Appraising literature
Dandream1023!Appraising literature
2 years ago
10
files (2)NUR8002APPRAISINGLITERATURE.docx
AppendixHSynthesisandRecommendations.docx
NUR8002APPRAISINGLITERATURE.docx
As you saw in Week 8, when conducting a literature review, you first search the evidence, and then you appraise it. Then, you are ready to summarize the evidence that you uncovered, and then you can synthesize it.
This Assignment is Part 2 of the Assignment you submitted in Week 8. In Part 1 of this Assignment, you used the Walden library to conduct a literature review and appraised your results to select the highest quality and most appropriate and significant evidence. Now, you will take the recent (within the last five years), peer-reviewed articles you selected and write brief summaries of each of them, and then write a synthesis of all of them.
To prepare:
· Review the Learning Resources for this week which focus on how to summarize and synthesize literature search results.
· Review the course textbook Appendix H, located in the Learning Resources for this week, which you will be required to complete and submit as part of this Assignment.
· Refer to your Assignment submission from Week 8 and prepare to write a summary of each of the three articles you selected.
· Refer to your Assignment submission from Week 8 and prepare to write a synthesis of the three articles you selected.
Note: For this Assignment, you must complete Appendix H. You will submit your completed Appendix H along with your 2–3-page paper.
Note: Be sure to review the grading rubric for this Assignment so you fully understand what is expected of you. To access the rubric, scroll down to the bottom of the Assignment page.
The Assignment: (2–3 pages)
Write a paper in which you do the following:
· Using a scholarly voice, summarize each of the three articles you selected.
· Using a scholarly voice, synthesize the three articles you selected.
· Include a copy of your completed Appendix H. Note: You will submit your completed Appendix H along with your 2–3-page paper. Save copies of your completed Appendix H in Word format. You will submit a total of two documents, your completed Appendix H and your 2-3 page synthesis of the three selected articles.
Note: Use this week’s Learning Resources to support your Assignment. Use proper APA format and style for all references and citations. The College of Nursing requires that all papers include a title page, introduction, summary, and references. Use the College of Nursing Writing TemplateLinks to an external site. for your Assignment submission.
By Day 7 of Week 9
Learning Resources
· Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.
· Chapter 5, “Searching for Evidence” (pp. 99–120)
· Chapter 6, “Evidence Appraisal: Research” (pp. 129–162)
· Appendix H, “Synthesis and Recommendations Tool (pp. 319–323) Download Appendix H, “Synthesis and Recommendations Tool (pp. 319–323) Note: Be prepared to complete and submit Appendix H for your Assignment this week.
Examples of Synthesis Resources Note: The resources below are good examples of the synthesis of literature. Review each resource as a model to emulate when you synthesize literature.
· Armstrong, M., Walters, K., Davies, N., Nimmons, D., Pigott, J., Read, J., & Schrag, A. (2024). Intervention components in the self-management of Parkinson’s: A mixed-methods synthesis of qualitative and quantitative evidence.Links to an external site. BMC Health Services Research, 24(1), 92. https://doi.org/10.1186/s12913-023-10436-4
· Boogaard, H., Atkinson, R. W., Brook, J. R., Chang, H. H., Hoek, G., Hoffmann, B., Sagiv, S. K., Samoli, E., Smargiassi, A., Szpiro, A. A., Vienneau, D., Weuve, J., Lurmann, F. W., & Forastiere, F. (2023). Evidence synthesis of observational studies in environmental health: Lessons learned from a systematic review on traffic-related air pollutionLinks to an external site.. Environmental Health Perspectives, 131(11), Article 115002. https://doi.org/10.1289/EHP11532
· Gearon, E., O'Connor, D., Wallis, J., Han, J. X., Shepperd, S., Makela, P., Disher, G., & Buchbinder, R. (2021). Factors influencing the implementation of early discharge hospital at home and admission avoidance hospital at home: A qualitative evidence synthesisLinks to an external site.. Cochrane Database of Systematic Reviews, 2021(3), Article CD014765. https://doi.org/10.1002/14651858.CD014765
· Martins-Filho, P. R., Tanajura, D. M., & Vecina-Neto, G. (2023). Multi-country monkeypox outbreak: A quantitative evidence synthesis on clinical characteristics, potential transmission routes, and risk factorsLinks to an external site.. European Journal of Internal Medicine, 107, 102–104. https://doi.org/10.1016/j.ejim.2022.09.013
· Sebastião, B. F., Hortelão, R. M., Granadas, S. S., Faria, J. M., Pinto, J. R., & Henriques, H. R. (2023). Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbationsLinks to an external site.. International Journal of Nursing Sciences, 11(1), 46–56. https://doi.org/10.1016/j.ijnss.2023.12.003
l
AppendixHSynthesisandRecommendations.docx
Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals
Synthesis and Recommendations Tool
Appendix H
|
EBP Question:
|
|||
|
Strength |
Number of Sources (Quantity) |
Synthesized Findings With Article Number(s) (This is not a simple restating of information from each individual evidence summary—see directions) |
|
|
Level |
Overall Quality Rating (Strong, good, or low) |
|
|
|
Level I · Experimental studies |
|
|
|
|
Level II · Quasi-experimental studies
|
|
|
|
|
Level III · Nonexperimental, including qualitative studies
|
|
|
|
|
Level IV · Clinical practice guidelines or consensus panels |
|
|
|
|
Level V · Literature reviews, QI, case reports, expert opinion
|
|
|
|
|
Where does the evidence show consistency? |
|
|
|
Where does the evidence show inconsistency? |
|
|
|
Best evidence recommendations (taking into consideration the quantity, consistency, and strength of the evidence): |
|
|
|
Based on your synthesis, select the statement that best describes the overall characteristics of the body of evidence. |
|
☐ Strong & compelling evidence, consistent results Recommendations are reliable; evaluate for organizational translation. ☐ Good evidence & consistent results Recommendations may be reliable; evaluate for risk and organizational translation. ☐ Good evidence but conflicting results Unable to establish best practice based on current evidence; evaluate risk, consider further investigation for new evidence, develop a research study, or discontinue the project. ☐ Little or no evidence Unable to establish best practice based on current evidence; consider further investigation for new evidence, develop a research study, or discontinue the project. |
See Chapter 11, Lessons from Practice, for examples of completed tools.
Directions for use of the Synthesis and Recommendations Tool
Purpose:
This tool guides the EBP team through the process of synthesizing the pertinent findings from the Individual Evidence Summary (Appendix G), sorted by evidence level, to create an overall picture of the body of the evidence related to the PICO question. The synthesis process uses quantity, strength (level and quality), and consistency to generate the best evidence recommendations for potential translation.
Overall quality rating and the total number of sources:
Record the overall quality rating and the number of sources for each level (strong, good, or low), ensuring agreement among the team members.
Synthesized findings:
This section captures key findings that answer the EBP question. Using the questions below, generate a comprehensive synthesis by combining the different pieces of evidence in the form of succinct statements that enhance the team’s knowledge and generate new insights, perspectives, and understandings into a greater whole. The following questions can help guide the team’s discussion of the evidence:
· How can the evidence in each of the levels be organized to produce a more comprehensive understanding of the big picture?
· What themes do you notice?
· What elements of the intervention/setting/sample seem to influence the outcome?
· What are the important takeaways?
Avoid repeating content and/or copying and pasting directly from the Individual Evidence Summary Tool. Record the article number(s) used to generate each synthesis statement to make the source of findings easy to identify.
Using this synthesis tool requires not only the critical thinking of the whole team but also group discussion and consensus building. The team reviews the individual evidence summary of high- and good-quality articles, uses subjective and objective reasoning to look for salient themes, and evaluates information to create higher-level insights. They include and consider the strength and consistency of findings in their evaluation.
Where does the evidence show consistency/inconsistency?
EBP teams must consider how consistent the results are across studies. Do the studies tend to show the same conclusions, or are there differences? The synthesized evidence is much more compelling when most studies have the same general results or point in the same general direction. The synthesized evidence is less compelling when the results from half the studies have one indication, while the findings from the other half point in a different direction. The team should identify the points of consistency among the evidence as well as areas where the inconsistency is apparent. Both factors are important to consider when developing recommendations or determining the next steps.
Best evidence recommendations:
In this section, the EBP team takes into consideration all the above information related to the strength, quantity, and consistency of the synthesized findings at each level to generate best practice recommendations from the evidence. Consider:
· What is the strength and quantity of studies related to a specific evidence recommendation?
· Is there a sufficient number of high-strength studies to support one recommendation over another?
· Are there any recommendations that can be ruled out based on the strength and quantity of the evidence?
· Does the team feel the evidence is of sufficient strength and quantity to be considered a best evidence recommendation?
Recommendations should be succinct statements that distill the synthesized evidence into an answer to the EBP question. The team bases these recommendations on the evidence and does not yet consider their specific setting. Translating the recommendations into action steps within the team’s organization occurs in the next step (Translation and Action Planning Tool, Appendix I).
Based on the synthesis, which statement represents the overall body of the evidence?
Choose the statement that best reflects the strength and congruence of the findings. This determination will help the team to decide the next steps in the translation process .
When evidence is strong (includes multiple high-quality studies of Level I and Level II evidence), compelling, and consistent, EBP teams can have greater confidence in best practice recommendations and should begin organizational translation
When most of the evidence is good (high-quality Level II and Level III) and consistent or good but conflicting, the team should proceed cautiously in making practice changes. In this instance, translation typically includes evaluating risk and careful consideration for organizational translation.
The team makes practice changes primarily when evidence exists that is of high to good strength. Never make practice changes on little to no evidence (low-quality evidence at any level or Level IV or Level V evidence alone). Nonetheless, teams have a variety of options for actions that include but are not limited to, creating awareness campaigns, conducting informational and educational updates, monitoring evidence sources for new information, and designing research studies.
© 2022 Johns Hopkins Health System/Johns Hopkins School of Nursing Page | 4
