Please write paper based on the following PICO question:
In adults (P), how effective are lifestyle interventions (I), compared to no lifestyle interventions (C) on reducing the risk of diabetes and/or poor diabetic/glycemic control(O)?
Evidence-Based Practice Project Guidelines
and Grading Criteria
This individual scholarly paper provides an opportunity for students to prepare a systematic plan to apply evidence into a clinical practice.
Instruction: Students must submit a clinical problem or PICOT question with 4-6 abstracts to the course instructor for an approval prior to proceeding with the EBP project. Students must follow specific requirements in this guideline to receive a full credit.
I. Introduction (25) (Estimated length: 1-2 paragraphs)
•Describe a specific clinical practice background that leads to PICOT question (5)
•Articulate the significance of the clinical problem and the need for an EBP investigation by 1 or more of the following methods (5):
o Use of evidence to establish the prevalence/incidence of a specific clinical problem/situation
o Use of evidence to establish the risks associated with a specific clinical problem/situation
o Use of evidence to establish the potential impact of a specific clinical problem/situation on clients’ quality of life
•Introduce the clinical question and set the stage for the subsequent EBP inquiry (5)
•Engage the reader and link to the clinical practice (5)
•A clinical question must be written clearly in a PICOT format with all five components identified, patient/population, intervention, comparison (if applicable), outcome, and time (5)
II. EBP Investigation Process (25)
◦Presentation of evidence investigation is objective, written in past tense, uses appropriate tentative language and active voice, third person, and utilizes the following subheadings:
§ Selection Criteria (5): (Estimated length: 1 paragraph)
◾State the specific criteria you established and used for selection of “best evidence”
◾Describe the selection criteria used and ensure they are appropriate for PICOT question
§ Search Process (15): (Estimated length: 1 paragraph)
§ Describe the search process in details that you followed in your comprehensive review of the literature relevant to selected topic. Provide rationales for the final selection of the studies included for the best evidence.
§ Include details about databases, source of evidence searched, the specific MeSH terms/key words utilized in your search process, and the specific types of evidence targeted in your search process.
§ Describe details of search results.
§ Selection of Best Evidence (5): (Estimated length: 1 paragraph)
§ Identify the specific studies/publications, which you selected as “best evidence”. Refer your readers to the matrix in the Appendix A for a summary of each selected evidence document.
§ Assure your readers that you selected all or a sufficient proportion of applicable best evidence, which met your pre-established selection criteria without bias.
§ Discuss/explain the reasons behind any exclusions of located applicable evidence (as appropriate).
III. Critical Appraisal of Collective Evidence (20): (Estimated length: 3-5 paragraphs)
§ Use appropriate critique templates according to the type of the study design provided at the bottom of this guideline to evaluate each selected study. Critique each selected article and organize templates in Appendix B.
§ Offer your critique of selected collective (not individual) evidence through the use of synthesis. Examples of aspects, which are typically critiqued, include the adequacy of sample sizes, appropriateness of methods for research question, bias demonstrated in inclusion/exclusion criteria, data collection, interventions, recency of research, and the level of significance of study results. For example: “All four of the studies implemented and intervention of vaccination with the HPV vaccine in young women and compared this to the placebo group…. Except for Smith et al’s study group (2009) which only included vaccination protection from type 16 and 18, the other studies included protection against type 6, 11, 16, and 18. Although the Smith et al’s study group (2009) investigation excluded protection in the vaccine from types 6 and 11, results showed cross protection from types 31, 33, and 45 which are also oncogenic.”
§ Evaluate the applicability of selected collective (not individual) evidence to clinical question/situation through the use of synthesis. Examples of aspects, which are typically evaluated, include the congruency/match between the selected evidence and clinical question in terms of PICO components—population, intervention, comparison, and outcome and the quality of the study. The purpose of this evaluation of applicability is to show the reader that application of the findings from the selected best evidence to your EBP clinical problem/situation is warranted/valid.
· Evaluate the sufficiency of selected collective (not individual) evidence to address the clinical problem/situation through the use of synthesis. Included in your evaluation of the sufficiency of collective evidence is your perception of the need (or lack of need) for further research.
IV. Collective Results (20): (Estimated length: 2-3 paragraphs)
§ Provide a summary or synthesis of the collective results of the EBP investigation (What is new or currently known about this topic?)
§ Offer a critical analysis of the research findings by comparing and contrasting the quality of research across collective studies including statistical findings and p-values or confidence interval.
§ Draw conclusions from the collective results of the examined evidence through the use of synthesis. The following example illustrates a summary of results and conclusions drawn from the synthesis of collective results:
Two systematic review studies and a case control study, which compared large samples of cases with ovarian cancer with large control groups did not find a greater risk of ovarian cancer development in individuals who breastfed their infants for 6 to 12months (Klaus, Penington, & Sim, 2006; Leawood et al., 2004; Mena, et al., 2008). In contrast, Bar-Yam, Smith, and Young (2009) in a pooled analysis of 2 case control studies with a smaller sample size found a greater risk for the development of ovarian cancer among non-breastfeeding women. A greater risk for the development of ovarian cancer was noted among those who did not breastfeed (Bar-Yam, Smith, and Young (2009).
V. Intervention Decision (10): (Estimated length: 1-2 paragraphs)
§ Discuss the implications for practice that can be drawn from the results of your EBP inquiry. What specific “evidence-based” practice intervention(s) are supported (not supported) by your findings? Are there specific parameters that should be followed in the implementation of supported intervention(s)?
§ If evidence did not support the intervention or insufficient evidence, research to generate new evidence may be needed. The implications should be discussed with respect to future research and recommendation for the next steps.
§ Explore and select an EBP model to guide the implementation of the project. Briefly describe steps of the model.
§ Explore how the values/preferences of “others” (patient, administrators, team members) may influence the implementation of the supported intervention (if applicable)
§ Explore your ability to implement the “evidence-based” intervention in terms of the available resources within clinical settings.
VI. Plan for Implementation and Evaluation of Intervention Decision or a brief research plan (if evidence of intervention was not supported) (10) (Estimated length: 1-2 paragraphs)
•Based on the above intervention decision and your chosen EBP model, outline a specific plan for the implementation of an “Evidence-based” intervention in clinical practice or brief research plan that may include: design, setting and sample, data analysis, and time frame.
•Clearly state description and protocol of your intervention. Be sure the effectiveness of the interventions are appropriately measured, e.g., Client’s cholesterol level will remain within X and Y.
•Delineate your plan for measurement of outcomes (e.g., frequency/duration of measurement). For example: Client’s cholesterol level will be monitored monthly for the first six months following initiation of intervention.
•Identify any data that you will used in order to evaluate the effectiveness of your intervention decision.
Appendix A: Review of Literature Matrix (20): (Estimated length: 2-3 pages)
◦Summary Table of evidence is clearly presented as an Appendix.
◦List of search results are relevant to PICO question
◦Summarize in your own words the details of each of the studies you selected. Details to consider for your discussion include the research question, methodology, sample size, inclusion/exclusion criteria, results, and level of significance of results. Be succinct.
◦Summary table information should be derived from original source (not from a secondary source or from a database abstract).
◦Quotations from primary source are not used or use is very limited and appropriate.
◦Summary Table includes all studies selected as “best evidence” (as discussed and appraised in review of literature).
Appendix B: Completion of Critique Template Evaluative Criteria (20) (Estimated length: 3-6 pages):
o Selected appropriate critique template for each selected study.
o Summaries of Selected Evidence using paraphrasing to complete summaries of selected evidence. Avoids use of quotes.
o Answers each summary question fully and accurately.
o Summaries accurately represent the original studies.
o Appraisals of Selected Evidence demonstrate understanding of essential elements of research
o Appraisals are based on personal critiques rather than a repeat of the original researcher(s) critiques
o Answers each appraisal question fully and accurately
o Answers demonstrate understanding of critical appraisal of various types of research designs including internal and external validity.
References (5) (Estimated length: 1 page)
•Sources are current and are “best evidence” for clinical question.
•All sources included in reference list have been cited within the paper.
Abstracts (10)
•Abstract (limit to 250 words) includes introduction, method, results, and conclusion
Quality of Writing (25)
•Accurate use of Grammar, Spelling, and Vocabulary
•Language use is appropriate for a scholarly paper
•Sentence and paragraph structure are accurate
•Accurate use of APA format:
◦Title Page
◦Page Headers and Page Limited to 20 pages
◦Appropriate heading levels
◦Citations
◦References
◦Appendix
Appendix A: Review of Literature Matrix
Directions: Complete matrix for each of the studies/publications you have selected as “best evidence” for your PICOT question.
Below is an example of the Summary of Review of Literature Matrix
PICOT question: Among adult intensive care unit (ICU) patients who require mechanical ventilation (P), does the use of oral care using chlorhexidine (I) compared to the usual care, placebos, or no intervention (C) reduce the incidence of the development of ventilator-associated pneumonia (VAP) (O)?
Author, Year, Title, Design/Type & Level of Evidence
Study Purpose
Population investigated
Intervention/Comparison & Outcomes
(Independent/Dependent Variables)
Results
Munro et al., (2009).
Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults.
Method: 2 x 2 factorial design, level 3
Examine the outcome of toothbrushing alone, chlorhexidine alone, or a combination on the incidence of VAP
Mechanically ventilated adults admitted to three ICUs
IV= chlorhexidine
DV= Incidence of pneumonia
Pneumonia developed in 24% by day 3 in patients treated with chlorhexidine with a CPIS ≥6. When data on all patients were analyzed together, mixed models analysis indicated no effect of either chlorhexidine (P=.29) or toothbrushing (P=.95). However, chlorhexidine significantly reduced the incidence of pneumonia on day 3 (CPIS ≥6) who had a CPIS < 6 at baseline (P=.006). Toothbrushing has no effect on CPIS and did not enhance the effect of chlorhexidine.
A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients
(Scannapieco et al., 2009)
Method: Randomized controlled trial. Double-blind, placebo-controlled, level 2
To identify the minimal effective frequency of 0.12% CHX to reduce colonization.
Mechanically ventilated pts admitted to the trauma ICU
IV= chlorhexidine
DV= Incidence of pneumonia
No statistical significant results were noted, all p≥0.05 in regards to reduction of plaque scores between all groups (p=0.8423), reduction of potential respiratory bacterial pathogens (PRPs) p=0.6750, delay of pneumonia (hazard risk= 0.555, 95% CI, 0.256-1.201, p=0.1348), or incidence of pneumonia (RR=41%, OR=0.54, 95% CI, 0-23-1.25, p=0.1459). Although, not statistically significant, trends of reduction in of S. aureus, delay of pneumonia, and incidence of pneumonia (7 in qd IG, 7 in bid IG, 12 in CG) were noted between the intervention groups and the control group.
Randomized controlled trial and meta-analysis of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associate pneumonia
(Tantipong et al., 2008)
Method: randomized controlled trial with stratified randomization, level 2
To evaluate the impact of 2% chlorhexidine use to delay or inhibit VAP.
Mechanically ventilated adult patients in ICU or medical wards
IV= chlorhexidine
DV= Incidence of pneumonia
Incidence of VAP in CHX-4.9% and 11.4% in saline group
(p=0.08)
Appendix B: Critique Template
Directions: Complete critique template for each of the research articles that you have selected as “best evidence” for your PICOT question. Provided below are critique templates for systematic reviews, meta-analyses, practice guidelines, quantitative studies, and qualitative studies. Utilize the critique template(s), which correspond with the type(s) of evidence you selected.
Here are two examples of completed critique templates for an RCT and a systematic review:
Single Quantitative Study (e.g., Randomized Controlled Trial, Nonrandomized Controlled Trial, Case-Control Study, Cohort Study) Template
Citation (APA)
(Scannapieco, Yu, Raghavendran, Vacanti, Owens, Wood, & Mylotte, 2009)
Title
A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients.
Database Source (& ID number)
PubMed (PMID: 19765321)
Type of Evidence
Randomized Controlled Trial
Hierarchical Evidence Rating Level
Level II
Your Summary of the Study/Publication (use paraphrasing, not quotes)
What was the stated research question/objective of the study?
To identify the minimal effective frequency of 0.12% chlorhexidine gluconate (CHX) to reduce colonization.
What research methodology was used (e.g., RCT, Case-Control, Cohort)?
Randomized controlled trial. Double-blind, placebo-controlled
Describe the sample (including size)?
175 total sample (58 in intervention group qd, 58 in intervention group bid, and 59 in control placebo group).
How was the sample selected (e.g., randomization, inclusion/exclusion criteria)?
Randomized sample with a block design. Inclusion criteria: ICU admissions, and intubation with mechanical ventilation w/in 48hrs of admissions. Exclusion criteria: witnessed aspiration, diagnosis of post-obstructive pneumonia, hypersensitivity to CHX, no consent, diagnosis or thrombocytopenia, do-not-intubate orders, younger than 18yrs.of age, diagnosis of pregnancy, legal incarceration, transfer from another ICU, oral mucositis, immunosuppression, or re-admission to the ICU.
What methods were used for data analysis?
Computerized quality assurance checks, ANOVA, chi-squared tests, Kaplan-Meier method, and Cox proportional hazards model.
What were the results of the study? At what Level of Significance?
No statistical significant results were noted, all p≥0.05 in regards to reduction of plaque scores between all groups (p=0.8423), reduction of potential respiratory bacterial pathogens (PRPs) p=0.6750, delay of pneumonia (hazard risk= 0.555, 95% CI, 0.256-1.201, p=0.1348), or incidence of pneumonia (RR=41%, OR=0.54, 95% CI, 0-23-1.25, p=0.1459). Although, not statistically significant, trends of reduction in of S. aureaus, delay of pneumonia, and incidence of pneumonia (7 in qd IG, 7 in bid IG, 12 in CG) were noted between the intervention groups and the control group.
What conclusions/implications for practice were drawn by the authors?
The intent of this study was to compare the frequencies of CHX. The sample size was estimated to be adequate for the three comparative groups of frequency and placebo. There were no real differences noted between once daily vs. twice daily application of CHX. Although the sample size wasn’t statistically adequate in terms of comparing CHX alone vs. placebo, it does infer that CHX is an effective intervention to prevent VAP. It is also effective in decreasing colonization of S. aureaus; however, not effective in decreasing colonization in biofilm d/t the properties of biofilm and plaque and it’s resistance to antimicrobial agents. No adverse effects were noted from CHX treatment, and no differences seen in length of days of ventilations, length of hospital stay, or mortality.
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Was the research design appropriate for the research question (e.g., RCT for cause-effect questions, Case Control for harm or causation questions, Cohort for questions regarding prognosis)? Support your response.
The research design (randomized controlled, double blind-placebo) was appropriate for answering intervention/effectiveness questions. The only better design would be systematic reviews or meta-analyses which would be a higher evidence level.
Was the sample size adequate? Was bias controlled with sample selection methods? Support your responses.
The sample size was adequate (minimal 53 participants per group) for the question of the most effective frequency; however, it wasn’t adequate to provide statistically significant findings in terms of the EBP question of CHX on VAP. Bias was limited with randomization, block design, and blinding.
Were the study results significant (level of significance)? Are the results valid and reliable? Is there a possibility of bias or of confounding variables? Support your responses.
The study results were not statistically significant; however, clinically significant for the EBP question in regards to VAP reduction. Results are valid and reliable with CI of 95%. There are some confounding variables that can introduce bias such as the disproportionate representation of African Americans, Asians, and American Indians among the groups. Different ethnicities may have different characteristics in terms of oral colonization amounts. Also, some co-morbidities were disproportionate among groups (i.e. renal/hepatic) that could play a part in immunosuppression.
Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response.
The study matches the EBP in terms of population (adult ICU patients who are mechanically ventilated >48hrs), and intervention (chlorhexidine use in oral care). However, the outcomes differ. The findings are clinically significance in terms of incidence of VAP and some reduction of colonization.
Systematic Review Template
Citation (APA)
(Berry, Davidson, Masters, & Rolls, 2007)
Title
Systematic literature review of oral hygiene practices for intensive care patients receiving mechanical ventilation
Database Source (& ID number)
PubMed (PMID: 17962500)
Type of Evidence
Systematic Review of Randomized Control Clinical Trials
Hierarchical Evidence Rating Level
Level 1
Your Summary of the Study/Publication (use paraphrasing, not quotes)
What was the stated research question/objective of the study?
To determine the best evidence available for providing oral care to mechanically ventilated ICU patients, and to provide a evidence-based plan to improve patient outcomes.
What search strategies were used to locate applicable studies for possible inclusion?
CINAHL, Medline, Joanna Briggs Institute, Cochrane Library, Embase, DARE, and Google.
What were the stated inclusion/exclusion criteria?
Both experimental and non-experimental study designs were included due to the limited review material on ICU patients. The review included 11 prospective controlled trials, 20 observational studies and 24 descriptive reports. The studies included ICU patients who were mechanically ventilated, and studies that proposed a link between oral hygiene and systematic diseases. The interventions of interest were those designed to affect dental plaque specifically and oral hygiene in general. Exclusion criteria: studies that included healthy participants, and studies that were done in a setting other than a critical care environment.
What was the total sample size (e.g., how many studies were included, number of subjects)?
Fifty-Five studies were included with a resultant sample of 3,415 participants in the 11 RCT’s. The review did not discuss how many participants were in the other studies.
What were the results of the study?
Overall, there was a reduction in VAP, but there is a lack of evidence based research for oral care outcome measures on ventilated patients to determine the effectiveness of oral hygiene interventions.
What conclusions/implications for practice were drawn by the authors?
The study found that there is a correlation between the colonization of dental plaque with respiratory pathogens and the occurrence of pneumonia, and a relationship between poor oral hygiene and the incidence of VAP, but there is limited protocols based on research studies for best practice in providing oral care in the ICU. Oral care may contribute to improved clinical outcomes, but further research is needed to establish best practice guidelines. Chlorhexidine mouth rinse in cardiothoracic ICU patients was shown to reduce the incidence of VAP .
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Is the sample size adequate? Support your response.
Although, the study did not list the total participants from all of the studies reviewed, the 11 RCT studies included 3, 415 participants which is an adequate sample size. However, two of the RCT studies used a small sample.
Are the research methods used appropriate for the study’s research question/objective? Support your response.
The research methods used are appropriate for the study’s research question. The researchers researched peer-reviewed literature to determine the best available evidence for providing oral care to ventilated ICU patients. According to Melnyk and Fineout-Overholt (2011), systematic reviews answer specific clinical questions using methods that reduce bias and draw conclusions about evidence gathered.
Was the completed search systematic, comprehensive, and without bias? Support your response.
The search was a comprehensive and systematic search, and the researchers did not show bias in the articles selected. The researchers used multiple databases to search for evidence and used articles published between 1985 to 2006, and the search strategy was verified by a health librarian.
Were selection criteria clearly described? Are they appropriate? Was bias demonstrated in the study’s inclusion/exclusion criteria? Support your responses.
Selection criteria were used and appropriate for this study. Researchers must specify criteria and consider a resulting sample that represents the population of interest (Polit & Beck, 2008).
Is the research recent enough to be applied to current clinical practice? Support your response.
Yes, the research is recent enough to apply to current clinical practice. The Systematic Review used at least 8 RCT studies from the last 10 years. The study did not specify in detail the years of the other studies, other than mentioning they used published articles from 1985 – 2006.
Were the study results significant? Support your response.
Yes, although study concluded that further research is needed for evidence based practice guidelines on oral hygiene, there was a significant reduction in of VAP in the ICU patients.
Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response.
Yes, the findings are directly applicable. The population included ICU mechanically ventilated patients, used various interventions (chlorhexidine use in oral care, no oral care, toothbrushing alone), outcome (incidence of VAP) are similar to our EBP question. The findings are significant, methodology and sample sizes are adequate, and the highest level of evidence is used.
Systematic Review Template
Citation (APA)
Title
Database Source (& ID number)
Type of Evidence
Hierarchical Evidence Rating Level
Your Summary of the Study/Publication (use paraphrasing, not quotes)
What was the stated research question/objective of the study?
What search strategies were used to locate applicable studies for possible inclusion?
What were the stated inclusion/exclusion criteria?
What was the total sample size (e.g., how many studies were included, number of subjects)?
What were the results of the study?
What conclusions/implications for practice were drawn by the authors?
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Is the sample size adequate? Support your response.
Are the research methods used appropriate for the study’s research question/objective? Support your response.
Was the completed search systematic, comprehensive, and without bias? Support your response.
Were selection criteria clearly described? Are they appropriate? Was bias demonstrated in the study’s inclusion/exclusion criteria? Support your responses.
Is the research recent enough to be applied to current clinical practice? Support your response.
Were the study results significant? Support your response.
Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response.
Meta-Analysis Template
Citation (APA)
Title
Database Source (& ID number)
Type of Evidence
Hierarchical Evidence Rating Level
Your Summary of the Study/Publication (use paraphrasing, not quotes)
What was the stated research question/objective of the study?
What search strategies were used to locate applicable studies for possible inclusion?
What were the stated inclusion/exclusion criteria?
What was the total sample size (e.g., how many studies were included, number of subjects)?
What were the results of the study? At what Level of Significance?
What conclusions/implications for practice were drawn by the authors?
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Is the sample size adequate? Support your response.
Are the research methods used appropriate for the study’s research question/objective? Support your response.
Was the completed search systematic, comprehensive, and without bias? Support your response.
Were selection criteria clearly described? Are they appropriate? Was bias demonstrated in the study’s inclusion/exclusion criteria? Support your responses.
Is the research recent enough to be applied to current clinical practice? Support your response.
Were the study results significant (level of significance)? Support your response.
Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response.
Clinical Practice Guidelines Template—Fill out based on review of Complete Summary (not brief summary)
Citation (APA)
Title
Database Source (& ID number)
Type of Evidence
Hierarchical Evidence Rating Level
Your Summary of the Study/Publication (use paraphrasing, not quotes)
Who are developed (not published) the Guidelines?
What is the stated scope and purpose for the guidelines?
For Example: Overall objective, clinical questions addressed by the guidelines, and/or patients to whom the guidelines are meant to be applied.
What search strategies were used to locate applicable studies/experts for possible inclusion?
What were the stated inclusion/exclusion criteria?
What type(s) and level (strength) of evidence are the guidelines based on?
Note: Evidence rating system used may differ from the hierarchical evidence rating system used in this course.
What method(s) was used to form major recommendations?
What are the major recommendations from the study/publication that are directly applicable to your EBP question?
What strength of evidence was given to those recommendations?
Note: Evidence rating system used may differ from the hierarchical evidence rating system used in this course.
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Is the stated scope and purpose appropriate? Is it applicable to your EBP question? Support your response.
Was the completed search systematic, comprehensive, and without bias? Support your response.
Were selection criteria clearly described? Are they appropriate? Was bias demonstrated in the study’s inclusion/exclusion criteria? Support your responses.
Was the method for forming recommendations clearly described? Is there a clear link between major recommendations and supporting evidence? Do the recommendations provide clear direction for management of the clinical problem/client condition?
Are the clinical practice guidelines and the major recommendations directly applicable to your EBP question (match all selection criteria)? Support your response.
Single Quantitative Study (e.g., Randomized Controlled Trial, Nonrandomized Controlled Trial, Case-Control Study, Cohort Study) Template
Citation (APA)
Title
Database Source (& ID number)
Type of Evidence
Hierarchical Evidence Rating Level
Your Summary of the Study/Publication (use paraphrasing, not quotes)
What was the stated research question/objective of the study?
What research methodology was used (e.g., RCT, Case-Control, Cohort)?
Describe the sample (including size)?
How was the sample selected (e.g., randomization, inclusion/exclusion criteria)?
What methods were used for data analysis?
What were the results of the study? At what Level of Significance?
What conclusions/implications for practice were drawn by the authors?
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Was the research design appropriate for the research question (e.g., RCT for cause-effect questions, Case Control for harm or causation questions, Cohort for questions regarding prognosis)? Support your response.
Was the sample size adequate? Was bias controlled with sample selection methods? Support your responses.
Were the study results significant (level of significance)? Are the results valid and reliable? Is there a possibility of bias or of confounding variables? Support your responses.
Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response.
Single Qualitative Study (e.g., Descriptive Study, Interpretive Ethnography, Grounded Theory, Phenomenological Study) Template
Citation (APA)
Title
Database Source (& ID number)
Type of Evidence
Hierarchical Evidence Rating Level
Your Summary of the Study/Publication (use paraphrasing, not quotes)
What is the stated objective/aim/purpose of the study?
What is the overall research design?
What methods were used for participant selection?
What methods were used to collect and analyze data? What strategies were taken to ensure accuracy and completeness of data?
What are the results of the study?
What conclusions/implications for practice were drawn by the author(s)?
Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice
Was the research approach appropriate in terms of the purpose of the study? Support your response.
Were methods for study participant selection appropriate? Support your response.
Were the data collection and analysis techniques appropriate? Support your response.
Is there a demonstrated consistency between reported study findings and research conclusions? Support your response.
Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response.
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