NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

Walden University NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

Whether one passes or fails an academic assignment such as the Walden University NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

The introduction for the Walden University NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

After the introduction, move into the main part of the NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

Introduction

A critical appraisal helps to reduce the research burden by allowing a researcher to identify and focus on articles that are relevant to their research question. Through the use of quality and evidence-based practice interventions, the research can either support or refute the researcher’s claims. The topic chosen for the research study is the use of resilience training to mitigate the problem of nurse burnout among nurses in various care settings. Nurse burnout is still a major issue that affects the quality of care and patient outcomes in various care settings. Resilience training enables nurses to create and implement evidence-based interventions to reduce burnout, improve overall performance, and improve care quality.

The 2010 IOM report had four key messages or recommendations for nurses to position themselves strategically in healthcare provision. Firstly, the report stresses the need for nurses to practice to the fullest level of their education and training without any hindrances imposed by state boards of nursing. The message influences nursing practice as it means that nurses should be barred from practicing what they have trained on in different specialties (Price & Reichert, 2018). Secondly, the report asserted that nurses should engage in lifelong learning to acquire higher levels of education and training based on a better education system. The message means that the nursing practice requires professional nurses to engage in continual professional development to attain the latest skills and knowledge in healthcare provision, especially the deployment of technology.

EBP combines best practices from studies and patient care information with clinician experience and patient preferences to deliver the

highest quality of care while improving patient outcomes. The use of EBP necessitates the formulation of a clinical question of interest by care providers. In this case, the PICOT question is: Does resilience training (I) versus no intervention (C) reduce burnout (O) in six months (T) among nurses with burnout (P)? The goal of this assignment is to critically review peer-reviewed articles for evidence to support resilience training among nurses experiencing burnout in order to reduce its prevalence.

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Full APA formatted	Article #1	Article #2	Article #3	Article #4
citation of selected article	Wang, Q. Q., Lv, W. J., Qian, R. L., & Zhang, Y. H. (2019). Job burnout and quality of working life among Chinese nurses: A cross‐sectional study. Journal of Nursing Management, 27(8), 1835-1844. https://doi.org/10.1111/jonm.12884	Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014	Brook, J., Aitken, L. M., MacLaren, J. A., & Salmon, D. (2021). An intervention to decrease burnout and increase retention of early career nurses: A mixed methods study of acceptability and feasibility. BMC Nursing, 20(1), 1-12. https://doi.org/10.1186/s12912-020-00524-9	Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open access Macedonian Journal of Medical Sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428

Evidence Level *

(I, II, or III)

III

Conceptual Framework

Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**

Not provided

Not mentioned

Behavioral change involving use of interventions like cognitive realignment, mindfulness and psychological skills training

Behavior change through increased resiliency training and interventions to improve coping mechanisms.

Design/Method

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

Cross-sectional survey where 2504 nurses participated in Eastern China. The researchers invited nurses to complete self-report questionnaire online.

Systematic Review with the aims of identifying the linked personal and work-related factors of nurse resilience.

The article’s design was explanatory sequential mixed methods. The participants were final year pre-registration nursing students in a UK university and healthcare organizations.

The article used a meta-analysis to conduct the study aimed at determining the effects of resiliency on various components of nurses’ professional burnout.

Sample/Setting The number and characteristics of patients, attrition rate, etc.	The study was conducted virtually with 2504 nurses completing self-report online questionnaires	The study used data from literature review in five databases based on terms like resilience, occupation, job, nursing and work.	The sample included 74 pre-registration nursing students and 7 academics in a UK university and healthcare organizations.	The researchers used data based on targeted literature review in national and international databases in Persian and English.
Major Variables Studied List and define dependent and independent variables	Dependent-Quality of life Independent- Job burnout	Dependent Variable-Various components in nursing care Independent Variable-Job burnout	Dependent Variable-Multiple Interventions Independent-Retention of nurses	Dependent-Resiliency & burnout Independent-Conducting nursing education
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The researchers measured the quality of working life based on different aspects like age, income and patient-nurse ratio.	The study used a total of 38 articles that met the criteria through a systematic review and narrative synthesis. The authors also used different scales leading to being unfeasible to synthesize the evidence.	Pre and Post measure of acceptability using an Acceptability Theoretical Framework	Researchers used heterogeneity to measure the results by I2 test.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The study used Pearson’s correlation and multiple regression to analyze collected data.	The study used a quality assessment tool to analyze articles that met the criteria where 23 were rated as good, 15 as fair and 20 as risky due to significant levels of bias.	The researchers used the COREQ guidelines to analyze collected data in a thematic manner.	The researchers used STATA software v.14 to analyze the data.

Findings and Recommendations General findings and recommendations of the research	The findings show that close to two-thirds of nurses experienced job burnout leading to a moderate level of quality of life.	Knowing nurse resilience can assist proactively in the identification and potential issues, this fostering job resources and ultimately attaining personal and professional growth. The study recommends more research to explore resilience and develop a regular instrument to measure resilience.	The authors assert that the interventions equipped nursing students with skills and experience to attain personal endurance.	The authors assert that the meta-analysis conducted on the observational studies illustrated a correlation between resiliency and burnout with values of -0.57 at a 95% confidential interval. The authors assert that there is a relationship between resiliency and burnout and recommend the planning for the interventional and resilient training courses in nursing education.
Appraisal and Study Quality Describe the general worth of this research to practice. What are the strengths and limitations of study?	The research has significant value to practice as it shows the relationship between job burnout and the quality of life among nurses. The main strength of the study is its use cross-sectional survey where nurses from different setting accepted to have online self-report questionnaire. However, a limitation of the study could be a possible bias from the self-reporting nurses.	The study is significant as it shows the need to enhance knowledge on resilience among nurses. Therefore, it is worth for practice interventions in nursing care. The strengths of the study include its design that allows collection of a wide-range of data with various outcomes, and better outcomes that can be applied in nursing care. However, bias is significant based on the application of different outcomes from the study.	The main strength of the study is its study design and the sample selected. The design allowed them to engage both academics and nursing students on ways to enhance resilience and fight job burnout. However, a limitation is its use of the sample since it does not involve the nurses who practically handle patients.	The research is essential to practice because it demonstrates the need to incorporate resiliency education in nursing to prepare nursing students and even practitioners. A primary strength of this study is the use of systematic review and meta-analysis that allows them to collect a wide-range of data on the issue at hand. The main limitation is that the data can lead to formulation and testing of research hypotheses based on false impressions.
What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The risk may include bias leading to misguided interventions among nurses and healthcare facilities. The feasibility of using the findings in my practice is high based on its outcomes.	The risk include misinterpretation due to possible bias. The feasibility of using the article’s findings is significant due to its outcomes and recommendations.	The risk inherent to implementation is that it may not capture the real work-life experience of burnout based on its selected sample. The study has no feasibility of being used in my practice due to its population sample as it does not capture practical nursing care situation.	The implementation of the recommended practices or processes does not have any risks except those associated with misinterpretation and possible false impression based on the multiple sources of data. The study’s findings can be used in my practice with a high feasibility based on the level of knowledge among the practitioners.
Key findings	The key findings suggest that job burnout has negative impact on the quality of nurse’s working life. The authors recommend consideration of work-associated factors to enhance nurses’ quality of life.	Key findings include the need to assist nurses establish strategies to deal with adversity and understand the impacts of job demands and research to discover nurse resilience and develop consistent tools to enhance resilience.	The findings show the need enhance endurance training for nursing students for their future career’s challenges as it will improve their ability to tackle job burnouts.	The study is emphatic that a relationship exists between resilience and nurse burnout as it demonstrates that through education, nurses can have reduced levels of burnout.
Outcomes	The outcomes suggest that a majority of nurses’ experience job burnouts that have negative effects on their working life.	The outcomes include understanding that increased nurse resilience assists nurses to reduce emotional exhaustion and enhance work engagement and function when they encounter challenges in the workplace.	The outcomes recommend feasibility of new knowledge concerning the importance of the suggested intervention to enhance resilience in dealing with nurse burnout.	The outcomes emphasize the need to plan and develop interventional approaches that enhance the level of evidence and implementation of educational training to increase nurses’ knowledge on the burnout and resiliency.
General Notes/Comments	The article is critical in enhancing understanding and the need for interventions to reduce job burnout among nurses and enhance use of evidence-based practice.	The article’s findings are essential in development of effective understanding about the effects of burnout and should be used in practice to highlight the significance of evidence-based practice interventions.	The study suggests effective use of endurance training to prepare nursing students to understand the nature of the nursing environment for better care provision.	The need to reduce burnout among nurses is essential and the article is emphatic that increased nursing education can assist in such endeavors. Therefore, the findings are critical in improving overall application of evidence-based practice interventions in different areas in nursing practice.

Part 3B: Critical Appraisal of Research

Nurse burnout is a leading cause of increasing rate of nurse turnover and nursing staff shortage in different care settings. The increasing demand for healthcare across the various demographics implores healthcare providers and organizations and their management to develop interventions based on evidence-based practice to address the issue of burnout. Nurse burnout leads to poor care delivery and outcomes for patients and low levels of satisfaction (The Joint Commission, 2019). As such, the best practice that emerges from the reviewed research is the need to enhance effective nurse training and education to help nursing professional deal with the issue and apply innovative ways in their care practice for better delivery and patient outcomes (Yılmaz, 2017). The research review demonstrates the need for stakeholders, especially leaders to invest in training programs to enhance resilience of nurses. The increased demand for health care across the demographics divide imply that nurses should understand the care environment and know that the possibility of burnout is significant but can be tackled using innovative approaches to lessen their emotional and psychological burden.

The best practice should focus in resiliency training as identified by different research studies highlighted in the first part of this paper. Resiliency has a positive interaction with nurse burnout as it allows nurses to adopt the best practices to lessen effects of burnout and remain focused on effective care interventions. As opined by Brook et al. (2021), both nursing students and professionals need effective resilience training to enhance their skills and have a positive attitude to solving rising demand and diversity in the healthcare environment. The training should incorporate cultural competence as an effective approach to improving overall understanding about the concept to tackle the adverse effects of burnout

Conclusion

Nurse burnout remains a critical health issue and leads to nursing shortage and turnover that impact quality care among different patient populations. The critical appraisal exercise and paper illustrate the need to develop interventions that will enhance overall care delivery by training nurses and nursing students on resilience framework to prepare them better in handling stressful situation associated with increased demand for care. Again, resilience training will impact their perspective on different and innovative ways to engage patients and ensure that they tackle the issue of burnout

References

Brook, J., Aitken, L. M., MacLaren, J. A., & Salmon, D. (2021). An intervention to decrease burnout and increase retention of early career nurses: A mixed methods study of acceptability and feasibility. BMC Nursing, 20(1), 1-12. https://doi.org/10.1186/s12912-020-00524-9

Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open access Macedonian Journal of Medical Sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428

The Joint Commission (2019). Quick Safety: Developing resilience to combat nurse burnout. https://www.jointcommission.org/-

/media/tjc/newsletters/quick_safety_nurse_resilience_final_7_19_19pdf.pdf

Wang, Q. Q., Lv, W. J., Qian, R. L., & Zhang, Y. H. (2019). Job burnout and quality of working life among Chinese nurses: A cross‐sectional study. Journal of Nursing Management, 27(8), 1835-1844. https://doi.org/10.1111/jonm.12884

Yılmaz, E. B. (2017). Resilience as a strategy for struggling against challenges related to the nursing profession. Chinese Nursing Research, 4(1),

9-13. https://doi.org/10.1016/j.cnre.2017.03.004

Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014

Sample Answer 2 for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

A critical appraisal assists in reducing the research burden by enabling a researcher to identify and focus more on relevant articles to their research question. The research can either provide support or disapprove the claims made by the researcher through the utilization of quality, and evidence-based practice interventions. The selected topic for the research study is use of resilience training to redice the problem of nurse burnout among nurses in different care settings. Nurse burnout remains a critical problem that impacts the quality of care and patient outcomes in different care setting. Resilience training allows nurses to develop and use evidence-based interventions to reduce burnout and enhance their overall performance and improve the quality of care.

Evidence-based practice (EBP) incorporates best practices from studies and patient care information with clinician experience and patient preferences leading to the delivery of highest quality of care, and improving patient outcomes. The use of EBP requires care providers to formulate a clinical question of interest. In this case, the PICOT question is: Among nurses with burnout (P), does resilience training (I) compared to no intervention (C) reduce burnout(O) in six months (T)? The purpose of this assignment is to appraises critically peer-reviewed article for evidence to support resilience training among nurses with burnout to reduce its prevalence.

Full APA formatted	Article #1	Article #2	Article #3	Article #4
citation of selected article	Wang, Q. Q., Lv, W. J., Qian, R. L., & Zhang, Y. H. (2019). Job burnout and quality of working life among Chinese nurses: A cross‐sectional study. Journal of Nursing Management, 27(8), 1835-1844. https://doi.org/10.1111/jonm.12884	Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014	Brook, J., Aitken, L. M., MacLaren, J. A., & Salmon, D. (2021). An intervention to decrease burnout and increase retention of early career nurses: A mixed methods study of acceptability and feasibility. BMC Nursing, 20(1), 1-12. https://doi.org/10.1186/s12912-020-00524-9	Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open access Macedonian Journal of Medical Sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428

Evidence Level *

(I, II, or III)

III

Conceptual Framework

Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**

Not provided

Not mentioned

Behavioral change involving use of interventions like cognitive realignment, mindfulness and psychological skills training

Behavior change through increased resiliency training and interventions to improve coping mechanisms.

Design/Method

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

Cross-sectional survey where 2504 nurses participated in Eastern China. The researchers invited nurses to complete self-report questionnaire online.

Systematic Review with the aims of identifying the linked personal and work-related factors of nurse resilience.

The article’s design was explanatory sequential mixed methods. The participants were final year pre-registration nursing students in a UK university and healthcare organizations.

The article used a meta-analysis to conduct the study aimed at determining the effects of resiliency on various components of nurses’ professional burnout.

Sample/Setting The number and characteristics of patients, attrition rate, etc.	The study was conducted virtually with 2504 nurses completing self-report online questionnaires	The study used data from literature review in five databases based on terms like resilience, occupation, job, nursing and work.	The sample included 74 pre-registration nursing students and 7 academics in a UK university and healthcare organizations.	The researchers used data based on targeted literature review in national and international databases in Persian and English.
Major Variables Studied List and define dependent and independent variables	Dependent-Quality of life Independent- Job burnout	Dependent Variable-Various components in nursing care Independent Variable-Job burnout	Dependent Variable-Multiple Interventions Independent-Retention of nurses	Dependent-Resiliency & burnout Independent-Conducting nursing education
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The researchers measured the quality of working life based on different aspects like age, income and patient-nurse ratio.	The study used a total of 38 articles that met the criteria through a systematic review and narrative synthesis. The authors also used different scales leading to being unfeasible to synthesize the evidence.	Pre and Post measure of acceptability using an Acceptability Theoretical Framework	Researchers used heterogeneity to measure the results by I2 test.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The study used Pearson’s correlation and multiple regression to analyze collected data.	The study used a quality assessment tool to analyze articles that met the criteria where 23 were rated as good, 15 as fair and 20 as risky due to significant levels of bias.	The researchers used the COREQ guidelines to analyze collected data in a thematic manner.	The researchers used STATA software v.14 to analyze the data.

Findings and Recommendations General findings and recommendations of the research	The findings show that close to two-thirds of nurses experienced job burnout leading to a moderate level of quality of life.	Knowing nurse resilience can assist proactively in the identification and potential issues, this fostering job resources and ultimately attaining personal and professional growth. The study recommends more research to explore resilience and develop a regular instrument to measure resilience.	The authors assert that the interventions equipped nursing students with skills and experience to attain personal endurance.	The authors assert that the meta-analysis conducted on the observational studies illustrated a correlation between resiliency and burnout with values of -0.57 at a 95% confidential interval. The authors assert that there is a relationship between resiliency and burnout and recommend the planning for the interventional and resilient training courses in nursing education.
Appraisal and Study Quality Describe the general worth of this research to practice. What are the strengths and limitations of study?	The research has significant value to practice as it shows the relationship between job burnout and the quality of life among nurses. The main strength of the study is its use cross-sectional survey where nurses from different setting accepted to have online self-report questionnaire. However, a limitation of the study could be a possible bias from the self-reporting nurses.	The study is significant as it shows the need to enhance knowledge on resilience among nurses. Therefore, it is worth for practice interventions in nursing care. The strengths of the study include its design that allows collection of a wide-range of data with various outcomes, and better outcomes that can be applied in nursing care. However, bias is significant based on the application of different outcomes from the study.	The main strength of the study is its study design and the sample selected. The design allowed them to engage both academics and nursing students on ways to enhance resilience and fight job burnout. However, a limitation is its use of the sample since it does not involve the nurses who practically handle patients.	The research is essential to practice because it demonstrates the need to incorporate resiliency education in nursing to prepare nursing students and even practitioners. A primary strength of this study is the use of systematic review and meta-analysis that allows them to collect a wide-range of data on the issue at hand. The main limitation is that the data can lead to formulation and testing of research hypotheses based on false impressions.
What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The risk may include bias leading to misguided interventions among nurses and healthcare facilities. The feasibility of using the findings in my practice is high based on its outcomes.	The risk include misinterpretation due to possible bias. The feasibility of using the article’s findings is significant due to its outcomes and recommendations.	The risk inherent to implementation is that it may not capture the real work-life experience of burnout based on its selected sample. The study has no feasibility of being used in my practice due to its population sample as it does not capture practical nursing care situation.	The implementation of the recommended practices or processes does not have any risks except those associated with misinterpretation and possible false impression based on the multiple sources of data. The study’s findings can be used in my practice with a high feasibility based on the level of knowledge among the practitioners.
Key findings	The key findings suggest that job burnout has negative impact on the quality of nurse’s working life. The authors recommend consideration of work-associated factors to enhance nurses’ quality of life.	Key findings include the need to assist nurses establish strategies to deal with adversity and understand the impacts of job demands and research to discover nurse resilience and develop consistent tools to enhance resilience.	The findings show the need enhance endurance training for nursing students for their future career’s challenges as it will improve their ability to tackle job burnouts.	The study is emphatic that a relationship exists between resilience and nurse burnout as it demonstrates that through education, nurses can have reduced levels of burnout.
Outcomes	The outcomes suggest that a majority of nurses’ experience job burnouts that have negative effects on their working life.	The outcomes include understanding that increased nurse resilience assists nurses to reduce emotional exhaustion and enhance work engagement and function when they encounter challenges in the workplace.	The outcomes recommend feasibility of new knowledge concerning the importance of the suggested intervention to enhance resilience in dealing with nurse burnout.	The outcomes emphasize the need to plan and develop interventional approaches that enhance the level of evidence and implementation of educational training to increase nurses’ knowledge on the burnout and resiliency.
General Notes/Comments	The article is critical in enhancing understanding and the need for interventions to reduce job burnout among nurses and enhance use of evidence-based practice.	The article’s findings are essential in development of effective understanding about the effects of burnout and should be used in practice to highlight the significance of evidence-based practice interventions.	The study suggests effective use of endurance training to prepare nursing students to understand the nature of the nursing environment for better care provision.	The need to reduce burnout among nurses is essential and the article is emphatic that increased nursing education can assist in such endeavors. Therefore, the findings are critical in improving overall application of evidence-based practice interventions in different areas in nursing practice.

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/conceptualframe

Sample Answer 3 for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

Nursing practices influence the risks for CAUTIs among the patients in ICU. Therefore, there is need to develop evidence-based practices that will help reduce the burden of CAUTIs among the patients on catheters. The current study appraises the various sources providing recommendations on the best practices to reduce CAUTIs.

Evaluation Table

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
Full APA formatted citation of selected article.	Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infections: a pre-post control intervention study. BMC Health Services, 17(314). doi: 10.1186/s12913-017-2268-2.	Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing,38(6), 273–302. DOI: 10.7257/1053-816X.2018.38.6.273.	Scanlon, K. A. (2017). Saving Lives and Reducing Harm: A CAUTI Reductions Program. Nursing Economics, 35(3):134-141.	Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., Canini, S. R. M. da S., Bakir., M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patient through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheter: A quasi-experimental study. Medicine. 98(8). DOI: 10.1097/MD.0000000000014417
Evidence Level * (I, II, or III)	II	II	I	I
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	No theoretical framework mentioned in the text.	No theoretical or conceptual framework defined.	The study was based on the dry bag Concept”, innovative modifications and root cause analysis concept.	No theoretical framework indicated
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	The study used the multiple pre-post control intervention design based on the phased mixed method. The sample population included four acute care hospitals from the two Health Districts in NSW. The point data were collected from all the adult inpatient wards in the hospital.	The study involved the use of survey design to assess the effects of offering on-time educational program to enhance nurses’ knowledge about CAUTIs.	The study involved quantitative measures in determining the overall success of standardized infection ratio, rations and catheter days in intensive care unit and non-critical areas in the facility	The study involved a quasi-experimental study conducted in an intensive care unit of hospital for over 12 years.
Sample/Setting The number and characteristics of patients, attrition rate, etc.	The sample used in the study were obtained from the acute care hospital. A total of 500 patients per Health District were targeted.	The sample population included two units in a 393-bed acute care facility and a total of 59 nurses completed the education program in three months-term	The study was conducted in non-ICU setting.	The study was conducted in the intensive care unit setting. Sample size not defined
Major Variables Studied List and define dependent and independent variables	The dependent variable was the catheter-associated urinary tract infections (CAUTI) while the dependent variable was appropriate urinary catheter insertion practices.	The dependent variable was education on CUATIs prevention while the independent variable was CAUTIs risk.	The dependent variable was risk for CAUTIs while independent variables included the interventions developed such as standardized infection ratio, rations and catheter days in intensive care unit and non-critical areas in the facility	The independent variables included healthcare workers (HCWs) educational program and a daily checklist for indwelling urinary catheter indications. The dependent variable included CAUTIs.
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	Descriptive statistics were used to determine the trends in the CAUTIs.	Descriptive statistics were used to compare the outcomes before and after the intervention.	The study involved the use of descriptive statistics.	Descriptive statistics were used in the study.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	No actual data indicated.	The mean value for the knowledge on institutional policies before and after the interventions were 9.71 and 12.3 respectively. Mean for the method to prevent catheter-related infections were 4.59 and 5.24 respectively.	The CAUTIs reduced by h, 2015 reduced by 57% with a SIR of .67, following the intervention.	The study reports that the urinary catheter utilization decreased from phase I to phase IV (73.1%, 74.1%, 54.9%, and 45.6%, respectively). The rate of CAUTI decreased from phase I to phase IV (14.9, 7.3, 3.8, and 1.1 per 1000 catheter-days, respectively
Findings and Recommendations General findings and recommendations of the research	The study findings indicated that regular evaluation in the clinical practices can significantly help in reducing the burden on CAUTIs.	The study recommends the provision of education to the nurses on CAUTIs prevention.	Healthcare institution should consciously develop measures to minimize CAUTIs.	Providing education to healthcare workers on CAUTIs prevention can be implemented to address the high burden of infections among patients in ICU.
*Appraisal and Study Quality* Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The strength of the study is that it used a multifaceted approach where the intervention focused on mixed methods to provide the answer to the research question. On the other hand, the main weakness in the study is that it fails to provide statistical evidence to the effectiveness of the improvement protocols developed in the hospitals. The findings from the study be supplemented with the results from other study.	The study’s strength is that it includes a multifaceted nature, interactive program that is consistent with literature on evidence-based care practice. On the other hand, the weakness is that the sample population was not adequate to provide data to be inferred to the general population. The study findings are feasible and can be used to address CAUTIs issues in hospitals.	The main strength in the article is that it provides data to show the effectiveness of developing and transferring best practices in all areas of care in the facility, especially in critical. On the other hand, the main weakness is that the study does not define the sample population characteristics. Findings from the study are feasible and can be used in clinical practice.	The study has strengths as it was carried out for over ten years and so provides tested and verified results. On the other hand, the weakness is that the study does not provides the approaches used in monitoring the practices in the ICU unit. Findings from the study are reliable and feasible for clinical practice.
Key findings	The critical care nurses can reduce CAUTIs by understanding the effects of indwelling catheters and catheterization.	Education can help reduce the burden of CAUTIs in hospitals.	Continuous education on infection prevention reduces the risk for CAUTIs.	Healthcare workers (HCWs) educational program and a daily checklist for indwelling urinary catheter indications reduced the risk of CAUTIs.
Outcomes	Reduced CAUTIs	Improved level of knowledge on CAUTIs prevention	Risk for CAUTIs	Risk for CAUTIs
General Notes/Comments	Healthcare facilities should engage continuous quality improvement process.	Healthcare facilities should have standard measures to prevent CAUTIs.	The study indicates that generation of data is a critical aspect of improving overall patient delivery and safety, especially in infection control.	The study indicates that effective programs over a duration provides a comprehensive outlook of the benefits of safety interventions focused on improving quality of care delivered to patients.

Part 3

The burden presented by CAUTIs among the patients in the intensive care units cannot be underestimated. Therefore, healthcare institutions should be deliberate in providing quality improvement and safety protocols for the healthcare workers in the units. The review of literature indicates the need to provide continuous education to the healthcare providers and ensuring that they promote the safety of their patients and minimize the risks of CAUTIs transmission. The role of education in reducing the burden of CAUTIs among the patients in ICU was highly emphasized (Ferguson, 2018).

The education should be provided continuously to the healthcare provider to increase their level of consciousness in promoting safety during the catheter insertion. Besides, the regular insertions and prolonged stay of the catheters were also associated with increased risk for infection. The findings from the studies provide relevant guidelines that can be implemented to promote safe treatment environment for the patients in needs of catheter insertion and they are supported by Durant (2017). It is apparent that some of the healthcare providers are not aware of the safety measures needed for the ICU practice and so may predispose the patients to CAUTIs by failing to observe the aseptic measures.

Finally, the results from the analysis are essential and can be used to promote safety in the ICU departments. The risk for CAUTIs is high among the patients with prolonged catheterizations (Carr, 2017). Therefore, the nurses and healthcare providers must observe aseptic protocols. However, such can only be effective with standardized protocols and procedures for ICU nursing practice.

Conclusion

CAUTIs are significant factors in the delivery of healthcare. Several studies have analyzed the interventions that could help facilities to address them. There is a consensus amongst the studies that education of healthcare providers will play a fundamental role in reducing the incidences of CAUTIs in facilities.

References

Carr, A. N. (2017). CAUTI Prevention: Streaming Quality Care in a Progressive Care Unit. Medsurg Nursing, 26(5).

Durant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. American journal of infection control, 45(12), 1331-1341. https://doi.org/10.1016/j.ajic.2017.07.020

Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing, 38(6). DOI: 10.7257/1053-816X.2018.38.6.273.

Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., Canini, S. R. M. da S., Bakir., M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patient through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheter: A quasi-experimental study. Medicine. 98(8). DOI: 10.1097/MD.0000000000014417

Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infections: a pre-post control intervention study. BMC Health Services, 17(314). doi: 10.1186/s12913-017-2268-2.

Scanlon, K. A. (2017). Saving Lives and Reducing Harm: A CAUTI Reductions Program. Nursing Economics, 35(3):134-141.

Sample Answer 4 for NURS 6052 Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

The burden of CLABSI is high and this compromises the quality of care delivered to the patients admitted in the hospitals. Therefore, there is need to explore the evidence-based practices that can be used to reduce the health issue especially in the ICU. The purpose of this study is to appraise the evidences provided on the various measures of responding to the CLABSI in the inpatient units.

Evaluation Table

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
Full APA formatted citation of selected article.	Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400	Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007	Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4	Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473
Evidence Level * (I, II, or III)	III	I	I	II
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	The conceptual framework not indicated	No conceptual or theoretical framework indicated.	No theoretical framework defined	No theoretical framework defined.
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	The study involved a systematic review and meta-analysis conducted in conformity to the PRISMA and MOOSE guidelines. Sources from the various databases including MEDLINE, CINAHL, EMBASE, Scopus and Cochrane were involved. Only studies that involved randomized trials, and quasi experiment on the effect of CHG bathing versus non-CHG bathing in preventing CLABSI among the adult populations were included.	The study involved a non-randomized clinical trial. The study focused on the patients admitted in the ICU in the University Hospital Zurich.	The study involved a wedged cluster-randomized design conducted in four sequences.	The study involved cross-sectional survey.
Sample/Setting The number and characteristics of patients, attrition rate, etc.	Data were obtained from reputable journal sources and covered studies conducted in clinical setting.	The study was conducted in an ICU setting.	The study was conducted in the university hospital setting.	The study was conducted in healthcare setting
Major Variables Studied List and define dependent and independent variables	The dependent variable was CHG baths while the independent variable was the risk of CLABSI.	The predictor variable included the daily chlorhexidine bathing in ICU and while the outcome variable was risk of CLABSI.	The dependent variable was CHG bathing while the independent variable was CLABSI rates.	The dependent variable was knowledge, attitude and practice among nurses while the outcome variable was CLABSI rates.
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The DerSimonian average intervention was used in estimating the average intervention effect. The logistic regression model was used in estimating the relationship between the dependent (predictor) and the outcome variable.	The statistics conducted included multivariable regression analysis, odd ratio, and descriptive statistics.	The primary statistics used included descriptive statistics and linear regression model.	Chis-square and t-test were used.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The data analysis was quantitative based. The risk for CLABSI infections reduced the incidence of CLABSI by about 40%. The effect of the CHG bath was significant (0.67, 95% CI: 0.53–0.85).	The study was quantitative based. Multivariate analysis indicated that the intervention was significant (OR 0.47, 95% CI 0.26e0.84, P¼0.011).	The study findings indicated that the number of healthcare providers correctly identifying facts about CHG bathing increased, from 31.11 to 50.0% (χ2 = 9.32, p = .002).	Majority of nurses, with frequencies ranging from 70.7% to 90.1% were aware of the CLABSI prevention guidelines. Nursing workshops and courses (67.3%) was the main source of information CLABSIs prevention, followed by guidelines (42.7%), and internet (30.7%).
Findings and Recommendations General findings and recommendations of the research	CHG bathing can help in reducing the risks of CLABSI among the patients admitted in hospitals.	CHG bathing can help reduce the risk of CLABSI in the ICU unit.	Educating the healthcare providers on the CHG bathing improves its implementation and reduce the risk for CLABSI.	Improved knowledge on CLABSI prevention helps in enhancing adherence to infection prevention protocols.
*Appraisal and Study Quality* Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The study involved a large sample population and the data covered were appropriate. On the other hand, the main weakness is that the study was based on adult populations alone and so cannot be inferred to children. However, the findings from the study can be used in reducing CLABSI among the adults.	The study’s setting was appropriate and could provide reliable answers to the research question. On the other hand, the weakness of the study was monocentric and did not monitor the intervention and this could bias the findings. However, the results from the study are feasible.	The study recruited adequate sample population. On the other hand, the weakness was that the CHG bathing processes were not standardized and this could affect the outcome recorded. The findings from the study are feasible for clinical practice.	The study covered various aspects influencing CLABSI prevention measures. The statistical tests were appropriate. On the other hand, the main weakness was lack of standard method for measuring attitude and level of knowledge. The findings from the study are feasible and can be used for clinical practice.
Key findings	CHG bathing reduces the risk for CLABI.	CHG bathing reduces the CLABSI.	There is a need to educate ICU nursing on CHG bathing protocols.	There is need to increase education programs on reducing CLABSI.
Outcomes	Reduced CLABSI	Reduced cases of CLABSI among the ICU patients.	Increased awareness on CHG bathing	Increased knowledge on CLABSI prevention.
General Notes/Comments	Healthcare institution should implement the CHG baths among other interventions to reduce CLABSI.	The use of CHG bath can be used to reduce the risks for CLABSI among patients in ICU.	Healthcare institutions should have standard guidelines for CHG bathing.	Educating the nurses on CLABSI prevention measures allows them to implement to protocols accordingly.

Critical Appraisal of Research

The studies reviewed explored the best practices that can be used to reduce the incidences of CLABSI among the patients in ICU. Nosocomial infections are common among the patients on catheters and those on central lines. Furthermore, the studies indicate that the risk of CLABSI increases with the prolonged hospital stay (Afonso et al., 2016). The healthcare providers have the responsibility to ensure that they engage the right interventions and only discharge the patients when they are ready. As a result, there is need to monitor and ensure safe practices and reduce the risk of the patients contracting CLABSI. The use of CHG bathing has been proven effective in reducing the risks for CLABSI (Reynolds et al., 2021). However, variations in the protocols for the CHG bathing procedure among the healthcare institutions remain a major concern. Therefore, there is need for standardizing the procedures and creating awareness so that all the nurses are aware of what they should do as they interact with the patients.

The study by Esposito et al. (2017) indicated a gap in the knowledge and practice of the CHG prevention measures by the nurses in the ICU units. Also, the study indicates variations in the attitudes of the nurses towards the clinical practice and this affects the level of its implementation in the healthcare settings. Therefore, there is a need to create awareness and let the nurses understand the importance and the procedures involved in the CHG bathing as part of preventing the CLABSI. Besides, there should be guidelines published and that are readily available to ensure standardized safety protocols in the ICU units. The burden of CLABSI is high and this needs that adequate and prompt interventions must be developed to curb the health menace. The guidelines should be made available to all inpatient units. Thirdly, there is a need to conduct regular trainings on the CLABSI prevention measures to ensure that all the nurses have updated information on how to respond to the CLABSI.

Finally, there is enough evidence from the analysis that CHG bathing can reduce CLABSI. Though, future studies should be conducted to explore other alternative methods that can be used alongside the intervention especially among children. In addition, having a standard protocol for CHG bathing will means that all people will be aware of what they should do to prevent CLABSI.

References

Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400

Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473

Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4

Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007