You are to create an 8- to 9-slide PowerPoint presentation in which you do the following: Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to

Critical Appraisal Tool Worksheet Template

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 APA formatted citation of selected articles.	Article #1	Article #2	Article #3	Article #4
Lin, S. H., Liao, W. C., Chen, M. Y., & Fan, J. Y. (2014). The impact of shift work on nurses' job stress, sleep quality, and self‐perceived health status. Journal of nursing management, 22(5), 604-612.	Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer	Schiffer, C. A., Mangu, P. B., Wade, J. C., Camp-Sorrell, D., Cope, D. G., El-Rayes, B. F., ... & Levine, M. (2013). Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol, 31(10), 1357-1370.	Ghadmgahi, F., Zighaimat, F., Ebadi, A., & Houshmand, A. (2011). Knowledge, attitude, and self-efficacy of nursing staff in hospital infection control. Journal Mil Med, 13(3), 167-172.
Evidence Level * (I, II, or III)	III			III
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here). **	None is mentioned	Educational intervention programs for parents of infants born prematurely instigated early in the Neonatal Intensive Care Unit can cut parental stress, depression, and anxiety, improve parent-infant relations, and decrease the length of stay in hospital.	None mentioned.	None mentioned
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	A cross-sectional study that included 266 nurses from four Chiayi county district hospitals. Data was collected using a demographics, stress checklist, work schedule forms, a health status measure, and sleep-quality measure. The collected data were analyzed using Pearson's r, one way ANOVA, Independent t-test, and hierarchical regression.	A randomized control trial study. Study subjects were randomly assigned to receive Creating Opportunities for Parental Empowerment or a comparison intervention program.	A systematic search of MEDLINE and the Cochrane library. All articles with evidence-based guidelines on central venous catheters for patients with cancer were included, while those lacking this information excluded.	Cross-sectional study, including 135 study subjects.
Sample/Setting The number and characteristics of patients, attrition rate, etc.	Two hundred and sixty-six nurses working in Taiwan. There was no attrition of the study participants.	Two hundred and sixty families with preterm infants. 61preterm infants were transferred to another hospital.	Five articles with evidence-based guideline questions.	135 nurses working in selected Mashhad hospitals
Major Variables Studied List and define dependent and independent variables.	Dependent variables- sleep quality, nurses’ stress, and self-perceived health status. Independent variables were the nurses’ ages and gender.	State anxiety, depressive symptoms, stress related to the NICU, quality of parent-infant interaction in the NICU. Independent variables-parental beliefs.	Dependent-Catheter type, insertion site, and placement. Independent-age, sex	Dependent-Nosocomial infections control, knowledge, attitude, and self-efficacy. Independent- Age, sex of nurses.
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	Independent t-test, one-way ANOVA, hierarchical regression, Pearson’s r	Parental stressor scale Index of parental behavior-NICU Parental beliefs scale.	Randomized controlled tests with results specific to cancer patients	Man-Whitney tests, Chi-square tests.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	266 nurses reported moderate job stress, poor sleep quality, and average self-perceived health status.	Stress-related to NICU-.94-.96. Quality of parent-infant interaction in NICU-.83-.86. Parental beliefs- .90-.93.	None	67.9% nurses have common knowledge, 29.9% had good understanding, and 90.4% had positive attitude, 25.2% average self-efficacy, and 74.8% functional self-efficacy.
Findings and Recommendations General findings and recommendations of the research	The nurses displayed moderate job stress, poor quality of sleep, and sensible self-perceived health regardless of the amount of shift work they did. Hospital managers should make sure more healthy work shifts scheduling to improve clinical performance and individual health status of nurses to improve the quality of care.	A reproducible theory-based intervention with parents of preterm babies in NICU results in less parental stress, more positive familial interactions in the NICU, less anxiety, and depressive symptoms after hospitalization and a decreased LOS for preterm. It is essential to encourage mothers with preterm infants to embrace NICU.	Femoral catheterization should be avoided, well-trained providers should place CVC. A clinical care CVC bundle to be used. Heparin-impregnated and antimicrobial-impregnated CVCs to be used.	No significant relationship between knowledge and self-efficacy. No correlation between attitude and efficacy. Significant relation between knowledge and sex. Recommendations- training of nurses to increase their knowledge and attitude.
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 article is essential in providing an insight into the significance of work shifts in healthcare facilities. Strengths- the methods and design of study were useful. No limitations.	The research is worth practicing by nurses to improve the health of parents with preterm infants. Strengths-the study methods and design were appropriate. Limitations-infants transferred before the end of the study period.	The quality of the study is sound. However, the literature had a small number of patients with heterogeneity in trial design, types of catheter, placement techniques, and evaluation methods. Also, there were changes in clinical practices.	The study is worth because the information therein is an eye-opener to nursing professionals regarding nosocomial infections. Strengths-the study design and methods were appropriate. Limitations- un-answered questionnaires.
Key findings	Job stress inversely related to sleep quality, sleep quality directly related to self-perceived health status.	Parental beliefs and roles significantly correlated with a shorter NICU length of stay. Less maternal depression, less stress, and anxiety in the NICU. Mothers and fathers in COPE program recorded positive interactions with their infants.	The overall quality of evidence regarding catheter use in cancer patients was good.	Nurses lack appropriate knowledge regarding control of nosocomial infections.
Outcomes	Moderate job stress, poor sleep quality, and average self-perceived health status.	Infants’ shorter days of stay in NICU.	The evidence-based guideline on central venous catheters for cancer patients was established.	Nurses lack appropriate knowledge regarding nosocomial infections.
General Notes/Comments	Giving healthcare workers shift at work is critical for their productivity and health.	The article was full of relevant information.	The article gave precise information concerning catheter use on cancer patients, a crucial area of study.	Knowledge regarding nosocomial infections is fundamental, and the article explains precisely why nurses should acquire this knowledge.

*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, a 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, a 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's academic guides, which helps explain conceptual frameworks and the reasons they are used in research. Here is the link https://academicguides.waldenu.edu/library/conceptualframework

Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.

As stated by Grant and Osanloo (2014), "Without a theoretical framework, the structure and vision for a study are unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next."

Theoretical and conceptual frameworks provide evidence of academic standards and procedures. They also explain why the study is pertinent and how the researcher expects to fill the literature gap.

Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.

References

The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing evidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019, from https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf

Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)

Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5

Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your" House." Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.

Laureate Education (Producer). (2018). Interpreting Statistics [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Review of research: Hierarchy of evidence pyramid [Mutlimedia file]. Baltimore, MD: Author.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Schulich Library McGill. (2017, June 6). Types of reviews [Video file]. Retrieved from https://youtu.be/5Rv9z7Mp4kg

Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019, from

https://academicguides.waldenu.edu/library/conceptualframework

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric

Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733