The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decis
The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
To Prepare:
- Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
- Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
- Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)
Part 4: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:
- Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
- Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
- Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
- Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
- Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
- Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
- Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
- Add a lessons learned section that includes the following:
- A summary of the critical appraisal of the peer-reviewed articles you previously submitted
- An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
Weekly Resources
- Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision makingLinks to an external site.. Journal of the American Medical Association, 312 (13), 1295–1296. doi:10.1001/jama.2014.10186
- Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statementLinks to an external site.. Critical Care Medicine, 44 (1), 188–201. doi:10.1097/CCM.0000000000001396
- Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practiceLinks to an external site.. Journal for Nurses in Professional Development, 32 (4), 176–184. doi:10.1097/NND.0000000000000483
- Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision makingLinks to an external site.. Health Expectations, 17 (1), 27–35. doi:10.1111/j.1369-7625.2011.00730.xThe Ottawa Hospital Research Institute. (2019). Patient decision aidsLinks to an external site.. https://decisionaid.ohri.ca/
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Part 3B: Critical Appraisal of Research
Student’s Name
Institution
Course
Instructor
Date
Best Practice Proposal
Based on the critical appraisal of the four articles, a best practice that emerges is the implementation of standardized structured handover protocols in healthcare settings to improve patient safety and communication. This practice is supported by evidence across all reviewed studies, demonstrating consistent benefits in reducing errors and enhancing care continuity.
The systematic review by Bukoh and Siah (2020) provides Level I evidence showing that structured handover interventions significantly improve patient safety outcomes. The pilot study by Nasiri et al. (2021) includes Level II evidence, demonstrating that handover checklists enhance communication effectiveness and team satisfaction in high-stakes environments, such as operating rooms. Toren et al. (2022) present Level II evidence from a national project, demonstrating that the large-scale implementation of structured handoffs reduces patient safety incidents across multiple hospitals, thereby proving the feasibility and effectiveness of this approach. Burgener's (2020) Level III conceptual review emphasizes that effective communication strategies, including structured handovers, are foundational to patient safety and satisfaction.
Standardized handover protocols address communication gaps, reduce errors, and enhance team dynamics, as evidenced by both quantitative and qualitative findings. The scalability demonstrated in the national project supports adoption across diverse healthcare settings. Implementation should include developing handover checklists tailored to specific clinical areas, training staff on structured protocols, monitoring compliance, and regularly evaluating outcomes such as error rates and staff feedback.
This best practice aligns with the Johns Hopkins evidence hierarchy, combining high-level evidence from systematic reviews with practical applications from pilot and national studies. By adopting structured handovers, healthcare organizations can enhance patient safety and operational efficiency while addressing ethical considerations such as patient privacy through structured frameworks.
References
Bukoh, M. X., & Siah, C. J. R. (2020). A systematic review on the structured handover interventions between nurses in improving patient safety outcomes. Journal of Nursing Management, 28(3), 744-755.
Burgener, A. M. (2020). Enhancing communication to improve patient safety and to increase patient satisfaction. The Health Care Manager, 39(3), 128-132.
Nasiri, E., Lotfi, M., Mahdavinoor, S. M. M., & Rafiei, M. H. (2021). The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study. Patient Safety in Surgery, 15, 1-9.
Toren, O., Lipschuetz, M., Lehmann, A., Regev, G., & Arad, D. (2022). Improving patient safety in general hospitals using structured handoffs: outcomes from a national project. Frontiers in Public Health, 10, 777678.
,
Critical Appraisal Tool Worksheet Template
Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical Appraisal of Research
|
Full APA formatted citation of selected article. |
Article #1 |
Article #2 |
Article #3 |
Article #4 |
|
Bukoh, M. X., & Siah, C. J. R. (2020). A systematic review of structured handover interventions between nurses in improving patient safety outcomes. Journal of Nursing Management, 28(3), 744-755. |
Nasiri, E., Lotfi, M., Mahdavinoor, S. M. M., & Rafiei, M. H. (2021). The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study. Patient Safety in Surgery, 15, 1-9. |
Toren, O., Lipschuetz, M., Lehmann, A., Regev, G., & Arad, D. (2022). Improving patient safety in general hospitals using structured handoffs: outcomes from a national project. Frontiers in Public Health, 10, 777678. |
Burgener, A. M. (2020). Enhancing communication to improve patient safety and increase patient satisfaction. The Health Care Manager, 39(3), 128-132. |
|
|
Evidence Level (I, II, or III) |
I (Systematic Review) |
II (Pilot Study) |
II (Quasi-Experimental) |
III (Conceptual/Review Article) |
|
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here). |
The study synthesizes existing evidence on structured handover interventions. |
The study focuses on the practical implementation of a handover checklist. |
The study evaluates a national project on structured handoffs. |
The article reviews communication strategies in healthcare. |
|
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
Systematic review of literature. Included studies were identified, appraised, and synthesized. |
Quantitative pilot study. Data collected via surveys, checklists, and incident reports before and after checklist implementation. |
Quasi-experimental design. Large-scale implementation of structured handoffs across multiple hospitals with pre-post data collection. |
Conceptual/review article. Synthesizes existing literature and expert opinions. |
|
Sample/Setting The number and characteristics of patients, attrition rate, etc. |
Multiple studies included in the review focused on nursing handovers in various healthcare settings. |
Intraoperative staff in a hospital setting. Sample size not specified. Attrition rate not applicable. |
General hospitals across the nation. Large sample size due to national scope. Attrition rate not specified. |
Not applicable (review article). |
|
Major Variables Studied List and define dependent and independent variables |
Independent: Structured handover interventions. Dependent: Patient safety outcomes. |
Independent: Handover checklist. Dependent: Communication effectiveness, OR team satisfaction, patient safety indicators. |
Independent: Structured handoff protocols. Dependent: Patient safety indicators. |
Independent: Communication strategies. Dependent: Patient safety and satisfaction. |
|
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done). |
Synthesis of findings from included studies. No primary statistics. |
Surveys, checklists, and incident reports. Statistical comparison of pre- and post-intervention data. |
Patient safety indicators (e.g., error rates). Statistical analysis of pre- and post-intervention data. |
No primary data collection. Analysis of existing literature. |
|
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data). |
Qualitative synthesis of evidence. No numerical results reported. |
Descriptive and inferential statistics (e.g., mean, standard deviation, t-tests). |
Descriptive and inferential statistics (e.g., error rates, statistical significance). |
Qualitative synthesis of themes and best practices. |
|
Findings and Recommendations General findings and recommendations of the research |
Structured handovers improve patient safety. Recommendations include standardized protocols and further high-quality studies. |
Checklist improved communication and satisfaction. Recommendations include larger-scale studies. |
Structured handoffs reduced errors. Recommendations include nationwide adoption. |
Effective communication improves safety and satisfaction. Recommendations include staff training. |
|
Appraisal and Study Quality Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice? |
High-quality synthesis but limited by heterogeneity of included studies. Valuable for overview. |
Preliminary findings with small sample size. Provides practical insights but requires further validation. |
Strong due to large-scale implementation but lacks randomization. Valuable for policy. |
Lacks empirical data but useful for conceptual understanding. |
|
Key findings |
Structured handovers reduce errors and improve care continuity. |
Checklists enhance communication and team satisfaction. |
Structured handoffs significantly improve patient safety. |
Communication is critical for safety and satisfaction. |
|
Outcomes |
Improved patient safety outcomes. |
Enhanced communication and team dynamics. |
Reduced error rates in hospitals. |
Better patient and staff satisfaction. |
|
General Notes/Comments |
Foundational for understanding handover interventions. |
Highlights the utility of checklists in high-stakes environments. |
Demonstrates scalability of structured handoffs. |
Emphasizes the broader impact of communication. |
*Refer to the Johns Hopkins Evidence-Based Practice Model for Nursing and HealthcarePprofessionals, Hierarchy of Evidence Guide on the following page
**Note on Conceptual Framework
· The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link https://academicguides.waldenu.edu/library/conceptualframework
· Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
· As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
· Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
· Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
References
The Johns Hopkins Hospital/Johns Hopkins School of Nursing (2022). Johns Hopkins evidence-based practice for nursing and healthcare professionals: appendix D: Hierarchy of Evidence Guide
Grant, C., & Osanloo, A. (2014). Understanding, selecting, and integrating a theoretical framework in dissertation research: Creating the blueprint for your house. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.
Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. https://academicguides.waldenu.edu/library/conceptualframework
Best Practice Proposal
Based on the critical appraisal of the four articles, the best practice that emerges is the implementation of standardized structured handover protocols in healthcare settings to improve patient safety and communication. This practice is supported by evidence across all reviewed studies, demonstrating consistent benefits in reducing errors and enhancing care continuity.
The systematic review by Bukoh and Siah (2020) provides Level I evidence showing that structured handover interventions significantly improve patient safety outcomes. The pilot study by Nasiri et al. (2021) includes Level II evidence, demonstrating that handover checklists enhance communication effectiveness and team satisfaction in high-stakes environments, such as operating rooms. Toren et al. (2022) present Level II evidence from a national project, demonstrating that the large-scale implementation of structured handoffs reduces patient safety incidents across multiple hospitals, thereby proving the feasibility and effectiveness of this approach. Burgener's (2020) Level III conceptual review emphasizes that effective communication strategies, including structured handovers, are foundational to patient safety and satisfaction.
Standardized handover protocols address communication gaps, reduce errors, and enhance team dynamics, as evidenced by both quantitative and qualitative findings. The scalability demonstrated in the national project supports adoption across diverse healthcare settings. Implementation should include developing handover checklists tailored to specific clinical areas, training staff on structured protocols, monitoring compliance, and regularly evaluating outcomes such as error rates and staff feedback.
This best practice aligns with the Johns Hopkins evidence hierarchy, combining high-level evidence from systematic reviews with practical applications from pilot and national studies. By adopting structured handovers, healthcare organizations can enhance patient safety and operational efficiency while addressing ethical considerations such as patient privacy through structured frameworks.
References
Bukoh, M. X., & Siah, C. J. R. (2020). A systematic review on the structured handover interventions between nurses in improving patient safety outcomes. Journal of Nursing Management, 28(3), 744-755.
Burgener, A. M. (2020). Enhancing communication to improve patient safety and to increase patient satisfaction. The Health Care Manager, 39(3), 128-132.
Nasiri, E., Lotfi, M., Mahdavinoor, S. M. M., & Rafiei, M. H. (2021). The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study. Patient Safety in Surgery, 15, 1-9.
Toren, O., Lipschuetz, M., Lehmann, A., Regev, G., & Arad, D. (2022). Improving patient safety in general hospitals using structured handoffs: outcomes from a national project. Frontiers in Public Health, 10, 777678.
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