Posted: June 13th, 2022

Lit Review

Lit review, Lit appraisal, Evidence (Evaluation) Table/Matrix
ATTACHED FILE(S)
Developing a Clinical Question and Selecting a Framework
Nursing research and evidence-based practice are generated from clinical problems identified in practice, often in search of a solution to the problem. Once a problem is selected, practice in asking and writing the right question about the problem is needed. Distinguishing between a background and a foreground question is the first step in this process. In general, nurses with less experience begin with a background question, but as experience increases, foreground questions become prominent. A focused foreground question in a Population, Intervention, Comparison, Outcome and Time (PICOT) framework provides the components of an answerable, searchable question. The language used in the question represents the purpose of the question. For example, research questions generally have a directional outcome. (i.e., to reduce or improve); clinical questions gather the evidence related to an outcome (i.e., who, what, and where); and quality improvement questions are focused on processes influencing the outcomes (i.e., why) (Fineout-Overholt & Stillwell, 2019). Once a clinical question is drafted, a literature search is conducted using key search terms, and a framework or model from which to develop a method for answering the question should follow.
As a doctorally prepared nurse, the ability to understand how to ask the clinical question, search the literature, appraise the information obtained, and organize it is imperative. The purpose of this course module is to practice building the skill for these critical features. This module is an exercise in asking an answerable, searchable question for study, performing a scholarly literature search, appraising the publications selected and creating an organized evidence (evaluation) table for easy reference when drafting the introduction and literature review for a clinical scholarship project. An evidence-based framework or model will also be selected to guide the draft of the clinical scholarship project.
Module Objectives
At the end of this learning module, the student will be able to:
· Identify a clinical problem of interest.
· Create a study question about the clinical problem.
· Perform a literature search to answer the study question.
· Appraise the factors impeding and facilitating the adoption of the evidence.
· Develop an evidence (evaluation) table or matrix highlighting the attributes and limitations of the literature selected from a scholarly literature search.
· Select an evidence-based practice framework or model from which to build a clinical scholarship project.
Assignments
Literature Search(25 points)
Directions:Identify a clinical issue or problem. Develop a study question to answer the question. Perform a literature search (consider working with a librarian on this).
Complete the following items on the word document (.docx) provided in the module(download the document, complete it, then upload into the assignment area).
Name(1 point deducted if missing)
Date(1 point deducted if missing)
Clinical Issue or Problem (3points) (e.g., there is a high number of pediatric needlesticks in an Emergency Department)
Problem Statement(3points) (e.g., the average number of needlesticks for children in an Emergency Department is 2.2 needlesticks per visit [author & author, 2021)
Study Question(5points)
· PICO(T) format (e.g., Melnyk & Fineout-Overholt, 2019, Appendix A, pp. 706-7)
Key Search Terms(5points) (include Boolean operators)
Search Engines Used(3points) (e.g., PubMed, CINAHL, etc.)
Number of Initial PublicationsGenerated(2points) (matching the search terms and phrases)
Refined Search: Inclusion and Exclusion Criteria(2points)
Number of Publications Generated and Number Selected the Literature Review(2points)
Literature Appraisal(25 points)
Directions: Select a research publication (not an evidence-based practice guideline) from the literature search to critically appraise.
Complete the following items on the word document (.docx) provided in the module(download the document, complete it, then upload into the assignment area). (adapted from Polit & Beck, 2017, p. 100).
Evidence (Evaluation) Table/Matrix(100 points)
Directions:The evidence table/matrix should include all studies which will be included in the draft of the introduction and literature review for the clinical scholarship project due at the end of the semester.At least10 studies should be included and in alphabetical order according to the author.Complete the following items on the word document (.docx) provided in the module(download the document, complete it, then upload into the assignment area).(adapted from Melnyk & Fineout-Overholt, 2019, p. 724). Each section is worth 10 points (10 sections x 10 points = 100 points)
Evidence Table/Matrix
(100 points)
Directions:The evidence table/matrix should include all studies which will be included in the draft of the introduction and literature review for the clinical scholarship project due at the end of the semester.At least 10 studies should be included and in alphabetical order according to author. Complete the following items on the word document (.docx) provided in the module (download the document, complete it, then upload into the assignment area).Or, copy and paste the assignment (below) into your own word document (.docx), then upload it into the assignment area. (adapted from Melnyk & Fineout-Overholt, 2019, p. 724).Each section is worth 10 points (10 sections x 10 points = 100 points). DO NOT ALTER THIS DOCUMENT (a 5-point deduction will occur)
Name (-1 point if missing):
Academic Program & Population of Focus (-1 point if missing; e.g., BSN-DNP, Pediatric Primary Care):

Citation (in APA)

Purpose of the Study

Framework/
Theory

Design/
Method

Setting/
Sample

Major Variables

Outcome Measures

Statistical Analysis

Findings

Strengths/Limitations/
Recommendations

Literature Search
(25 points)
Directions:Identify a clinical issue or problem.Develop a study question to answer the question.Perform a literature search (consider working with a librarian on this).Complete the following items on the word document (.docx) provided in the module (download the document, complete it, then upload into the assignment area).Or, copy and paste the assignment (below) into your own word document (.docx), then upload it into the assignment area. DO NOT ALTER THIS DOCUMENT (a 5-point deduction will occur)
Name (-1 point if missing):
Academic Program & Population of Focus (-1 point if missing; e.g., BSN-DNP, Pediatric Primary Care):
Clinical Issue or Problem (3 points) (e.g., there is a high number of pediatric needlesticks in an Emergency Department)
Problem Statement (3 points) (e.g., the average number of needlesticks for children in an Emergency Department is 2.2 needlesticks per visit [author & author, 2019])
Study Question (5 points)
· PICO(T) format (e.g., Melnyk & Fineout-Overholt, 2019, Appendix A, pp. 706-7)
Key Search Terms (5 points) (include Boolean operators)
Search Engines Used (5 points) (e.g., PubMed, CINAHL, etc.)
Number of Initial Publications Generated (1 point) (matching the search terms and phrases)
Refined Search:Inclusion and Exclusion Criteria (2 points)
Number of Publications Generated and Number Selected the Literature Review (1 point)
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Literature Appraisal
(25 points)
Directions:Select a research publication (not an evidence-based practice guideline) from the literature search to critically appraise. Complete the following items on the word document (.docx) provided in the module (download the document, complete it, then upload into the assignment area).Or, copy and paste the assignment (below) into your own word document (.docx), then upload it into the assignment area. (adapted from Polit & Beck, 2017, p. 100). DO NOT ALTER THIS DOCUMENT (a 5-point deduction will occur).

Name (-1 point if missing)

Academic Program & Population of Focus (-1 point if missing)

APPRAISAL

APA Citation (3 points)

Purpose of the Study (1 point)

Type of Study
(1 point)

Quantitative
Qualitative
Mixed Methods
Meta Analysis
Systematic Review
Other:
Any Specifics?
Cross-sectional
Longitudinal
Phenomenology
Other:

Setting (1 point)

Intervention (1 point)

Variables (1 point)

Independent Variables:
Dependent Variables:
Controlled Variables:
Other:

Framework/Theory
(1 point) (If none, state none)

Design (1 point)

Experimental
Randomized Control Trial
Factorial Design
Quasi-Experimental
Non-Experimental
Descriptive
Survey
Correlational
Other:

Sample (1 point)

Population:
Number in Sample:
Sampling Method:
Generalizable?YesNo

Data Sources
(1 point)

Self-Report/Survey
Observational
Retrospective
Prospective
Other:

Outcome Measures
(1 point)
(what data was collected?)

Statistical Analysis
(1 point)

Bivariate (e.g., t-test, ANOVA, Pearson’s r):
Multivariate (e.g., multiple regression, logistic regression):
Other:

Effect size (if provided) and/or p values (if provided) (1 point)

Findings/Themes
(2 point)

Results Valid or Reliable? (2 point) (Explain)

Conclusions (2 points)

Strengths (2 points)

Limitations (2 points)

5/15/22
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Literature Reviews
Laura L. Kuensting, DNP, APRN,
PCNS-BC, CPNP, CPEN
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Types of
Literature
Reviews
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Systematic Review
Meta-Analyses
Qualitative Review
Integrative Review ✓
• Each has a distinct purpose, sampling
frame, definition, and method for analysis
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Review Methods
Systematic Review
• Com bine evidence fromm ultiple studies about
a specific clinical problem
• Clear study question, explicit m ethod, and
com prehensive search for prim ary research
• Includes statistical m ethods of a m eta-
analysis
• M ethod of choice for evidence-based practice
(EBP) initiatives (e.g., Cochrane
Collaboration)
Meta-Analysis Review
• Com bines results of m ultiple prim ary studies
using statistical m ethods
• Enhances objectivity and validity of
findings
• Each study is coded and entered in a
quantitative database
• Effect size is calculated
• Adjustm ents for sam ple size and study quality
can be included
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3
Review Methods (cont’d)
Qualitative Review
• Meta-synthesis, meta-studies,
formal grounded theory, and
meta-ethnography methods
synthesize findings into a new
theory or framework about a
phenomena
• Differing approaches in
analysis and interpretation
• Potentially broaden the
generalizability of the
qualitative research
Integrative Review ✓
• Broadest type of review
• Many purposes: define concepts, review theories, review
evidence, analyze methods
• Combines theoretical and empirical literature
• Results in a comprehensive portrayal of complex
concepts, theories, or health care problems
• Bias and error can occur
• Examples:literature search may be incomplete or
without primary sources, or data may be inaccurately
interpreted
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What is an Integrativereview?
• A review method summarizing past
empirical or theoretical literature for a more
comprehensive understanding of a
particular phenomenon or healthcare
problem (W hittem ore &K nafle, 2005)
• Allows for diverse methodologies (i.e.,
experimental and nonexperimental
research)
• Allows for varied perspectives (e.g.,
nursing science, social science, etc.)
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Rigour
Research reviews are
considered research of research
(G a n o n g , 1 9 8 7 ; C o p p e r, 1 9 9 8a sc ite dinW h itte m o re&K n a fle , 2 0 0 5 )
G E N E R A L P R O C E S S
1. Identify a problem
2. P erforma w ell-defined literature search (prim ary
studies and publications)
3. E valuate/A ppraise the literature
4. A nalyze the data (com pare/contrast the findings)
5. O rganize the findings
6. P resent the findings
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Whittemore and Knafle
(2005)
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Hour-Glass Approach
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Introduction (Background &
Significance): Begin broad
then narrow the focus
Stemof the paper: Focused
Literature Review
Sum m ary (of key findings):
Begin focused but end
broad
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5/15/22
3
Integrative
Review
Components
9
INTRODUCTION (2-3 pages)
• Begin broad, with background information: set the stage for why this is a problem,
then identify the problem in a problem statement as the focus narrows
Description of the problem
Describe the significance of the problem
• Purpose of the literature review
• EBP framework or model identified (not explained) to guide the review
• Study (Review) question(s) stated in a PICO(T) format, preferably open-ended
• Brief description of content concepts to be addressed and how the review will be
organized
Last paragraph of this section should be focused and include:
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Integrative Review
Components (cont’d)
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LIT E R AT U R ER E V IE W (5 -7PA G ES ) B e g inw ithap a ra g ra p hd e scrib in gth e
lite ratu rese a rchp ro ce ss:
Search engines used (at least three engines)
Key search terms and phrases (including
Boolean operators)
Number of initial publications generated
Refined search with inclusion and exclusion
criteria
Number of publications generated after refined
search
Any other search methods (such as an ancestry
method) and number of publications generated
Final number of publications selected for the
literature review
10
Integrative Review
Components (cont’d)
LITERATURE REVIEW (cont’d)
• EBP, conceptual, or theoretical framework or model
described
• Provide an in-depth analysis of the current literature and
EBP related to the problem
• Key concepts, themes, similarities, differences,
strengths, and weaknesses dispersed throughout the
review
• Use transitions between concepts or themes
• Use literature appraisals and evidence table/matrix
• Identify any gaps (lack of published work on a concept
or theme)
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Elements of Data Analysis
• Note patterns and themes
• Seeing plausibility
• Clustering
• Counting
• Making findings as intervening factors
• Building a logical chain of evidence
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(Whittemore & Knafle, 2005)
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5/15/22
4
Integrative
Review
Components
(cont’d)
LITERATURE REVIEW (cont’d)
• End with a paragraph (or two)
summarizing key findings (from
each concept) of the literature
review
• Any gaps in the literature
reiterated, strengths and
limitations of the review
• Recommendations for future
research
• Generalization of the
importance of the topic on
nursing practice (broad ending)
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Summary
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Errors may occur due to inadequate literature
searches, inaccurate data interpretation, and
implicit bias
Results in identification of trends, themes, etc.,
on a focused topic or theme
Integrative reviews are literature reviews utilizing:
Va ryin gd iscip lin estu d ie s (e .g ., so cia l
scie n ce s, m e d ica l scie n ce s,
p sych o lo g ica l scie n ce s, etc.)
Va ryin gstu d y d e sig n s (e .g ., ra n d o m ize d
co ntro l tria ls, o b se rvatio n a l, q u a litative ,
etc.)
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Reference
Whittemore, R., & Knafl, K. (2005). The integrative review: updated
methodology. Journal of Advanced Nursing, 52(5), 546-553.
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