Summarizing and synthesizing research
ngoregina1
2 years ago
15
files (3)Week9Assignment.docx
Week9AssignAkonwahG.docx
AppendixH.docx
Week9Assignment.docx
Summarizing and synthesizing research
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.
Resources
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
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.
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Week9AssignAkonwahG.docx
5
Effective Search and Appraisal of Evidence for Reducing Hospital-Acquired Infections
Geraldine Akonwah
Walden University
Dr Letha Thomas
10/27/2024
Effective Search and Appraisal of Evidence for Reducing Hospital-Acquired Infections
Hospital-acquired infections are a critical concern globally, especially in health care. This paper summarizes three recent peer-reviewed studies that relate to HAIs, thereby synthesizing the findings of the articles reviewed. The foci of the studies on HAIs are different: the prevalence of HAIs, prevention, and hand hygiene compliance as mitigates for infection.
Summary of Articles
The scope of the first review, entitled " The Prevalence of HAIs and Associated Factors in Ethiopia," by Gebregiorgis et al., 2020, is the prevalence of HAIs and associated factors in the country. This study, therefore, tries to fill the gaps that the existing research has left and provides a state-of-the-art systematic review and meta-analysis of HAIs in the country. Results were identified from major scholarly databases, including PubMed, Embase, and Scopus, for articles published from January 2000 to December 2020. They used the Johanna Briggs Institute checklist for critical appraisal and statistical methods for heterogeneity and publication bias analyses. The primary outcome of interest was any estimate of HAI prevalence in Ethiopia. The review is essential because it points out that only a few developing countries have reliable nationwide data on HAIs, indicating that high challenges characterize infection control in the regions.
The second article is by Mouajou et al., “ Prevention of hospital-acquired infections," which discusses HHC among HCWs and its relationship to reducing the incidence of HAI in high-income countries. In this review, both randomized controlled trial studies and non-randomized studies were implemented in healthcare facilities. According to the results, the HAI incidence is observed when the rate of HHC is optimally around 60% to 70%. However, a few gaps in the research design were found that may limit causal inferences. Hand hygiene is widely recognized as critical to infection control, although achieving consistently high levels of compliance often proves elusive. The review considers the need for further research to establish more apparent HHC targets for reducing HAIs with greater clarity.
The third article, by Mitra et al. (2021), " Hand Hygiene Compliance in the Prevention of hospital-acquired infections," assesses the influence of the COVID-19 pandemic on the rates of HAI and compliance with hand hygiene at a multispecialty hospital in Eastern India. One study that leveraged the retrospective data for infection control monitoring activities between January 2019 and December 2020 reported a decrease in different kinds of HAIs during the pandemic, including CAUTI and CLABSI. These authors attribute these reductions to heightened infection control practices and improved hand hygiene compliance during the pandemic. The study, therefore, concluded that pandemic-driven improvements in hygiene compliance could be a model for HAI reduction even when there is no pandemic (Mitra et al., 2021).
Synthesis of the Articles
These three studies present valuable insights into the prevalence, prevention, and control of HAIs; all three emphasize using hand hygiene to stem infection rates. Gebregiorgis et al. (2020) and Mitra et al. (2021) mention systemic infection control measures as very important, though these are placed in different contexts. Gebregiorgis et al. give insight into Ethiopia, an area with inferior data on HAI, while Mitra et al. reflect on the critical infection control developments witnessed in India due to the COVID-19 pandemic. The consistency in data collection and implementation of preventive strategies is echoed by the two as paramount if HAIs are to be suitably dealt with.
Indeed, a more focused assessment of hand hygiene compliance was given by Mouajou et al. (2022), where it was established that 60% to 70% compliance among the HCWs equates to low HAI incidence. Many methodological challenges interfere with the results of the study; nevertheless, the findings of Mitra et al. (2021) were supported since they initially showed an increase in compliance with hand hygiene during the COVID-19 pandemic. Both these studies support the belief that HHC significantly contributes to minimizing HAIs, although maintaining compliance seems challenging.
Although there is some variation in the geographical and contextual focus of the three studies, all three recommend stringent infection control measures through hand hygiene to combat HAIs. All three articles stress that it is essential for individual HCWs and healthcare systems to put stress on HAI prevention strategies, which are not only a matter of public health but also an economic measure of savings for healthcare institutions.
Conclusion
The synthesis of the three studies establishes that continued research and practice improvements are crucial in reducing HAIs, especially in hand hygiene practices. Whether it is developing countries such as Ethiopia or international medical crises such as COVID-19, infection control is a global area of concern that must be addressed at all health facilities worldwide.
References
Gebregiorgis, B. G., Takele, G. M., Ayenew, K. D., & Amare, Y. E. (2020). Prevalence of hospital-acquired infections (HAIs) and associated factors in Ethiopia: a systematic review and meta-analysis protocol. BMJ open, 10(12), e042111. https://bmjopen.bmj.com/content/10/12/e042111.abstract
Mitra, M., Ghosh, A., Pal, R., & Basu, M. (2021). Prevention of hospital-acquired infections: A construct during Covid-19 pandemic. Journal of Family Medicine and Primary Care, 10(9), 3348-3354. https://journals.lww.com/jfmpc/fulltext/2021/10090/Prevention_of_hospital_acquired_infections__A.33.aspx
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2022). Hand hygiene compliance in the prevention of hospital-acquired infections: a systematic review. Journal of Hospital Infection, 119, 33-48. https://www.sciencedirect.com/science/article/pii/S0195670121003418
AppendixH.docx
Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals
Synthesis and Recommendations Tool
Appendix H
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EBP Question:
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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) |
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Level |
Overall Quality Rating (Strong, good, or low) |
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Level I · Experimental studies |
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Level II · Quasi-experimental studies
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Level III · Nonexperimental, including qualitative studies
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Level IV · Clinical practice guidelines or consensus panels |
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Level V · Literature reviews, QI, case reports, expert opinion
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Where does the evidence show consistency? |
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Where does the evidence show inconsistency? |
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Best evidence recommendations (taking into consideration the quantity, consistency, and strength of the evidence): |
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Based on your synthesis, select the statement that best describes the overall characteristics of the body of evidence. |
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☐ 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.
The exact quantity of sources needed to determine the strength of the evidence is subjective and depends on many factors, including the topic and the amount of available literature. The EBP team should discuss what they consider sufficient given their knowledge of the problem, literature, and setting
© 2022 Johns Hopkins Health System/Johns Hopkins School of Nursing Page | 4
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Week9Assignment.docx
Summarizing and synthesizing research
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.
Resources
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
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.
