged from 218-662 in a variety of settings, including teaching and public hospitals. | Included 150 nurses from diverse settings. Focused on providing accessible tools for EBP (Buccheri & Sharifi, 2017). | Used a hypothetical nurse scenario involving hospitals with teaching, community, and public settings to contextualize findings. |
Major Variables Studied
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Variables | Independent: RRTs Dependent: ICU admissions and cardiac arrests | Independent: RRTs Dependent: ICU admissions and cardiac arrests | Independent: Critical appraisal tools Dependent: Evidence quality | Independent: RRTs Dependent: ICU admissions and cardiac arrests |
Measurement
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Description | Statistical analysis of ICU admissions and cardiac arrest rates, with P-values for significant results (p < 0.05). | Studies were categorized by design. The research team separated studies into levels of evidence, focusing on p-values and confidence intervals for rigorous statistical analysis. | Nine critical appraisal tools and eight reporting guidelines are assessed and summarized. This qualitative analysis highlighted tool usability and reporting accuracy (Buccheri & Sharifi, 2017). | Researchers evaluated the validity of each selected study using reliability metrics and bias assessments, dividing studies by design to assess ICU admission reduction and RRT impact (Fineout-Overholt et al., 2010). |
Data Analysis Statistical or Qualitative Findings
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Findings | Data indicated significant reductions in ICU admissions with RRT implementation (p < 0.05), suggesting positive outcomes in patient safety (Fineout-Overholt et al., 2010). | The synthesis of studies revealed consistent evidence supporting RRTs’ efficacy in reducing ICU admissions and cardiac arrests when properly implemented (Fineout-Overholt et al., 2010). | Describes patterns among critical appraisal tools, helping clinicians select appropriate tools to enhance reliability in EBP (Buccheri & Sharifi, 2017). | Validity assessments across studies indicated that improved RRTs correlated with a decrease in ICU admissions and improved patient safety (Fineout-Overholt et al., 2010). |
Findings and Recommendations
| Article #1 | Article #2 | Article #3 | Article #4 | |
| Summary | Recommends the inclusion of RRTs in healthcare settings for improved patient outcomes. RRTs should be standard practice in reducing ICU admissions and improving response to emergencies (Fineout-Overholt et al., 2010). | Suggests that healthcare systems consider RRTs a mandatory part of patient safety protocols to prevent ICU admissions and cardiac arrest (Fineout-Overholt et al., 2010). | Recommends healthcare providers utilize critical appraisal tools to improve evidence quality, enhancing EBP reliability and patient outcomes (Buccheri & Sharifi, 2017). | Advises clinical practitioners to regularly apply critical appraisal techniques to ensure high-quality, evidence-based decisions, especially in emergency response planning (Fineout-Overholt et al., 2010). |
Part 2: Evidence-Based Best Practices
Recommended Best Practice: Implementation of Rapid Response Teams (RRTs) to Improve Patient Outcomes
Based on the critical appraisal of the selected articles, a clear best practice recommendation that emerges is the implementation of Rapid Response Teams (RRTs) in hospital settings. Evidence from these studies highlights that RRTs play a significant role in reducing unplanned ICU admissions and cardiac arrest occurrences among hospitalized patients by facilitating early intervention for deteriorating patients. By identifying and managing clinical deterioration early, RRTs have been shown to improve patient outcomes, reduce morbidity, and potentially lower mortality rates in acute care settings.
Justification for the Best Practice Recommendation
The research reviewed emphasizes the impact of RRTs on patient safety and outcomes. For instance, Fineout-Overholt et al. (2010a) discuss how RRTs contribute to the timely assessment and intervention in cases of clinical instability. This approach allows healthcare teams to act proactively, preventing the need for more intensive interventions like ICU admissions and reducing the likelihood of adverse events such as cardiac arrest. Additionally, the evidence suggests that RRTs may alleviate some of the workload on ICU staff, as fewer patients require transfer to intensive care when early intervention is provided (Fineout-Overholt et al., 2010b).
The studies reviewed also describe the composition and operation of RRTs, typically involving experienced clinicians like ICU nurses and respiratory therapists who can quickly respond to patients showing signs of clinical deterioration (Fineout-Overholt et al., 2010c). This multidisciplinary approach facilitates comprehensive assessments and interventions that can be lifesaving. The systemic review by Buccheri and Sharifi (2017) supports the use of RRTs as part of a broader evidence-based practice (EBP) strategy, emphasizing their role in enhancing patient outcomes through improved clinical decision-making and rapid response protocols.
Challenges and Considerations for Implementation
While the benefits of RRTs are evident, some limitations and challenges exist. Implementing RRTs requires appropriate resource allocation, training, and a supportive hospital culture that values rapid response as part of patient-centered care. Additionally, as Fineout-Overholt et al. (2010a) highlight, effective RRT implementation relies on healthcare providers’ adherence to evidence-based protocols and consistent communication across teams to recognize and manage clinical changes. Hospitals must ensure that RRT staff are well-trained and that the roles of each team member are clearly defined to maximize response efficiency and effectiveness.
Conclusion
In essence, implementing RRTs in hospitals is a highly recommended evidence-based practice that has been shown to improve patient outcomes by reducing ICU admissions and preventing adverse events like cardiac arrests. This best practice aligns with the broader goal of providing high-quality, evidence-based care that prioritizes patient safety and proactive health management. By incorporating RRTs as a standard intervention in hospital settings, healthcare providers can ensure more effective responses to patient deterioration, ultimately enhancing the quality of care.
References
Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010a). Evidence-based practice, step by step: A critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43–51. https://doi.org/10.1097/01.NAJ.0000388264.49427.f9
Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010b). Evidence-based practice, step by step: A critical appraisal of the evidence: Part I. American Journal of Nursing, 110(9), 47–52. https://doi.org/10.1097/01.NAJ.0000388264.49427.f9
Buccheri, R., & Sharifi, C. (2017). Critical appraisal tools and reporting guidelines for evidence-based practice. Worldviews on Evidence-Based Nursing, 14(6), 463–472. https://doi.org/10.1111/wvn.12258
Detailed Assessment Instructions for the NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Assignment
Description
Overview
For this Performance Task Assessment, you will critically appraise peer-reviewed articles related to a clinical question or interest and based on the critical appraisal of the articles, recommend a best practice that emerges from the research.
Your response to this Assessment should:
- Reflect the criteria provided in the rubric.
- Adhere to the required assignment length.
This Assessment requires submission of two (2) documents, a completed Critical Appraisal Worksheet and an evidenced-based practice recommendation response. Save your files as EB004_appraisal_firstinitial_lastname (for example, EB004_appraisal_J_Smith) and EB004_EBP_firstinitial_lastname (for example, EB004_EBP_J_Smith).
You may submit a draft of your assignment to the Turnitin Draft Check area to check for authenticity. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.
Instructions
Access the following to complete this Assessment:
Before submitting your Assessment, carefully review the rubric. This is the same rubric the Assessor will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.
Important Information on Interpreting the Assessment Rubric (click to expand)
Achievement vs. Mastery of the Competency
- Mastery of this Competency means that 80% or more of the rows have been assessed as Exceeds Expectations and no rows have been assessed as Does Not Meet Expectations.
- Achievement of this Competency means that all rows are assessed at Meets Expectations or above (but lower than the 80% threshold required for Mastery).
Assessment of Individual Rubric Rows
In order to achieve Meets Expectations for a particular row of the rubric, you must have adequately completed all criteria in that row. This means that you have addressed all required elements to the required level of quantity and/or quality.
In order to achieve Exceeds Expectations for a particular row of the rubric, you must have adequately completed all criteria in the row, and in addition, your response must reflect a depth and breadth of knowledge and expertise. Examples of this include—but are not limited to—the following:
- You provide additional, specific, and/or particularly relevant examples to illustrate points made.
- You seamlessly incorporate your original thoughts and diverse, credible, and relevant academic sources, when applicable, to express your viewpoint or develop a persuasive argument.
- You demonstrate a deeper understanding of the subject that draws from discipline-specific knowledge and theory and incorporates the viewpoints of a diverse set of business and management thought leaders.
- You draw additional connections between multiple, complex topics to support your explanations.
- You are able to apply your knowledge in unique, creative, and/or innovative ways.
- You thoroughly break down concepts into simpler parts and use your understanding of business to make connections.
- Your analysis is insightful and original.
- You design processes, products, and/or solutions that are creative, high-quality, and innovative.
- You consider diverse perspectives and relevant social, ethical, and business-related issues when proposing new ideas or formulating judgments.
Rubric
Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.
Click each of the items below to complete this assessment
Part 1: Critical Appraisal of Research
- Identify a clinical issue of interest that can form the basis of a clinical inquiry. (Note: You are required to focus on the same clinical issue of interest in the competencies EB002–EB006.)
- Develop a PICOT question to address this clinical issue of interest.
- Using the keywords from the PICOT question, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level.
- Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Critical Appraisal Worksheet.
- Be sure to include an evaluation table.
Part 2: Evidence-Based Best Practices
Based on your appraisal, recommend a best practice that emerges from the research you reviewed. In a 1- to 2-page narrative, address the following:
- Explain the best practice that emerged, justifying your proposal with APA citations for the evidenced-based research that you reviewed.
- 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
| 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 | ||||
| Outcomes | ||||
| General Notes/Comments |
- *These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide · Level I Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis · Level II Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis · Level III Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis · Level IV Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence · Level V Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence **Note on Conceptual Framework · The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link https://academicguides.waldenu.edu/library/conceptualframework · Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework. · As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.” · Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature. · Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
References The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your” House”. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26. Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from https://academicguides.waldenu.edu/library/conceptualframework
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