Critical Appraisal of Research in Evidence-Based Practice or EBP

he 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. Critical Appraisal of Research in Evidence-Based Practice or EBP.

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Part A: Critical Appraisal of Research (Matrix)

Part B: Critical Appraisal of Research Narrative

From the critical appraisal of evidence above, there are several interventions that can be described as best practice that emerge. These practices are evidence-based because they have been tried and tested by way of research. Furthermore, this scholarly research has been peer-reviewed and published in reputed journals. Three of these four studies reviewed are systematic reviews and meta-analyses. In the pyramid of evidence, systematic reviews and meta-analyses provide the highest level of evidence that is needed (level 1) to prove that an intervention is indeed efficacious. For this reason, the following best practice in the form of practice recommendations has the best possible evidence that supports their inclusion into evidence-based practice protocols. The best practice recommendations that emerge are:

• The practice of regular handwashing with soap and water is an effective measure that reduces the rate of infection with hospital-acquired infections or HAIs (Andriani & Nadjib, 2018). This systematic review found that handwashing on a regular basis is a cost-effective way to prevent healthcare-associated infections (HAIs). This is what nurses must do regularly in practice. Critical Appraisal of Research in Evidence-Based Practice or EBP.
• There are significantly increased infections with Clostridium difficile (CD), resulting in high mortality. Handwashing with soap and water has proved effective in preventing this scenario (Borren et al., 2017). CD is one of the most resistant strains of bacteria and a leading cause of HAIs. Handwashing with soap and water in developing countries was found to effective at preventing its spread.
• Handwashing reduces the incidence of diarrheal diseases (Freeman et al., 2014).
• Handwashing with chlorhexidine and environmental cleaning with 10% Na hypochlorite solution reduces CDI HAIs significantly (Gerding et al., 2008). Of all the three studies, this one is the most specific in terms of the chemical agents that can be used to battle Clostridium difficile infection as a HAI in hospitals.

References

Andriani, Y., & Nadjib, M. (2018). The importance of implementation of hand hygiene practice in reducing healthcare-associated infections: A systematic review. The 2nd International Conference on Hospital Administration (KnE Life Sciences),135–145. https://doi.org/10.18502/kls.v4i9.3565

Borren, N.Z., Ghadermarzi, S., Hutfless, S., & Ananthakrishnan, A.N. (2017). The emergence of Clostridium difficile infection in Asia: A systematic review and meta-analysis of incidence and impact. PLOS ONE, 12(5), 1-16. https:// doi.org/10.1371/journal.pone.0176797

Freeman, M.C., Stocks, M.E., Cumming, O., Jeandron, A., Higgins, J.P.T., Wolf, J., Prüss-Ustün, A., Bonjour, S., Hunter, P.R., Fewtrell, L., & Curtis, V. (2014). Hygiene and health: Systematic review of handwashing practices worldwide and update of health effects. Tropical Medicine & International Health, 19(8), 906–916. https://doi.org/10.1111/tmi.12339. Critical Appraisal of Research in Evidence-Based Practice or EBP.

Gerding, D.N., Muto, C.A., & Owens Jr, R.C. (2008). Measures to control and prevent Clostridium difficile infection. Clinical Infectious Diseases, 46(Supplement 1), S43-S49. http://dx.doi.org/10.1086/521861

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4^th ed. Wolters Kluwer.

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

*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

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**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. Critical Appraisal of Research in Evidence-Based Practice or EBP.

• 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. Critical Appraisal of Research in Evidence-Based Practice or EBP.