Realtors rely on detailed property appraisalsconducted using appraisal toolsto assign market values to houses and other properties. These values ar
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
- Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
- Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
- Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
Resources:
- Schmidt, N. A. & Brown, J. M. (2025). Evidence-based practice for nurses: Appraisal and application of research (6th ed.). Jones & Bartlett Learning
- Chapter 13, “Quantitative Data Considerations” (pp. 397-445)
- Chapter 13 will help students understand descriptive and inferential statistics as well as population and sample statistics.
- Chapter 14, “What do the Qualitative Data Mean?” (pp. 446-471)
- Chapter 14 will help students understand how qualitative data is determined, evaluated and used in research and EBP.
- Chapter 15, “Appraising Evidence to Determine Best Practice” (pp 472-495)
- Chapter 15 will help students understand the importance of critically appraising evidence and using the ranking system based on the hierarchy of evidence.
- Chapter 13, “Quantitative Data Considerations” (pp. 397-445)
- Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of NursingLinks to an external site., 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c
- Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. American Journal of NursingLinks to an external site., 110(7), 47-52
- Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence.American Journal of NursingLinks to an external site., 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5
- Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses AssociationLinks to an external site., 15(3), 202–207. doi:10.1177/1078390309338733
Criteria Ratings Pts
Part 3A: Critical Appraisal of ResearchCritical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: · An Evaluation Table
45 pts
Part 3B: Evidence-Based Best PracticesEvidence- Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with the selected resources.
35 pts
45 to >40.0 pts Excellent The critical appraisal accurately and clearly provides a detailed evaluation table. …The responses provide a detailed, specific, and accurate evaluation of each of the peer- reviewed articles selected.
40 to >35.0 pts Good The critical appraisal accurately provides an evaluation table. …The responses provide an accurate evaluation of each of the peer- reviewed articles selected with some specificity.
35 to >31.0 pts Fair The critical appraisal provides an evaluation table that is inaccurate or vague. …The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.
31 to >0 pts Poor The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.
35 to >31.0 pts Excellent The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. …The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. …The responses provide a complete, detailed, and specific synthesis of the four peer reviewed articles.
31 to >27.0 pts Good The responses accurately suggest a best practice that is adequately aligned to the research reviewed. …The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. …The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained.
27 to >24.0 pts Fair The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. …The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. …The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained.
24 to >0 pts Poor The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. …The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field or are missing. …A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing.
7/2/25, 9:03 PM Module 4: Assignment
https://waldenu.instructure.com/courses/174419/assignments/2278310?module_item_id=6876425 2/4
Criteria Ratings Pts
Resource Synthesis
5 pts
Written Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused— neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.
5 pts
Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.
5 pts
5 to >4.0 pts Excellent The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.
4 to >3.0 pts Good The response integrates at least one outside resource and two or three course- specific resources that may support the responses provided.
3 to >2.0 pts Fair The response minimally integrates resources that may support the responses provided.
2 to >0 pts Poor The response fails to integrate any resources to support the responses provided.
5 to >4.0 pts Excellent Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.
4 to >3.0 pts Good Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.
3 to >2.0 pts Fair Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.
2 to >0 pts Poor Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. …No purpose statement, introduction, or conclusion is provided.
5 to >4.0 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts Good Contains a few (one or two) grammar, spelling, and punctuation errors.
3 to >2.0 pts Fair Contains several (three or four) grammar, spelling, and punctuation errors.
2 to >0 pts Poor Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the
7/2/25, 9:03 PM Module 4: Assignment
https://waldenu.instructure.com/courses/174419/assignments/2278310?module_item_id=6876425 3/4
Criteria Ratings Pts
Written Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in- text citations, and reference list.
5 pts
Total Points: 100
reader’s understanding.
5 to >4.0 pts Excellent Uses correct APA format with no errors.
4 to >3.0 pts Good Contains a few (one or two) APA format errors.
3 to >2.0 pts Fair Contains several (three or four) APA format errors.
2 to >0 pts Poor Contains many (five or more) APA format errors.
7/2/25, 9:03 PM Module 4: Assignment
https://waldenu.instructure.com/courses/174419/assignments/2278310?module_item_id=6876425 4/4
,[removed],
Evidence-Based Project: Pressure Injury Prevention in Immobile Elderly Patients
Dayana Suri
Walden University
NURS-6052
Dr. Connie Cooper
June 25th,2025
Clinical Issue of Interest
The topic of interest is pressure injury prevention in immobile elderly patients.
Pressure injuries (PIs) are localized skin/tissue damage due to prolonged pressure, common in immobile elderly due to limited mobility and fragile skin.
PIs increase morbidity and healthcare costs and reduce quality of life.
The project identifies effective PIs’ prevention strategies using evidence-based research.
Pressure ulcers (also called pressure injuries) are a serious problem in immobile elderly patients, who are at risk because of age-related skin fragility and impaired mobility. They are caused by prolonged pressure, shear, or friction, causing high morbidity, prolonged hospital stays, and healthcare expenses. They also lead to poor quality of life for patients, resulting in pain and complications. The clinical problem was selected because it is common in the clinical environment and it affects geriatric care. The goal is to determine evidence-based prevention measures that can be used to minimize the incidence of PI, including pressure-relieving devices.
2
PICOT Question Development
PICO(T) Question: In immobile elderly patients (P), how does the use of pressure-relieving devices (I) compared to standard care (C) affect the incidence of pressure injuries (O) over a 6-month period (T)?
Development Process:
Identified high PI incidence in clinical practice.
Reviewed literature to explore prevention methods.
Applied PICO(T) framework (Stillwell et al., 2010) to create a focused question.
Key terms: "immobile elderly," "pressure injury," "pressure-relieving devices."
The PICO(T) question was developed to guide the evidence-based inquiry. This focus was triggered by the high rate of pressure injuries experienced in immobile elderly patients within the clinical practice. A preliminary literature search has revealed prevention methods such as pressure-relieving devices. Based on the PICO(T) model proposed by Stillwell et al. (2010), I developed a specific, answerable question: How do pressure-relieving devices versus standard care differ in the incidence of pressure injuries in immobile elderly patients after six months? The main keywords were "immobile elderly," "pressure injury," and "pressure-relieving devices." This methodical process made the question specific and researchable, which is in line with the assignment that required the development of a narrow PICO(T) question to use in clinical research.
3
Research Databases
PubMed: Vast biomedical literature hub
CINAHL: Premier nursing research resource
Cochrane Library: Gold-standard systematic reviews
Embase: Extensive biomedical and pharmacological studies Strategy:
Used Boolean operators (AND, OR) per Library of Congress (n.d.)
Filtered for systematic reviews, peer-reviewed, last seven years
To find the most relevant evidence, I searched 4 databases: CINAHL, PubMed, Cochrane Library, and Embase. The Cochrane Library offers top-tier systematic reviews, and Embase spans broad biomedical research. My strategy leveraged Boolean operators (AND, OR), as recommended by the Library of Congress (n.d.), combining terms like “pressure injury” and “immobile elderly.” Filters for systematic reviews, peer-reviewed articles, and recent publications (last seven years) ensured high-quality evidence. This approach fulfills the assignment’s requirement to identify premier research databases for clinical inquiry with precision.
4
Peer-Reviewed Articles
Buh, A. W., Mahmoud, H., Chen, W., McInnes, M. D., & Fergusson, D. A. (2021). Effects of implementing Pressure Ulcer Prevention Practice Guidelines (PUPPG) in the prevention of pressure ulcers among hospitalised elderly patients: a systematic review protocol. BMJ Open, 11(3), e043042. https://doi.org/10.1136/bmjopen-2020-043042
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults. Cochrane Database of Systematic Reviews, (6), CD009958. https://doi.org/10.1002/14651858.CD009958.pub3
Moore, Z. E. H., & Patton, D. (2019). Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews, (1), CD006471. https://doi.org/10.1002/14651858.CD006471.pub4
Shi, C., Dumville, J. C., & Cullum, N. (2018). Support surfaces for pressure ulcer prevention: a network meta-analysis. PloS one, 13(2), e0192707. https://doi.org/10.1371/journal.pone.0192707
Four stellar peer-reviewed articles, all systematic reviews or protocols, anchor our pressure injury prevention research. Buh et al. (2021) outline guidelines for prevention in elderly patients. Moore and Patton (2019) assess risk tools. Gillespie et al. (2020) evaluate repositioning techniques, while Shi et al. (2021) analyze support surfaces via network meta-analysis. Cited in APA format with all authors listed, these sources meet the rubric’s standards. As Level I evidence, they deliver robust frameworks. Selected for their alignment with our PICO(T) question, these articles fulfill the assignment’s call for high-level evidence and precise citations, driving impactful research for pressure injury prevention.
5
Levels of Evidence
All articles are top-tier Level I
Buh et al. (2021): Planned systematic review of prevention guidelines
Moore & Patton (2019): Leveraged Cochrane rigor for risk tools
Gillespie et al. (2020): Assessed repositioning with large sample size
Shi et al. (2021): Compared support surfaces via network meta-analysis
The four articles are all Level I evidence, the gold standard of synthesizing or planning high-quality studies. Buh et al. (2021) present a systematic review of the guidelines on pressure ulcer prevention, which can serve as a strong structure. Moore and Patton (2019) use a stringent approach of Cochrane to risk assessment tools. The study by Gillespie et al. (2020) is based on a large sample size that enhances generalizability used in repositioning research. Shi et al. (2021) use network meta-analysis to compare support surfaces, which allows multi-intervention knowledge. These strengths guarantee objective, strong results, as illustrated by Schmidt and Brown (2025).
6
Strengths of Systematic Reviews
Advantages:
Synthesize data from multiple RCTs, increasing reliability (Level I evidence).
Reduce bias through transparent methodology.
Example: Beeckman et al. (2020) found foam mattresses reduce PI incidence.
Clinical Impact: Inform evidence-based prevention strategies.
Limitations Addressed: Comprehensive inclusion criteria ensure robust findings.
Systematic reviews, classified as Level I evidence, are highly reliable due to their synthesis of multiple randomized controlled trials, as explained by Schmidt and Brown (2025). Their transparent methodology minimizes bias, ensuring trustworthy results. For example, Beeckman et al. (2020) found that high-specification foam mattresses significantly reduce pressure injury incidence, guiding clinical practice. These reviews have a strong clinical impact by identifying effective prevention strategies, such as optimal support surfaces. Comprehensive inclusion criteria and rigorous protocols address limitations, enhancing validity. This slide fulfills the assignment’s requirement to explain the strengths of systematic reviews, highlighting their role in evidence-based practice for pressure injury prevention in immobile elderly patients.
7
References
Buh, A. W., Mahmoud, H., Chen, W., McInnes, M. D., & Fergusson, D. A. (2021). Effects of implementing Pressure Ulcer Prevention Practice Guidelines (PUPPG) in the prevention of pressure ulcers among hospitalised elderly patients: a systematic review protocol. BMJ Open, 11(3), e043042. https://doi.org/10.1136/bmjopen-2020-043042
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults. Cochrane Database of Systematic Reviews, (6), CD009958.
https://doi.org/10.1002/14651858.CD009958.pub3
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. https://catalog.loc.gov
References (Cont.’)
Moore, Z. E. H., & Patton, D. (2019). Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews, (1), CD006471. https://doi.org/10.1002/14651858.CD006471.pub4
Schmidt, N. A., & Brown, J. M. (2025). Evidence-based practice for nurses: Appraisal and application of research (6th ed.). Jones & Bartlett Learning.
Shi, C., Dumville, J. C., & Cullum, N. (2021). Support surfaces for pressure ulcer prevention: A network meta-analysis. PLoS One, 16(2), e0247031. https://doi.org/10.1371/journal.pone.0247031
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. https://doi.org/10.1097/01.NAJ.0000368959.11129.79
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