B.  Discuss the impact of a clinical practice problem on the patient or patients and the organization it affects.
1.  Identify each of the following PICO components of the clinical practice problem:
•   P: patient, population, or problem
•   I: intervention
•   C: comparison
•   O: outcome
2.  Develop an evidence-based practice (EBP) question based on the clinical practice problem discussed in part B and the PICO components identified in part B1.
Note: Refer to the “Appendix B: Question Development Tool” web link for information on the creation of an EBP question.
C.  Select a research-based article that answers your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1.  Discuss the background or introduction (i.e., the purpose) of the research-based article.
2.  Describe the research methodology used in the research-based article.
3.  Identify the level of evidence for the research-based article using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to level a research-based article.
4.  Summarize how the researcher analyzed the data in the research-based article.
5.  Summarize the ethical considerations of the research-based article. If none are present, explain why.
6.  Identify the quality rating of the research-based article according to the JHNEBP model.
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to establish the quality rating.
7.  Analyze the results or conclusions of the research-based article.
a.  Explain how the article helps answer your EBP question.
D.  Select a non-research-based article from a peer-reviewed journal that helps to answer your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1.  Discuss the background or introduction (i.e., the purpose) of the non-research-based article.
2.  Describe the type of evidence (e.g., case study, quality improvement project, clinical practice guideline) used in the non-research-based article.
3.  Identify the level of evidence in the non-research-based article using the JHNEBP model.
Note: Refer to the “Appendix F: Non-Research Evidence Appraisal Tool” web link for information on how to level the non-research-based article.
4.  Identify the quality rating of the non-research-based article according to the JHNEBP model.
5.  Discuss how the author’s recommendations in the non-research-based article help answer your EBP question.
E.  Recommend a practice change that addresses your EBP question using both the research-based and non-research-based articles you selected for part C and part D.
1.  Explain how you would involve three key stakeholders in supporting the practice change recommendation.
2.  Discuss one specific barrier you may encounter when implementing the practice change recommendation. 
3.  Identify one strategy that could be used to overcome the barrier discussed in part E2.
4.  Identify one outcome (the O component in PICO) from your EBP question that can be used to measure the recommended practice change.
F.  Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
G.  Demonstrate professional communication in the content and presentation of your submission.
File RestrictionsFile name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7zF
Nonresearch Evidence

Appraisal Tool

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EBSCO Publishing : eBook Collection (EBSCOhost) – printed on 1/8/2023 11:52 PM via WESTERN GOVERNORS UNIVERSITY
AN: 1625431 ; Debora Dang, Sandra L. Dearholt.; Johns Hopkins Nursing Evidence-Based Practice Third Edition: Model and Guidelines
Account: ns017578.main.eds

Johns Hopkins Nursing Evidence-Based Practice Nonresearch Evidence Appraisal Tool292

Evidence level and quality rating:
____________

Article title: Number:

Author(s): Publication date:

Journal:

Setting: Sample

(composition and size):

Does this evidence address my EBP
question?

❑ Yes ❑ No
Do not proceed with appraisal of this evidence.

❑ Clinical Practice Guidelines LEVEL IV
Systematically developed recommendations from nationally recognized experts based on research
evidence or expert consensus panel

❑ Consensus or Position Statement LEVEL IV
Systematically developed recommendations, based on research and nationally recognized expert
opinion, that guide members of a professional organization in decision-making for an issue of
concern

■■ Are the types of evidence included identified? ❑ Yes ❑ No

■■ Were appropriate stakeholders involved in the development of
recommendations?

❑ Yes ❑ No

■■ Are groups to which recommendations apply and do not apply
clearly stated?

❑ Yes ❑ No

■■ Have potential biases been eliminated? ❑ Yes ❑ No

■■ Does each recommendation have an identified level of evidence
stated?

❑ Yes ❑ No

■■ Are recommendations clear? ❑ Yes ❑ No

Complete the corresponding quality rating section.

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F Nonresearch Evidence Appraisal Tool 293

❑ Literature review LEVEL V
Summary of selected published literature including scientific and nonscientific such as reports of
organizational experience and opinions of experts

❑ Integrative review LEVEL V
Summary of research evidence and theoretical literature; analyzes, compares themes, notes gaps
in the selected literature

■■ Is subject matter to be reviewed clearly stated? ❑ Yes ❑ No

■■ Is literature relevant and up-to-date (most sources are within the
past five years or classic)?

❑ Yes ❑ No

■■ Of the literature reviewed, is there a meaningful analysis of the
conclusions across the articles included in the review?

❑ Yes ❑ No

■■ Are gaps in the literature identified? ❑ Yes ❑ No

■■ Are recommendations made for future practice or study? ❑ Yes ❑ No

Complete the corresponding quality rating.

❑ Expert opinion LEVEE
Research Evidence

Appraisal Tool

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EBSCO Publishing : eBook Collection (EBSCOhost) – printed on 1/8/2023 11:45 PM via WESTERN GOVERNORS UNIVERSITY
AN: 1625431 ; Debora Dang, Sandra L. Dearholt.; Johns Hopkins Nursing Evidence-Based Practice Third Edition: Model and Guidelines
Account: ns017578.main.eds

Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool282

Evidence level and quality rating:
_________________

Article title: Number:

Author(s): Publication date:

Journal:

Setting: Sample

(composition and size):

Does this evidence address my EBP
question?

❑ Yes ❑ No
Do not proceed with appraisal of this evidence.

Is this study:

■■ QuaNtitative (collection, analysis, and reporting of numerical data)

Measurable data (how many; how much; or how often) used to formulate facts, uncover patterns
in research, and generalize results from a larger sample population; provides observed effects of a
program, problem, or condition, measured precisely, rather than through researcher interpretation of
data. Common methods are surveys, face-to-face structured interviews, observations, and reviews of
records or documents. Statistical tests are used in data analysis.

Go to Section I: QuaNtitative

■■ QuaLitative (collection, analysis, and reporting of narrative data)

Rich narrative documents are used for uncovering themes; describes a problem or condition from
the point of view of those experiencing it. Common methods are focus groups, individual interviews
(unstructured or semistructured), and participation/observations. Sample sizes are small and are
determined when data saturation is achieved. Data saturation is reached when the researcher
identifies that no new themes emerge and redundancy is occurring. Synthesis is used in data
analysis. Often a starting point for studies when little research exists; may use results to design
empirical studies. The researcher describes, analyzes, and interprets reports, descriptions, and
observations from participants.

Go to Section II: QuaLitative

■■ Mixed methods (results reported both numerically and narratively)

Both quaNtitative and quaLitative methods are used in the study design. Using both approaches,
in combination, provides a better understanding of research problems than using either approach
alone. Sample sizes vary based on methods used. Data collection involves collecting and analyzing
both quaNtitative and quaLitative data in a single study or series of studies. Interpretation is continual
and can influence stages in the research B
Question Development Tool

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EBSCO Publishing : eBook Collection (EBSCOhost) – printed on 1/8/2023 11:48 PM via WESTERN GOVERNORS UNIVERSITY
AN: 1625431 ; Debora Dang, Sandra L. Dearholt.; Johns Hopkins Nursing Evidence-Based Practice Third Edition: Model and Guidelines
Account: ns017578.main.eds

268 Johns Hopkins Nursing Evidence-Based Practice Question Development Tool

1. What is the problem?

2. Why is the problem important and relevant? What would happen if it were not addressed?

3. What is the current practice?

4. How was the problem identified? (Check all that apply.)

❑ Safety and risk-management
concerns

❑ Quality concerns (efficiency,
effectiveness, timeliness, equity,
patient-centeredness)

❑ Unsatisfactory patient, staff, or
organizational outcomes

❑ Variations in practice within the
setting

❑ Variations in practice compared to community
standard

❑ Current practice that has not been validated

❑ Financial concerns

5. What are the PICO components?

P – (Patient, population, or problem)

I – (Intervention)

C – (Comparison with other interventions, if foreground question)

O – (Outcomes are qualitative or quantitative measures to determine the success of change)

6. Initial EBP question ❑ Background ❑ Foreground

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269B Question Development Tool

7. List possible search terms, databases to search, and search strategies.

8. What evidence must be gathered? (Check all that apply.)

❑ Publications (e.g., EBSCOHost,
PubMed, CINAHL, Embase)

❑ Standards (regulatory, professional,
community)

❑ Guidelines

❑ Organizational data (e.g., QI, financial data, local
clinical expertise, patient/family preferences)

❑ Position statements

9. Revised EBP question

(Revisions in the EBP question may not be evident until after the initial evidence review;
the revision can be in the background question or a change from the background to a
foreground question.)

10. Outcome measurement plan

What will we
measure?

(Structure, process,
outcome measures)

How will we
measure it?

(Metrics
expressed as rate
or percent)

How often will
we measure it?

(Frequency)

Where will
we obtain
the data?

Who will
collect the
data?

To whom
will we
report the
data?

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270 Johns Hopkins Nursing Evidence-Based Practice Question Development T




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