NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

template

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Evaluation Table

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

Full citation of selected article Article #1 Article #2 Article #3 Article #4
 

 

 

Conceptual FrameworkDescribe the theoretical basis for the study

 

 

 

 

Design/Method

 Describe the design

and how the study

was carried out

 

       
Sample/SettingThe number and

characteristics of

patients,

attrition rate, etc.

  

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

 

 

     
Major Variables StudiedList and define dependent and independent variables
MeasurementIdentify primary statistics used to answer clinical questions
Data AnalysisStatistical or

qualitative

findings

Findings and RecommendationsGeneral findings and recommendations of the research
AppraisalDescribe 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?

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
General Notes/Comments NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

 

 

 

 

Levels of Evidence Table

Use this document to complete the levels of evidence table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

Author and year of selected article Article #1 Article #2 Article #3 Article #4
 

 

 

Study DesignTheoretical basis for the study

 

 

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

 

Sample/SettingThe number and

characteristics of

patients

Evidence Level *(I, II, or III)

 

Outcomes

 

 

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
General Notes/Comments  

 

 

 

 

 

* Evidence Levels:

  • 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 NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

  • 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

NURS 6052 Week 6-7 Assignment: Critical Appraisal Tools

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Outcomes Synthesis Table

Use this document to complete the outcomes synthesis table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

Author and year of selected article Article #1 Article #2 Article #3 Article #4
 

 

 

Sample/SettingThe number and

characteristics of

patients

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Outcomes 

 

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Key Findings
Appraisal and Study Quality
General Notes/Comments  

 

 

 

 

 

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

NURS_6052

NURS 6052 Week 6-7 Assignment: Critical Appraisal Tools Sample Template 

In order to address the topic of HAIs’ potential to influence positive health outcomes in clinical settings, this report thoroughly and methodically evaluates four investigations. There are tables for the level of evidence, the synthesis of the results, and the review of the literature. Valid and trustworthy information on what is or is not likely to damage patients and the approaches to care that are cost-effective is required for nurses to protect public health and deliver high-quality services.

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Introduction

Evaluation Table

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

 

Full citation of selected article Article #1 Article #2 Article #3 Article #4
Ford, C., & Park, L. J. (2018). Hand hygiene and handwashing: key to preventing the transfer of pathogens. British Journal of Nursing, 27(20), 1164–1166.

 

 

Hovi, T., Ollgren, J., & Savolainen-Kopra, C. (2017). Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure -adjusted analysis of a randomized trial. BMC Infectious Diseases, 17, 1–9 Kingston, L. M., O, C. N. H., & Dunne, C. P. (2018). A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students. Nurse Education Today, 63, 112–118. Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Conceptual FrameworkDescribe the theoretical basis for the study

 

Not provided Not provided Not provided Not provided NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Design/Method 

Describe the design

and how the study

was carried out

Design- Clinical practice guidelinesMethod-clinical guidelines based on the review of literature of hand hygiene and handwashing by NICE, WHO and other studies. Design-

Randomized control trial

Method-1270 people from designated clusters were randomized to two different interventions (either the use of alcohol hand-rubs or water and soap).On a weekly basis self-reported data of GTI and RTI symptoms were collected through emails. The multilevel binary regression model was used to analyze data.

Design-

Observational cross-sectional design

Method-a questionnaire was administered electronically to 872 medical and nursing students in a university and outcome data analysed using relevant software.

Design-

Systematic review

Method-a comprehensive search was conducted in the electronic databases of MEDLINE and CINAHL using the keywords: contact dermatitis, handwashing, dermatitis and hand hygiene.

Sample/SettingThe number and

characteristics of

patients,

attrition rate, etc.

Step by step clinical guidelines on how to maintain hand hygiene and to conduct handwashing in the clinical setting.  1270 people from designated clusters were randomized to two different interventions (either the use of alcohol hand-rubs or water and soap). 323 medical and nursing students responded to online questionnaires on the barriers to adherence to hand hygiene guidelines. 3 studies which assessed the impact of handwashing vs. alcohol-based handrubs on the skin were reviewed. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Major Variables StudiedList and define dependent and independent variables Dependent variable-noneIndependent variable-none

 

Dependent variable-RTI and GTI symptomsIndependent variable-alcohol hand rubs, water and soap

 

Dependent variables-body fluid exposure, patient surroundingIndependent variable– alcohol hand rubs, use of soap and water Dependent variable-dermatitisIndependent variable-alcohol-based handrubs and handwashing

 

MeasurementIdentify primary statistics used to answer clinical questions Guidelines provided by NICE and the WHO on hand hygiene and handwashing. Weekly prevalence of RTI and GTI symptoms NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Compliance with WHO hand hygiene model, compliance with hand hygiene practices after contact with the surrounding of a patient or exposure to body fluids. Incidence and prevalence of dermatitis/contact dermatitis
Data AnalysisStatistical or

qualitative

findings

Decontamination of the hands through handwashing using soap and water is the most effective and easy way to prevent the spread of infections in the clinical setting. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Within 16 months of the trial, 230 participants who used nothing, 297 participants who used soap and water, and 238 participants who used alcohol-based handrubs all presented their reports. Both the intervention and control groups showed an increase in RTI and GTI exposure. When compared to the control group, the prevalence of GTI dropped to 24% among individuals who used soap and water. Alcohol rubs had no impact on the symptom prevalence.

 

 

Of the 872 participants, 323 responded. Nursing students complied more with the WHO “my five moments for hand hygiene” model as compared to medical students. Compliance with hand hygiene was high after being exposed to body fluids (MS 91%. NS 99.5%) and low after contact with a patient’s environment (MS-57.5%, NS-61.5%). Both disciplines had a positive attitude towards hand rubbing. 45% of MS and 16% of NS were not aware of the clinical contraindications to using ABHR. 36% of MS and 9% of NS did not know when to use ABHR and when to use soap and water. 22% NS and 46% MS routinely used ABHR for decontamination.   3 relevant studies were retrieved. ABHRs were not linked to reduced skin hydration, allergic reactions and disruption of the skin barrier. Skin tolerance of ABHRs was high with reports from healthcare providers on less irritation of the skin and less dryness in comparison to the use of lotions, creams or handwashing. 

 

 

Findings and RecommendationsGeneral findings and recommendations of the research Washing hands with soap and water is the best decontamination method in preventing HAIs. Handwashing with soap and water safeguarded the participants from GTI and RTI. In clinical settings, it should be adopted as an infection control measure to prevent/reduce the incidence and prevalence of HAIs.

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

 

 

Gaps in knowledge on hand hygiene and handwashing are a potential barrier to deficits in hand hygiene practice and use of ABHRs. In clinical settings, leadership should identify potential knowledge gaps, frequently review hand hygiene policies and address them as required. Evidence on how ABHRs influence contact dermatitis and the effectiveness of antiseptic hand hygiene protocols in preventing dermatitis was level II and III. Lipid-emulsifying alcohols or agents disrupt the skin barrier and cause a lot of skin irritation thus should be avoided.
AppraisalDescribe 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?

Adds to clinical knowledge on how to prevent the transfer of pathogens in healthcare settings through handwashing and hand hygiene. It has no risks associated with implementation in clinical practice and is highly feasible in my practice. The study adds to the nursing knowledge on how to prevent RTI and GTI infections in the clinical setting.A major strength is that since a wide study sample was used, the results can be applied to wide population settings. However, since the data collected on RTI and GTI symptoms were based on electronic self-reporting; varied reports might include biased data which affects the validity and reliability of the results. The research is however feasible in my practice. The research adds to nursing knowledge on the potential barriers in observing hand hygiene practices in clinical settings. Its major limitation is that since it had a self-reporting design, the likelihood of potential biases is high. However, the huge random study sample increases the validity, reliability and applicability of the results. The study is highly feasible in my practice. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

Levels of Evidence Table

Use this document to complete the levels of evidence table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

 

Author and year of selected article Article #1 Article #2 Article #3 Article #4
Ford, C., & Park, L. J. (2018). Hand hygiene and Handwashing: key to preventing the transfer of pathogens. British Journal of Nursing, 27(20), 1164–1166.

 

 

 

 

Hovi, T., Ollgren, J., & Savolainen-Kopra, C. (2017). Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure -adjusted analysis of a randomized trial. BMC Infectious Diseases, 17, 1–9 Kingston, L. M., O, C. N. H., & Dunne, C. P. (2018). A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students. Nurse Education Today, 63, 112–118. Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs. Handwashing. American Journal of Critical Care, 27(4), 334–337. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Study DesignTheoretical basis for the study

 

Clinical practice guideline that is based on the review of literature on hand hygiene and handwashing by NICE, WHO and other studies.

 

Randomized control trial where 1270 people from designated clusters were randomized to two different interventions (either the use of alcohol hand-rubs or water and soap).On a weekly basis self-reported data of GTI and RTI symptoms were collected through emails. The multilevel binary regression model was used to analyze data. Observational cross-sectional design where a questionnaire was administered electronically to 872 medical and nursing students in a university and outcome data analysed using relevant software. Systematic review that involved a comprehensive search of literature in the electronic databases of MEDLINE and CINAHL using the keywords: contact dermatitis, handwashing, dermatitis and hand hygiene. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Sample/SettingThe number and

characteristics of

patients

Step by step clinical guidelines on how to maintain hand hygiene and to conduct handwashing in the clinical setting. 1270 people from designated clusters were randomized to two different interventions (either the use of alcohol hand-rubs or water and soap). 323 medical and nursing students responded to online questionnaires on the barriers to adherence to hand hygiene guidelines. 3 studies which assessed the impact of handwashing vs. alcohol-based handrubs on the skin were reviewed.
Evidence Level *(I, II, or III)

 

Level VII Level II Level IV Level I NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Outcomes

 

 

Decontamination of the hands through handwashing using soap and water is the most effective and easy way to prevent the spread of infections in the clinical setting. Within 16 months of the trial, 238 people who used alcohol-based handrubs, 297 who used soap and water and 230 who used nothing provided their reports. An increase in RTI and GTI exposure was reported in both the intervention and control groups. Among those who used soap and water, the prevalence of GTI reduced to 24% as compared to the control group. Alcohol rubs did not affect the prevalence of the symptoms.

 

Of the 872 participants, 323 responded. Nursing students complied more with the WHO “my five moments for hand hygiene” model as compared to medical students. Compliance with hand hygiene was high after being exposed to body fluids (MS 91%. NS 99.5%) and low after contact with a patient’s environment (MS-57.5%, NS-61.5%). Both disciplines had a positive attitude towards hand rubbing. 45% of MS and 16% of NS were not aware of the clinical contraindications to using ABHR. 36% of MS and 9% of NS did not know when to use ABHR and when to use soap and water. 22% NS and 46% MS routinely used ABHR for decontamination.   3 relevant studies were retrieved. ABHRs were not linked to reduced skin hydration, allergic reactions and disruption of the skin barrier. Skin tolerance of ABHRs was high with reports from healthcare providers on less irritation of the skin and less dryness in comparison to the use of lotions, creams or handwashing. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

 

 

General Notes/Comments Low evidence

 

 

 

High evidence

 

Medium evidence

 

 

High evidence NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

 

* Evidence Levels: NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

  • 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 NURS 6052 Week 6-7 Assignment Critical Appraisal Tools

  • 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 NURS_6052_wk_6-7_assign_CriticalAppraisalTools_template

Outcomes Synthesis Table – NURS 6052 Week 6-7 Assignment: Critical Appraisal Tools Sample

Use this document to complete the outcomes synthesis table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

Author and year of selected article NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Article #1 Article #2 Article #3 Article #4
Ford, C., & Park, L. J. (2018). Hand hygiene and handwashing: key to preventing the transfer of pathogens. British Journal of Nursing, 27(20), 1164–1166.

 

 

 

 

Hovi, T., Ollgren, J., & Savolainen-Kopra, C. (2017). Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure -adjusted analysis of a randomized trial. BMC Infectious Diseases, 17, 1–9 Kingston, L. M., O, C. N. H., & Dunne, C. P. (2018). A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students. Nurse Education Today, 63, 112–118. Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337.
Sample/SettingThe number and

characteristics of

patients

Step by step clinical guidelines on how to maintain hand hygiene and to conduct handwashing in the clinical setting. 1270 people from designated clusters were randomized to two different interventions (either the use of alcohol hand-rubs or water and soap). 323 medical and nursing students responded to online questionnaires on the barriers to adherence to hand hygiene guidelines. 3 studies which assessed the impact of handwashing vs. alcohol-based handrubs on the skin were reviewed. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Outcomes 

 

Key Findings Washing hands with soap and water is the best decontamination method in preventing HAIs. Handwashing with soap and water safeguarded the participants from GTI and RTI. In clinical settings, it should be adopted as an infection control measure to prevent/reduce the incidence and prevalence of HAIs. Deficits in hand hygiene practice and the use of ABHRs may be hindered by information gaps about handwashing and hand hygiene. Leadership in clinical settings should recognize potential knowledge gaps, regularly evaluate hand hygiene guidelines, and remedy them as necessary. Evidence on how ABHRs influence contact dermatitis and the effectiveness of antiseptic hand hygiene protocols in preventing dermatitis was level II and III. Lipid-emulsifying alcohols or agents disrupt the skin barrier and cause a lot of skin irritation thus should be avoided. NURS 6052 Week 6-7 Assignment Critical Appraisal Tools
Appraisal and Study Quality NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Adds to clinical knowledge on how to prevent the transfer of pathogens in healthcare settings through handwashing and hand hygiene. It has no risks associated with implementation in clinical practice.Medium  quality NURS 6052 Week 6-7 Assignment Critical Appraisal Tools The study adds to the nursing knowledge on how to prevent RTI and GTI infections in the clinical setting.A major strength is that since a wide study sample was used, the results can be applied to wide population settings. However, since the data collected on RTI and GTI symptoms were based on electronic self-reporting; varied reports might include biased data which affects the validity and reliability of the results.

High quality

The research adds to nursing knowledge on the potential barriers in observing hand hygiene practices in clinical settings. Its major limitation is that since it had a self-reporting design, the likelihood of potential biases is high. However, the huge random study sample increases the validity, reliability and applicability of the results.Medium quality The study adds to the nursing knowledge on health worker perceptions that influence compliance with hand hygiene practices and its influence on the rates of HAIs. Since it is a systematic review that included only 3 articles, the reliability and applicability of its findings is not entirely guaranteed. A major strength of the study is that it recommends the use of ABHRs to reduce bacterial count since it causes less irritation to the skin.High quality
General Notes/Comments Highly feasible in practice Feasible in practice Feasible in my practice Feasible in my practice

NURS 6052 Week 6-7 Assignment Critical Appraisal Tools Conclusion

Based on this critical appraisal, the studies recommend routine hand hygiene with soap and water as the effective decontamination method to reduce the spread of pathogens and rates of HAIs in the clinical setting.

References for NURS 6052 Week 6-7 Assignment: Critical Appraisal Tools

  • Ford, C., & Park, L. J. (2018). Hand hygiene and handwashing: key to preventing the transfer of pathogens. British Journal of Nursing, 27(20), 1164–1166.
  • Hovi, T., Ollgren, J., & Savolainen-Kopra, C. (2017). Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure -adjusted analysis of a randomized trial. BMC Infectious Diseases, 17, 1–9.
  • Kingston, L. M., O, C. N. H., & Dunne, C. P. (2018). A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students. Nurse Education Today, 63, 112–118.
  • Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337.
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