EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

· Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.

· Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.

· Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

LEARNING RESOURCES


Required Readings

· Melnyk, B. M., & Fineout-Overholt, E. (2023). 
Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

· Chapter 6, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 189–228)

· Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. 


American Journal of Nursing

Links to an external site.
, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

· Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. 


American Journal of Nursing

Links to an external site.
, 110(7), 47-52

· Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence.

American Journal of NursingLinks to an external site.
, 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5

· Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. 

Journal of the American Psychiatric Nurses AssociationLinks to an external site.
, 15(3), 202–207. doi:10.1177/1078390309338733

·

Document: Critical Appraisal Tool Worksheet Template (Word document)

Research Table (Healthcare)

Due 10/4   5 pm EST

Please Follow instructions. attach article

 

Nursing CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT

Episodic/Focused SOAP Note Template

 

Patient Information:

Initials, Age, Sex, Race


S.

CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s own words – for instance “headache”, NOT “bad headache for 3 days”.

HPI: This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:

Location: head

Onset: 3 days ago

Character: pounding, pressure around the eyes and temples

Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia

Timing: after being on the computer all day at work

Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better

Severity: 7/10 pain scale

Current Medications: include dosage, frequency, length of time used and reason for use; also include OTC or homeopathic products.

Allergies: include medication, food, and environmental allergies separately (a description of what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs intolerance).

PMHx: include immunization status (note date of
last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed

Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system.

Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent.

ROS: cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows:
General:
Head:
EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL:  Denies weight loss, fever, chills, weakness or fatigue.

HEENT:  Eyes: Denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat:  Denies hearing loss, sneezing, congestion, runny nose or sore throat.

SKIN:  Denies rash or itching.

CARDIOVASCULAR:  Denies chest pain, chest pressure or chest discomfort. No palpitations or edema.

RESPIRATORY:  Denies shortness of breath, cough or sputum.

GASTROINTESTINAL:  Denies anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY:  Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.

NEUROLOGICAL:  Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL:  Denies muscle, back pain, joint pain or stiffness.

HEMATOLOGIC:  Denies anemia, bleeding or bruising.

LYMPHATICS:  Denies enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  Denies history of depression or anxiety.

ENDOCRINOLOGIC:  Denies reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

ALLERGIES:  Denies history of asthma, hives, eczema or rhinitis.


O.

Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History.
Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format i.e. General: Head: EENT: etc.

Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines)


A

.

Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines.


P.
  

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.

© 2021 Walden University, LLC

Page 1 of 3

WK1D1

Be sure to provide 5 APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.

Please be sure to follow EACH AND EVERY BULLET POINT.

Make sure to ANSWER EACH QUESTION ACCURATELY.

(TOPIC: topic in attachment ) ***

***Please be sure to include all information from the attachment in the assignment*****

Please do not plagiarize nor reword another person’s assignment that has been previously submitted.

Look at the attachment for the assignment!!!

DO NOT turn in late, please pay attention to the DUE DATE.

FOCUSED CASE STUDY 2

 Marie, A 58-year-old woman with a complicated history which includes chronic low back pain, bipolar disorder, mixed anxiety, and depressive disorder presents to her PCP, a PA, complaining of constipation for several months 

reply

It is no secret that phones, computers, and technology in general have started to take over the world. It is safe to say that every one of our co-workers owns a cellphone of their own and has probably used it in the workplace at one point or another. “Information technology opens our windows and doors upon the world, allowing us to quickly communicate and exchange data and information within facilities, within healthcare delivery systems, and even across the globe” (Chamberlain College of Nursing, 2020). This can become tricky when put into legal terms in relation to patient safety and privacy. “Communication within the medical field is critical to ensure safe, timely delivery of healthcare” (Chandra, et al., 2023). Considering this patient scenario, it is both unethical and unlawful to take photos and send and receive patient photos on your personal cellphone. This can very easily violate the HIPAA policy because the patient photos are not sent under a secure network and can be breached through the firewall of your own personal cellphone by hackers. It is also possible that someone is using your phone and sees it mistakingly, or you decide to show friends or family the photos of another patients wound. With that being said, technology is very important in healthcare as it allows for more efficient healthcare when used appropriately. “Technology in healthcare today allows for global healthcare information systems (HISs), more specialized clinical information systems (CIS), and the electronic health record” (EHR) (Hebda et al., 2019). Many facilities have started to incorporate secure messaging devices in order to taking pictures, and send messages relating to patient data/care. This makes it so that the healthcare personnel are not taking any healthcare data home as they are to return the device at the end of their shift and the messages delete are a certain amount of time if not deleted previously by the employee. My facility has specific guidelines regarding the use of personal communication devices in patient care settings. This policy states that we are not allowed to take phones within the health care setting that could breech patient information. This includes taking pictures at the desk that could possibly include patient care charts and patient boards in the background of the photo. We do have access to our hospital email, and secure messaging services within applications on our personal cellphones but we have to download and encrypt our phone with certain secure firewalls in order to keep these apps so that the messages remain secure. This allows for us to use our personal phones, almost like in the scenario, but we would be messaging the PCP with a secure application that could not be hacked or shared. 

 

Resources 

Chamberlain College of Nursing. (2020). 
NR-361 RN Information Systems in Healthcare: Week 7 Lesson. Downers Grove, IL: Online Publication.

Chandra, S., Oberg, M., Hilburn, G., Wu, D. T., & Adhyaru, B. (2023). Improving Communication in a Large Urban Academic Safety Net Hospital System: Implementation of Secure Messaging. 
Journal of medical systems
47(1), 56. https://doi.org/10.1007/s10916-023-01956-x

Hebda, T., Hunter, K., & Czar, P. (2019). 
Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.

module 4 dicussion

 

Scenario – There is a new Board running the hospital, and they are aggressive about the hospital being the best in the State. They have decided that you are best suited to lead the nurses in the hospital so that they will initially get status. From there, they are planning on having the nurses lead the way by having every nurse be a leader in their field. Your knowledge of how to reach these milestones is the reason that you were selected to lead the nurses in the hospital.

Instructions:

  1. Read the scenario above, and then answer the following questions:
    1. What will the nurses need to do so that the hospital will become magnet status and be respected in the industry?
    2. What other certifications and awards, etc., will the nurses need to obtain so that the hospital will be named a magnet institution?
    3. What types of organizational designs and structures will need to happen for magnet status?
  2. Answer the questions as thoroughly and concisely as possible.
    • Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format).
  3. Please respond to at least one (1) of your classmate’s postings.
  4. To see the grading rubric, click on the 3-dot menu 3-dot menu on the top-right side of screen. 

Self-Assessment of Leadership Skills

 

  1. Determine your preferred leadership style using The Foundation of Nursing Leadership’s Leadership Development – Test One – What is your leadership style?Links to an external site.
  2. Analyze your leadership’s skills based on your self-assessment.
  3. Identify strengths and opportunities for improvement based on your self-assessment.
  4. Create an action plan to address self-assessment capitalizing on strengths and addressing opportunities for improvement.

Submission Instructions:

  • The is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.
  • The is to be 2 – 3 pages in length, excluding the title, and references page.
  • Incorporate a minimum of 2 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

Health Assessment

 

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each

Case Study

 

A 60-year-old male patient is admitted with chest pain to the telemetry unit where you work. While having a bowel movement on the bedside commode, the patient becomes short of breath and diaphoretic. The ECG waveform shows bradycardia.

  • What other assessment findings should you anticipate?
  • Why does this patient probably have bradycardia?
  • Does this dysrhythmia need treatment? Why or why not? What intervention would you implement first?
  • What is the drug treatment and dosage of choice for symptomatic bradycardia? How does this drug increase heart rate?

Please use complete sentences to answer the questions. Ensure that you are using correct grammar. In additions, support your answers by using your textbooks, scholarly journals, and credible Internet sources. All citations must be in APA format.