As future Nurse Practitioners (NPs), you will frequently rely on evidence-based practice (EBP) to inform clinical decisions, improve patient outcomes, and advance healthcare delivery. This assignment focuses on developing skills in critically appraising research literature by creating an "evidence grid" (also known as an evidence table or synthesis grid). An evidence grid is a structured tool that organizes key information from multiple studies, allowing for quick comparison and evaluation of evidence quality.
You will select a review paper (e.g., a systematic review or meta-analysis) or a professional clinical guideline relevant to NP practice. From this source, identify and analyze 10 cited research articles. For each article, evaluate its level of evidence using a standardized hierarchy, and compile your findings into a clear, tabular format. This exercise will enhance your ability to discern high-quality evidence, identify gaps in the literature, and apply EBP principles.
1. Locate and select a high-quality review paper or professional guideline in a topic area relevant to NP practice.
2. Identify and extract key research articles from the source.
3. Apply an evidence hierarchy to evaluate the level and quality of evidence in each article.
4. Organize findings into a professional evidence grid for synthesis and comparison.
5. Reflect on how the evaluated evidence could inform NP clinical decision-making.
Instructions
Step 1: Select Your Source Document
• Choose one review paper or professional guideline published within the last 5 years (2020–2025) that is relevant to NP practice. Examples of topics include chronic disease management (e.g., diabetes, hypertension), preventive care, mental health, or palliative care.
o Review Paper Options: Systematic reviews or meta-analyses from sources like Cochrane Database, PubMed, or Joanna Briggs Institute.
o Guideline Options: Clinical practice guidelines from organizations like the American Heart Association (AHA), American Diabetes Association (ADA), U.S. Preventive Services Task Force (USPSTF), or Agency for Healthcare Research and Quality (AHRQ).
• Ensure the source cites at least 10 primary research articles (e.g., RCTs, cohort studies) that you can access via your university library or open-access platforms.
• In your introduction, briefly describe the selected source (1 paragraph): Include the full citation, topic, purpose, and why it is relevant to NP practice.
Step 2: Choose 10 Research Articles
• From the references or included studies in your selected review paper/guideline, select 10 primary research articles. These should be original studies (not other reviews or editorials).
• Prioritize a mix of study designs if possible (e.g., RCTs, observational studies) to demonstrate variety in evidence levels.
• Ensure you can access the full text of each article for accurate evaluation.
Step 3: Evaluate the Level of Evidence
• For each article, determine its level of evidence using a recognized hierarchy. Recommended: Melnyk and Fineout-Overholt's Levels of Evidence for Nursing (2019), which is tailored to EBP in nursing:
o Level 1: Systematic reviews or meta-analyses of RCTs.
o Level 2: Single well-designed RCTs.
o Level 3: Well-designed controlled trials without randomization (quasi-experimental).
o Level 4: Well-designed case-control or cohort studies.
o Level 5: Systematic reviews of descriptive/qualitative studies.
o Level 6: Single descriptive or qualitative studies.
o Level 7: Expert opinions or reports from committees.
• Alternatively, you may use the Oxford Centre for Evidence-Based Medicine (OCEBM) levels if it better fits your topic—justify your choice in the introduction.
• Assess additional elements: Study design, sample size, strengths (e.g., large sample, rigorous methods), weaknesses (e.g., bias, small sample), and relevance to the guideline's recommendations.
Step 4: Create the Evidence Grid
• Compile your evaluations into a table (evidence grid). Use a word processor or spreadsheet tool to format it clearly.
• Required Columns (Minimum):
1. Article Citation: Full APA citation (author, year, title, journal).
2. Study Design: e.g., RCT, cohort study, qualitative.
3. Sample Size/Population: Number of participants and key demographics.
4. Key Findings: 1–2 sentence summary of main results.
5. Level of Evidence: Using the chosen hierarchy (e.g., Level 2).
6. Strengths: Bullet points (e.g., randomized, blinded).
7. Weaknesses/Limitations: Bullet points (e.g., selection bias, generalizability issues).
8. Relevance to NP Practice: How this evidence could inform clinical decisions (1–2 sentences).