Assignment: Evidence Based Project Part 3: Critical Appraisal of Research
Assignment: Evidence Based Project Part 3: Critical Appraisal of Research
5052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research
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 th
e research.
See attachments for module 2 and 3 article
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Solution
Critical Appraisal Tool Worksheet Template
Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical Appraisal of Research
Full APA formatted citation of the selected article. Article #1 Article #2
Tamata, A. T., Mohammadnezhad, M., & Tamani, L. (2021). Registered nurses perceptions on the factors affecting nursing shortage in the Republic of Vanuatu Hospitals: A qualitative study. PLoS ONE. 16(5), e0251890. https://doi.org/10.1371/journal.pone.0251890
Neves, M. A., Parreira, P. M., Graveto, J. M., de Freitas, M. J., & Rodrigues, V. J. (2020). Nurse managers perceptions of nurse staffing and nursing care quality: A cross-sectional study. Journal of Nursing Management, 28(3), 625-633. https://doi.org/10.1111/jonm.12966
Evidence Level *
(I, II, or III)
III V
Conceptual Framework
Describe the theoretical basis for the study (If there is no one mentioned in the article, say that here).**
There is no conceptual framework mentioned
The researchers based their hypothesis on the Donabedian model which postulates that healthcare organizations should consider the structure, process, and result model to meet patients needs and improve the level of safety and care quality. The researcher hypothesized that allocation of nurses and teamwork impacts the response capacity, utilization of new work methods, and conditions the quality of nursing care.
Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).
The study utilized a qualitative research method. The method involved interviews to determine participants opinions. The researchers included registered nurses with more than 6 months work experience and working in any of the three selected hospitals. Nurses excluded from the study were those who did not give consent. The researchers used a qualitative research method to collect descriptive information on the perceptions of nurse managers. The inclusion criteria were being a nurse manager and an expert with broad knowledge of nursing work. Nurses excluded from the study were those offering direct nursing care.
Sample/Setting
The number and characteristics of
patients, attrition rate, etc.
The study included a sample of 25 registered nurses. The settings for data collection were three hospitals selected randomly among 6 hospitals in Vanuatu.
The researchers included 73 participants selected through the nonprobability convenience sampling technique. The nurses were selected from 12 public hospitals.
Major Variables Studied
List and define dependent and independent variables
Influence of work conditions on the performance of nursing care
Influence of work conditions such as heavy workload and unusual working hours on the quality of care
Reinforcing factors
Perceived risks
Dependent variable The quality of nursing care
Dependent variables outcomes of nursing care such as adverse events
Independent variables- structural factors such as nurse staffing (number, competencies, and teamwork) and care outcomes
Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done).
Thematic analysis to derive themes and sub-themes. Descriptive analysis such as measures of central tendency, dispersion, and frequency using the SPSS (version 22.0).
Multivariate multiple regression analysis to determine the causal model of structural relations between variables
Data Analysis Statistical or
Qualitative findings
(You need to enter the actual numbers determined by the statistical tests or qualitative data).
The analysis of qualitative data showed that the four themes determined from the collected data were difficulty in working conditions, heavy workload, perceived risks, and lack of support. The response rate was 75.34% meaning that only 55 out of 73 nurse managers responded completely.
Most nurse managers (83.64%) had at least four years of experience after attaining their Bachelors degree.
The score for staffing levels was lower than the midpoint scale meaning that nurses were inadequate to meet the safety and quality needs of the patients
The frequency of adverse effects was low (M = 2.93; SD = 0.87).
Findings and Recommendations
General findings and recommendations of the research
Data analysis revealed that lack of support, minimal opportunities for advancement in nurse education and practice, and lack of workforce were major challenges faced by nurses. The themes and subthemes such as the risk for stress, mental disorders, and family breakups revealed the impact of the nursing shortage. The effect of nursing shortage on quality of care was low.
Nurse staffing had an indirect impact on the quality of care.
All effects of nurse shortage on nursing are and outcomes were significant (p ? .05).
Appraisal and Study Quality
Describe the general worth of this research to practice.
What are the strengths and limitations of the study?
What are the risks associated with the implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice?
The qualitative study has high quality because of its transparency in justifying decisions and formulation of themes. The participant-driven inquiry helped shape the scope and breadth of the research question and interpretation. The study contributed a lot to the overall review of findings and has the transparency in how data was utilized to justify recommendations.
The study is of good quality because the verification process ensured methodological coherence needed to avoid prejudices and bias during analysis and interpretation.
Key findings
Several factors contribute to the current nursing shortage and the impact is felt b a workforce who are inadequate to perform highly and offer services of the best quality. The risk of deterioration due to low staffing and supervision was low and still significant.
Although staffing affected the quality of services, the occurrence of adverse events, the response capacity, and the utilization of new work methods ensured fewer events.
Outcomes
Low performance by nursing staff
Less quality of nursing services.
Lower quality of services
The perceptions of nurse managers on staffing and safety
General Notes/Comments Governments should address the chronic nurses shortage and review the current staffing situation to ensure enhanced nursing services at all levels of care.
Safe staffing covers the number of nurses, competencies, and the utilization of new work methods to deliver care with minimal chances of adverse events.
Part 3B: Critical Appraisal of Research
Nursing shortages deserve the attention of relevant stakeholders such as nurse managers and organizational management to improve the quality of care and enhance the value of nursing care offered to clients. Evidence from a study conducted by Neves et al. (2020) reveals that the number and competencies of nurses and other factors affecting teamwork influence the quality of care.
Therefore, optimizing staffing norms would be significant in enhancing the quality of care, safety, and outcomes. Considering the study findings, the best practice that develops is the increase in staffing ratios. The expected outcomes of the increased staffing norms are improved patient healthcare outcomes and satisfaction within four months.
The proposed best practice would attract and reduce or curb the intention to leave the job. According to Neves et al. (2020), inadequate nurse staffing harms nursing practice and health care organizations whereby impedes the care process. Because nurses who quit jobs cause more pressure on those who retain jobs, there is a need to address the number and competencies of staffing to ensure the smooth provision of services with minimal utilization of resources and promptly.
Neves et al. (2020) posit that nurses frequently face burnout and excessive workload in different departments of care which face inadequate nurse staffing. The potential effects of such a shortage are poor care quality, medication errors, poor health outcomes, and low patient satisfaction (Muabbar and Alsharqi, 2021).
Increasing nurse staffing will provide a long-term solution as opposed to short-term approaches such as floating and paying nurses for overtime work. As a result, nurse staffing has an impact on patient health outcomes in inpatient units, posing a danger to patient care.
Muabbar and Alsharqi (2021) reveal that short-term solutions could create client dissatisfaction with the quality of care and eventually have negative effects on patient outcomes. Therefore, increasing staffing is the best practice backed by previously published literature to relieve the impacts of nurse shortage on healthcare.
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 who 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 Oslo (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 evidence-based practice: appendix C: evidence level and quality guide. 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. https://academicguides.waldenu.edu/library/conceptualframework
