Johns Hopkins Nursing Evidence-Based Practice

Johns HopkinsNursing Evidence-Based Practice

Appendix E:Research Evidence Appraisal Tool

Article Nurses’ perspectives regarding thedisclosure of errors to patients: A qualitative study

Number:5170

Author(s):Publication 1 October 2014

Journal:International Journal of Nursing Studies

Setting: Nursingdepartments from hospitals in two German-speaking cantons inSwitzerland. Sample

(Composition &ampsize): 18 nurses from a range of fields, positions in organisationalhierarchy, work experience, hospitals, and religious perspectives.

Does thisevidence address my EBP question? *Yes

No

Do not proceedwith appraisal of this evidence

Level ofEvidence (Study Design)

A. Is this areport of a single research study? Yes

1. Was there anintervention? No

2. Was there acontrol group? No

3. Were studyparticipants randomly assigned to the intervention and control

groups?

If Yes to allthree, this is a Randomized Controlled Trial (RCT) or Experimental

Study

If Yes to #1and #2 and No to #3, OR Yes to #1 and No to #2 and #3, this is Quasi

Experimental(some degree of investigator control, some manipulation of

an independentvariable, lacks random assignment to groups, may have a

control group)

If Yes to #1only, OR No to #1, #2, and #3, this is Non-Experimental (nomanipulation

of independentvariable, can be descriptive, comparative, or correlational, often

uses secondarydata) or Qualitative (exploratory in nature such as interviewsor

focus groups, astarting point for studies for which little research currentlyexists,

has small samplesizes, may use results to design empirical studies)

NEXT, COMPLETETHE BOTTOM SECTION ON THE FOLLOWING PAGE, “STUDY

FINDINGS THATHELP YOU ANSWER THE EBP QUESTION”

 LEVEL I

 LEVEL II

* LEVEL III

Yes

Yes

Yes

Yes

No

No

No

No

Evidence Leveland Quality:__Level Three_High Quality

Johns HopkinsNursing Evidence-Based Practice

Appendix E:Research Evidence Appraisal Tool

B. Is this asummary of multiple research studies? No

EvidenceAppraisal Form.

1. Does it employa comprehensive search strategy and rigorous appraisal method

(SystematicReview)Yes

a. Does itcombine and analyze results from the studies to generate a new

statistic (effectsize)? No.

b. Does itanalyze and synthesize concepts from qualitative studies?

Yes.

If Yes toeither a or b, go to #2B below.

2. For SystematicReviews and Systematic Reviews with meta-analysis or metasynthesis:

a. Are allstudies included RCTs?

b. Are thestudies a combination of RCTs and quasi-experimental or

quasi-experimentalonly?

c. Are thestudies a combination of RCTs, quasi-experimental and

non-experimentalor non-experimental only?

d. Are any or allof the included studies qualitative?

COMPLETE THENEXT SECTION, STUDY FINDINGS THAT HELP YOUANSWER

THE EBPQUESTION”

It is evident that a significant percentage of nurses are comfortablewith the issue of disclosure of errors but none is willing to complybecause of the repercussions that are likely to ensue. It begs theneed to establish systems within the hospital that enables the staffto disclose such errors without being victimized.

 LEVEL I

 LEVEL II

 LEVEL IIl

* LEVEL IIl

Yes

Yes

Yes

Yes

No

No

No

No

STUDY FINDINGSTHAT HELP YOU ANSWER THE EBP QUESTION:

NOW COMPLETETHE FOLLOWING PAGE, “QUALITY APPRAISAL OF RESEARCH STUDIES”, ANDASSIGN A

QUALITY SCORETO YOUR ARTICLE

Johns HopkinsNursing Evidence-Based Practice

Appendix E:Research Evidence Appraisal Tool

QualityAppraisal of Research Studies

 Does theresearcher identify what is known and not known about the problem andhow the

study willaddress any gaps in knowledge? Yes

 Was thepurpose of the study clearly presented? Yes

 Was theliterature review current (most sources within last 5 years orclassic)? Yes.

 Was samplesize sufficient based on study design and rationale? No

 If there is acontrol group:

o Were thecharacteristics and/or demographics similar in both the control and

interventiongroups?

o If multiplesettings were used, were the settings similar?

o Were all groupsequally treated except for the intervention group(s)?

 Are datacollection methods described clearly? Yes

 Were theinstruments reliable (Cronbach`s α [alpha] &gt 0.70)? Yes

 Wasinstrument validity discussed? No

 Ifsurveys/questionnaires were used, was the response rate &gt 25%?Yes

 Were theresults presented clearly? Yes

 If tableswere presented, was the narrative consistent with the table content?Yes

 Were studylimitations identified and addressed? Yes

 Wereconclusions based on results? Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

NA

NA

NA

NA

NA

NA

NA

QualityAppraisal of Systematic Review with or without Meta-Analysis orMeta-Synthesis

 Was thepurpose of the systematic review clearly stated?

 Were reportscomprehensive, with reproducible search strategy?

o Key searchterms stated

o Multipledatabases searched and identified

o Inclusion andexclusion criteria stated

 Was there aflow diagram showing the number of studies eliminated at each levelof

review?

 Were detailsof included studies presented (design, sample, methods, results,outcomes,

strengths andlimitations)?

 Were methodsfor appraising the strength of evidence (level and quality)described?

 Wereconclusions based on results?

o Results wereinterpreted

o Conclusionsflowed logically from the interpretation and systematic reviewquestion

 Did thesystematic review include both a section addressing limitations andhow they were

addressed?

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

No

No

No

No

No

No

QUALITY RATINGBASED ON QUALITY APPRAISAL

A Highquality: consistent, generalizable results sufficient samplesize for the study design adequate control definitive

conclusionsconsistent recommendations based on comprehensive literature reviewthat includes thorough reference

to scientificevidence

B Goodquality: reasonably consistent results sufficient sample sizefor the study design some control, and fairly

definitiveconclusions reasonably consistent recommendations based on fairlycomprehensive literature review that

includes somereference to scientific evidence

C Low qualityor major flaws: little evidence with inconsistent resultsinsufficient sample size for the study design

conclusionscannot be drawn