evidence base nursing project
Evidence Based Nursing Project
Spring 2019
Group members:
Be sure to list the names of those who participated in the project.
1
Knowledge Discovery
Do not add anything to this slide.
2
Nursing problem
Desired outcome
4
Background questions with answers
May need to put answers here
5
Background questions with answers (con’t)
May need to put answers here
6
PICOT question
Keywords used for literature search
Databases used for literature search
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Search strategy to find systematic reviews
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Search strategy to find practice guidelines
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Number and types of studies
This should be the number that you found that studied both the same intervention and outcome since these are the “keeper” studies. Note: this number may be more then you actually end up critiquing.
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Level of evidence of studies found
See page 11 in the textbook
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Evidence Summary
Give author (s) date of research article
Study design:
Sample size:
Sample characteristics:
Setting:
Intervention studied:
Outcome studied:
Measurement of outcome:
Study findings:
Strength/quality of study:
Level of evidence:
Quantitative research individual study critical analysis
Name of group member who did critique: _________________________
Give the permalink for the article you are analyzing in space below:
Is there a comparison? (yes or no):
If there is a comparison what is it? (put N/A if there is no comparison)
If there is a comparison is it the same as you noted for the comparison above? (yes/no or N/A):
What is the study question(s) or hypotheses? (Use a direct quote. If neither of these are not stated put not stated)
Is the design appropriate for testing an intervention? (yes or no)
Is the setting similar to your setting/population of interest? (yes or no)
What was/were the sampling inclusion criteria?
What was/were the sampling exclusion criteria?
“Were the subjects randomly assigned to the experimental and control groups?” (Melynk & Fineout-Overholt, 2015, p. 118)
(enter yes or no – note: if this is no then the study is not as strong and it is not a randomized controlled trial)
If the subjects were randomly assigned “was random assignment concealed from the individuals who were first enrolling subjects into the study?” (Melynk & Fineout-Overholt, 2015, p. 118)
(yes or no)
“Were the subjects and providers kept blind to study group?” (Melynk & Fineout-Overholt, 2015, p. 118)
yes or no – also note this is the blinding and an randomized controlled trial is strong but it is very strong if it is double blinded)
“Were reasons given to explain why subject did not complete the study?” (Melynk & Fineout-Overholt, 2015, p. 118)
(yes or no)
“Were the subjects analyzed in the group to which they were … assigned?” (Melynk & Fineout-Overholt, 2015, p. 118) put yes or no
“Was the control group appropriate?” (Melynk & Fineout-Overholt, 2015, p. 118)
Put yes or no
“Were the subjects in each of the groups similar on demographic and baseline clinical variables?” (Melynk & Fineout-Overholt, 2015, p. 118)
Put yes or no
Did the researcher use power analysis to determine the appropriate sample size?
Put yes or no
Is the same size adequate?
Put yes, no, or unknown)
Are you convinced that everyone received the same intervention?
Yes or no – explain why or why not
“Were the follow-up assessments conducted long enough to fully study the effects of the intervention?” (Melynk & Fineout-Overholt, 2015, p. 118)
Yes or no – explain why or why not
After reading how the outcome was measured do you think this is the same as your O in your PICO question?
Yes or no and explain
What type of validity was used to make sure that the measurement tool really measured what it was intended to measure? (put an X next to all that apply below)
Experts reviewed the tool to determine that it was valid _____
The tool was compared to a similar tool _____
Equipment commonly utilized to measure the outcome such as thermometers, sphygmomanometers, scales etc. were used and properly calibrated. _____
Other (specify) _________________________
Did researcher convince you of the validity (the method really measured what it was supposed to measure) of the outcome measure?
Yes or no
What type of reliability (tool would get the same results each time it was used under the same conditions) was reported? Check below and give value:
Chronbach alpha ______ value reported ________
Item to total ______ value reported _______
Test retest _______ value reported ______
Interrater reliability ______ value reported _____
Other (specify) ______ value reported ______
Did the researcher convince you that the measurement was reliable?
Yes or no and explain why or why not
“What are the results?” (Melnyk & Fineout-Overholt, 2015, p. 96)
“How were the data analyzed?” (Melynk & Fineout-Overholt, 2015, p. 88)
“How large is the intervention or treatment effect (NNT, NNH, effect size, level of significance)?” (Melynk & Fineout-Overholt, 2015, p. 118) Note: give results (direct quotes are OK but you should also explain what this means).
Was there a statistically significant difference between the intervention group and control group?
Yes or no
”How precise is the intervention or treatment (CI)?” (Melynk & Fineout-Overholt, 2015, p. 118)
(if not given just indicate that)
Did the findings show that the intervention will produce the outcome?
Yes or no
“Will the results help me in caring for my patients?” (Melnyk & Fineout-Overholt, 2015, p. 107)
“Were all clinically important outcomes measured?” (Melynk & Fineout-Overholt, 2015, p. 118)
yes or no
“What are the risks and benefits of the treatment?” (Melynk & Fineout-Overholt, 2015, p. 118)
“Were there any untoward events during the conduct of the study? “ (Melynk & Fineout-Overholt, 2015, p. 88) If so explain and if not just say no.
“Is the treatment feasible in my clinical setting?” (Melynk & Fineout-Overholt, 2015, p. 118)
Yes or no
“What are my patients/family’s values and expectations for the outcome that is trying to be prevented and the treatment itself?” (Melynk & Fineout-Overholt, 2015, p. 118)
Overall how confident are you that this intervention will work in your setting (as indicated in the PICOT question) and produce the outcome you desire? Give rationale for your answer.
Include the full reference citation on your reference list.
Reference
Melnyk, B.M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best
practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
15
Give author (s) date of research article
Study design:
Sample size:
Sample characteristics:
Setting:
Intervention studied:
Quantitative research individual study critical analysis
Name of group member who did critique: _________________________
Give the permalink for the article you are analyzing in space below:
Is there a comparison? (yes or no):
If there is a comparison what is it? (put N/A if there is no comparison)
If there is a comparison is it the same as you noted for the comparison above? (yes/no or N/A):
What is the study question(s) or hypotheses? (Use a direct quote. If neither of these are not stated put not stated)
Is the design appropriate for testing an intervention? (yes or no)
Is the setting similar to your setting/population of interest? (yes or no)
What was/were the sampling inclusion criteria?
What was/were the sampling exclusion criteria?
“Were the subjects randomly assigned to the experimental and control groups?” (Melynk & Fineout-Overholt, 2015, p. 118)
(enter yes or no – note: if this is no then the study is not as strong and it is not a randomized controlled trial)
If the subjects were randomly assigned “was random assignment concealed from the individuals who were first enrolling subjects into the study?” (Melynk & Fineout-Overholt, 2015, p. 118)
(yes or no)
“Were the subjects and providers kept blind to study group?” (Melynk & Fineout-Overholt, 2015, p. 118)
yes or no – also note this is the blinding and an randomized controlled trial is strong but it is very strong if it is double blinded)
“Were reasons given to explain why subject did not complete the study?” (Melynk & Fineout-Overholt, 2015, p. 118)
(yes or no)
“Were the subjects analyzed in the group to which they were … assigned?” (Melynk & Fineout-Overholt, 2015, p. 118) put yes or no
“Was the control group appropriate?” (Melynk & Fineout-Overholt, 2015, p. 118)
Put yes or no
“Were the subjects in each of the groups similar on demographic and baseline clinical variables?” (Melynk & Fineout-Overholt, 2015, p. 118)
Put yes or no
Did the researcher use power analysis to determine the appropriate sample size?
Put yes or no
Is the same size adequate?
Put yes, no, or unknown)
Are you convinced that everyone received the same intervention?
Yes or no – explain why or why not
“Were the follow-up assessments conducted long enough to fully study the effects of the intervention?” (Melynk & Fineout-Overholt, 2015, p. 118)
Yes or no – explain why or why not
Include the full reference citation on your reference list.
Reference
Melnyk, B.M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
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Give author(s) dates con’t
Outcome studied:
Measurement of outcome:
Study findings:
Strength/quality of study:
Level of evidence:
After reading how the outcome was measured do you think this is the same as your O in your PICO question?
Yes or no and explain
What type of validity was used to make sure that the measurement tool really measured what it was intended to measure? (put an X next to all that apply below)
Experts reviewed the tool to determine that it was valid _____
The tool was compared to a similar tool _____
Equipment commonly utilized to measure the outcome such as thermometers, sphygmomanometers, scales etc. were used and properly calibrated. _____
Other (specify) _________________________
Did researcher convince you of the validity (the method really measured what it was supposed to measure) of the outcome measure?
Yes or no
What type of reliability (tool would get the same results each time it was used under the same conditions) was reported? Check below and give value:
Chronbach alpha ______ value reported ________
Item to total ______ value reported _______
Test retest _______ value reported ______
Interrater reliability ______ value reported _____
Other (specify) ______ value reported ______
Did the researcher convince you that the measurement was reliable?
Yes or no and explain why or why not
“What are the results?” (Melnyk & Fineout-Overholt, 2015, p. 96)
“How were the data analyzed?” (Melynk & Fineout-Overholt, 2015, p. 88)
“How large is the intervention or treatment effect (NNT, NNH, effect size, level of significance)?” (Melynk & Fineout-Overholt, 2015, p. 118) Note: give results (direct quotes are OK but you should also explain what this means).
Was there a statistically significant difference between the intervention group and control group?
Yes or no
”How precise is the intervention or treatment (CI)?” (Melynk & Fineout-Overholt, 2015, p. 118)
(if not given just indicate that)
Did the findings show that the intervention will produce the outcome?
Yes or no
“Will the results help me in caring for my patients?” (Melnyk & Fineout-Overholt, 2015, p. 107)
“Were all clinically important outcomes measured?” (Melynk & Fineout-Overholt, 2015, p. 118)
yes or no
“What are the risks and benefits of the treatment?” (Melynk & Fineout-Overholt, 2015, p. 118)
“Were there any untoward events during the conduct of the study? “ (Melynk & Fineout-Overholt, 2015, p. 88) If so explain and if not just say no.
“Is the treatment feasible in my clinical setting?” (Melynk & Fineout-Overholt, 2015, p. 118)
Yes or no
“What are my patients/family’s values and expectations for the outcome that is trying to be prevented and the treatment itself?” (Melynk & Fineout-Overholt, 2015, p. 118)
Overall how confident are you that this intervention will work in your setting (as indicated in the PICOT question) and produce the outcome you desire? Give rationale for your answer.
Include the full reference citation on your reference list.
Reference
Melnyk, B.M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
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Author(s) year (use if critique is of a systematic review).
Inclusion criteria for studies:
Exclusion criteria for the studies
Number of studies reviewed:
Intervention studied:
Outcome studied:
Systematic review conclusions:
Quantitative systematic review critical analysis
Name of group member who did critique: _________________________
Give the permalink (if article accessed thru EBSCO) or the URL/web address (if the article is open access) to the article below.
Is the intervention the same as (or very similar to) the intervention in your PICOT? (yes or no)
“Are the studies contained in the review all Randomized Controlled Trials (RCTs)?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Yes or no
“Does the review include a detailed description of the search strategy to find all relevant studies?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Yes or no
Did the search include a strategy to find unpublished research studies?
Yes or no
Do you feel confident that the search was comprehensive and found all relevant studies? Yes or no and explain your rationale for your answer to this below:
“Does the review describe how validity of the individual studies was assessed (e.g., methodological quality, including the use of random assignment to study groups and complete follow-up of the subjects?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Yes or no
Was the validity (quality) of the studies assessed independently by at least two members of the research team?
Yes or no
Were conclusions of the review based on only high quality studies?
Yes or no
“Were the results consistent across studies?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Yes or no
Did the review include a table showing the results of the studies which were included in the review?
Yes or no
“Were individual patient data or aggregate data used in the analysis?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Individual _______ Aggregate _________
Was a meta-analysis statistical test done?
Yes or no
If a meta-analysis was calculated what was the combined sample size used? (if not done put N/A)
If a meta-analysis was calculated what were the results? (if not done put N/A)
“How large is the intervention or treatment effect (NNT, NNH, effect size, level of significance)?” (Melynk & Fineout-Overholt, 2015, p. 127) Note: give results (direct quotes are OK but you should also explain what this means).
”How precise is the intervention or treatment (CI)?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Did the findings show that the intervention will produce the outcome?
Yes or no
“Are my patients similar to the ones included in the review?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Yes or no
“Is it feasible to implement the findings in my practice setting?” (Melnyk & Fineout-Overholt, 2015, p. 127)
Yes or no
“Were all clinically important outcomes considered including, risks and benefits of the treatment?” (Melnyk & Fineout-Overholt, 2015, p. 127)
yes or no
“What is my clinical assessment of the patient and are there any contraindications or circumstances that would inhibit me from implementing the treatment?” (Melnyk & Fineout-Overholt, 2015, p. 127) Note: for this discuss any contraindications or circumstances that would prevent you from implementing the treatment.
“What are my patient’s and his or her family’s preferences and values about the treatment under consideration?” (Melnyk & Fineout-Overholt, 2015, p. 127) Note for this discuss the values and preferences which you would need to consider when deciding whether or not to implement the intervention/treatment.
Overall how confident are you that this intervention will work in your setting and produce the outcome you desire? Give rationale for your answer.
Include the full reference citation on your reference list.
Reference
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best
practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
Adapted from:
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
By
Mary Ann Notarianni, PhD, RN
Sentara College of Health Sciences
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Practice guideline recommendations
If you did not find any practice guidelines just put none found here.
If you found a practice guideline then
- only put the recommendations that are related to your PICOT question
- put the author(s), year, p. number in parentheses at the bottom
- be sure to put the full citation on the reference list
- strength of evidence
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Synthesis
| Design | Sample | Outcome | |
| Studies | |||
Note: each column only needs basic, concise information. See example in the textbook on page 553.
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| Design | Sample | Outcome | |
| Studies | |||
Synthesis (con’t)
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| Design | Sample | Outcome | |
| Studies | |||
Synthesis (con’t)
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| Design | Sample | Outcome | |
| Studies | |||
Synthesis (con’t)
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Summary of Synthesis
Translation and Integration of Evidence into Practice
Practice change supported by evidence
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Format of practice change
A clear and comprehensive explanation of the format.
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Clinical problems that may be a contraindication
Patient preferences that need consideration
29
Patient value considerations
30
Planning the change
Plans for implementing change (such as what will need to be done – education, equipment etc. as appropriate) clearly discussed.
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Anticipated barriers to change
32
Strategies to overcome barriers to this change
33
Evaluation and dissemination
Evaluating if the change worked
Data to be collected
Method of data collection
Discuss what resources you will need for measuring the outcomes
35
Time frame for evaluating change
Give rationale for why you picked this time frame
36
Disseminating the results of the project
37
References
References (con’t)
References (con’t)
References (con’t)
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