Examining the Evidence

Rubric- Examining the Evidence

The paper should be carefully written in a formal style, based on primary sources, provide an integration of ideas, and be no more than 5-6 pages in length, excluding title page, reference list, and evidence matrix (any appendix). Organized flow, logical progression of ideas, and clarity in thought are essential. Only include evidence related to this assignment and not all of the evidence you have rated since doctoral school. Since you started to think about a practice issue/problem,i expect your investigation to evolve over time and will take into consideration the similarity from the Turnitin report. You MUST have headings corresponding to rubric points.

Grading Rubric

Criteria

Points

1.Introduction paragraph (one paragraph). Identify a nursing practice issue/problem/policy/clinical administrative issue. There must be a thesis statement at the end of the paragraph that tells the reader the purpose of paper and what will be discussed. 1 points

2.

Offer background information. Why is the practice issue/problem significant? Why is the selected issue a quality and/or safety issue? Has anything been done to address the issue in your practice? Is there a problem/issue that you are aware of in your current practice or previous nursing experience? If addressing a system in which you currently practice or plan to practice, briefly describe the system to give the reader of sense of place about your system. You may want to consider using the IOM aims for quality care as you Examine the Evidence. 3points

3. How will you use the model in your quality improvement initiative? How does it fit? Include additional conceptual models that are guiding you in the process. Include the model/s as an appendix. 3 points

4.Construct a PICO (burning question) question and identify key search terms related to the question. Describe your search strategy. What were your key terms? How did you determine the terms? How many “hits” did you get using the key terms? Did you refine your question? 2points

5. Provide a synthesis/overview of the evidence related to your topic of concern. Pay particular attention to gaps in the evidence or areas that are not well supported. 3points

6. Describe the 3 best strategies/interventions that you identified from the literature for improving the practice issue/problem. Briefly describe the interventions/strategies and an overview of the supporting evidence. Did you discover evidence-based guidelines or protocols? Is there enough quality evidence to support the 3 strategies? What tools did you use to level the evidence and recommendations? Provide a copy of the method/tool you used to rate the evidence as a separate appendix.6points

7. Conclusions: Summarize the essential points of paper (one paragraph). How will you build on this beginning research? 1points

8.Provide a matrix of evidence related to the translation of evidence into practice systems. In NU 608, you identified at least four (4) levels of evidence and began to construct the Evidence Review Matrix. You may use the matrix format and sources from NU 608 but you must include new evidence to support your strategies. Include at least 10 NEW sources that can be justified using the hierarchy of evidence. Critically evaluate and grade the levels of evidence and recommendations. All appendices must be merged with the paper and be submitted as one pdf document (the matrix is an appendix and should not be included in the body of the paper).m6points

TOTAL 25

Examining the Evidence Helpful Hints

Here are some helpful hints regarding Examining the Evidence. 1. The introduction section of your paper should begin with some general statements. Try to share something that is interesting or attention grabbing. The last sentence in the introduction paragraph (one paragraph) will be your thesis statement which tells the reader the purpose of the paper and what will be discussed. Don’t pose your thesis statement as a question. It should clearly state that the purpose of the paper is to…..

2. Describe the system in which you currently practice (even if you are not presently an advanced practice nurse. We know that many of you are in the BSN to DNP program and do not have a specialty yet. Be specific about your system. What kind of institution is it, where is it located, how many beds, etc? Give the reader a sense of place about your system. Describe your practice issue for us. Be clear and succinct. Why did you choose this issue? Is there a problem on your unit/in your system that really needs your focus? Has some problem resulted in negative patient outcomes?

3. Which EBP model and or conceptual framework will guide you?

4. Formulate your PICO question. Take a look at Mateo &Kirchhoff, Chapter 2 and Hall & Roussel, Chapter 14 as well as a variety of other sources. You will need to describe your search methodology (see sample in resources). We want to be sure you are doing a thorough search and need to see what databases and any other sources you have accessed. Include the number of hits you have obtained.

5. When we say provide a synthesis of the evidence, we are not talking about a listing of studies…we are referring to an overview of the literature. What is out there? Where are the gaps? This section of your paper should probably be around 1 ½ pages in length, depending on how much literature there is related to your issue. Again, do not include a listing of each study and what was found, give a synthesis.

Ex. In relation to pain management of breast cancer patients, 5 of the 20 studies reviewed concluded that nurse practitioners do not….(citation 1; citation 2; citation 3; citation 4; citation 5).

However, we don’t want to see something like, “Three studies found X. Two studies found Y. Five studies found Z.” If you are confused and want to see an example of what is meant by a synthesis, look at an article in the background or literature review section.

6. The section identifying the best strategies (also called best practices or interventions…same thing) recommended to address the clinical issue is worth a good deal of points. Always look at the rubric and see where the most points are allocated and pay particular attention to that section. You can refer to clinical practice guidelines, research studies, systematic reviews…whatever the best rated evidence you have. Choose the 3 interventions that are best supported; identify and discuss those and the supporting evidence. Tell the reader what level of evidence supports the strategies. What tool did you use for leveling the evidence and rating the recommendations? Again, provide a synthesis or overview of the practices. This section is not the same as the section above where you provide an overview/synthesis of the evidence related to translating evidence on your issue or topic into practice. This section is specific only for the strategies. Include in the matrix (located in the appendix) a section of the evidence supporting the best practices. Separate these studies from the others so we can see what kind of evidence you found to support the conclusion that your three chosen practices were indeed the best of all interventions. However, in the synthesis portion of this section of the paper, you need to state how these are the three best practices.

7. The conclusion paragraph is just a restatement of the main points of the paper. This section should be short & sweet and to the point. Do remember though that paragraphs are at least 3 (and some say 5) sentences. Conversely, don’t have an overly long paragraph….we recommend not longer than 1/3 of a page. After that you just lose your reader. I’m not sure why that is, but it is tiresome to read long paragraphs. Make your point in a succinct, but substantive way and move along.

8. Matrix: When organizing your evidence, we recommend that all evidence you review should be included in a matrix (located in the Appendix). Pull out the studies for this particular assignment. Computer software programs like endnote can help you organize your searches. One of the most difficult things in doctoral study is trying to organize the massive literature you come across. If you start from the beginning with a system for organization, this will really benefit you. Remember our biomedical library personnel. They are wonderful resources for information. Feel free to contact them for helpful hints as well.

The matrix should focus on content related to translating evidence into practice. Don’t include every study about your topic, just those related to putting the evidence in to practice. Separate out those studies in your matrix about implementation strategies/best practices. We don’t want to see a listing of all studies you’ve ever looked at related to this topic. Tell us what method you are using to rate the evidence. It is your choice, but we need to know what you are using and provide us a copy in the Appendix

Title Page and Reference Page: Use the APA formatting text 6th edition title page. There’s really no reason to lose points for this! It’s a freebie….just type in your appropriate information on the title page and put into your paper. Use the 6th edition for your reference page citations. We will be looking at the text to compare to your references page.

If you have any questions about Examining the Evidence, please post in the Q&A.

Please also upload a pdf copy of your assignment in Assignments.

The following information in resources will be helpful as you complete this assignment:

Articles related to PICO question:

AJN (2010):

Timm, D.F., Banks D.E., & McLarty, J. (2012). Critical appraisal process: Step-by-step. Southern Medical Journal, 105(3), 144-148.

Davies, K. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library & Information Practice, 6(2), 75-80.

Fineout-Overholt (2005):

Using the tools below (you can expand and make more useful for your needs), begin your search of databases. You are also asked to begin or add to your NU 608 evidence review matrix from your database search. Identify at least ten (10) NEW sources of evidence from your database search. As you review your research evidence select you will need to select a tool to help you grade the evidence (you find find some example of tools below however, tool selection is your choice).

EBP Toolkit

Sandaloski (2002)

EBP literature review tool

Search methodology sample

Resources for Evidence-Based Practice

National Guidelines Clearing House

US Preventive Health Guidelines Recommendations

Evidence Levels

Matrix Format

Example 1 of the evidence matrix

Example 2 of the evidence matrix

Canadian Task Force Tool

GRADE tool article (2008)

Deductions:

Papers must be submitted to turnitin.com and students are to review the report generated by this software system.

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