NURS-6052 Critical Appraisal of Research 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
Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2018). The effect of aloe vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: A randomized triple-blind clinical trial. BMC Complementary and Alternative Medicine, 18(1), 1-11.  https://doi.org/10.1186/s12906-018-2326-2

Article #2
Alshahrani, B., Sim, J., & Middleton, R. (2021). Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. Journal of Clinical Nursing, 30(15-16), 2151-2168.  https://doi.org/10.1111/jocn.15709

Article #3
Fulbrook, P., Mbuzi, V., & Miles, S. (2021). Incidence and prevalence of pressure injury in adult cardiac patients admitted to intensive care: A systematic review and meta-analysis. International Journal of Nursing Studies, 114, 103826. https://doi.org/10.1016/j.ijnurstu.2020.103826

Article #4
Lovegrove, J., Fulbrook, P., Miles, S., & Steele, M. (2022). Effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings: A systematic review and meta-analysis of randomized controlled trials. Australian Critical Care, 35(2), 186-203. https://doi.org/10.1016/j.ijnurstu.2021.104027

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Evidence Level:

The level of evidence for Article #1 is Level II (Randomized Controlled Trial) (The John Hopkins Hospital, n.d.).

The level of evidence for Article #2 is Level I (Systematic Review) (The John Hopkins Hospital, n.d.).

The level of evidence for Article #3 is Level I (Systematic Review and Meta-Analysis) (The John Hopkins Hospital, n.d.).

The level of evidence for Article #4 is Level I (Systematic Review and Meta-Analysis) (The John Hopkins Hospital, n.d.).

Conceptual Framework:

The theoretical basis of Article #1 suggests that Aloe Vera gel may effectively prevent pressure ulcers due to its therapeutic properties, including inflammation reduction, pain relief, and wound healing improvement. The gel is thought to help maintain normal skin temperature, thereby reducing the risk of skin breakdown.

The theoretical basis for Article #2 is rooted in evidence-based practice (EBP), aiming to integrate the best available evidence, clinical expertise, and patient values to identify effective nursing interventions for pressure injury prevention among critically ill patients.

The theoretical basis for Article #3 is the recognition that pressure injuries are common and preventable adverse events in healthcare settings, with a focus on cardiac patients in intensive care.

The basis of Article #4 is grounded in evidence-based practice, emphasizing the importance of the most up-to-date evidence, healthcare professionals’ expertise, and patient values in preventing pressure injuries in adults admitted to acute care settings.

Design/Method:

Article #1: A randomized, triple-blind clinical trial with 80 participants selected from an orthopedic ward in Arak town in 2016. Participants were purposefully chosen and randomly assigned to intervention and control groups. Aloe Vera gel was applied twice a day to the intervention group, along with routine preventive care. The control group received a placebo gel. Evaluations were conducted on days 3, 7, and 10 to assess pressure ulcer development.

Article #2: A systematic review of literature guided by PRISMA and SWIM. Inclusion criteria focused on nursing interventions for pressure injury prevention among critically ill patients, excluding reviews and unrelated studies.

Article #3: A systematic review and meta-analysis examining the incidence and prevalence of pressure injuries in adult cardiac patients admitted to intensive care. Fifteen studies meeting inclusion criteria were identified.

Article #4: A systematic review and meta-analysis of randomized controlled trials assessing interventions’ effectiveness in preventing pressure injuries in adults admitted to acute care facilities. The search included 2000 records, and meta-analyses were conducted when interventions were similar.

Sample/Setting:

Article #1: 80 purposefully selected patients from an orthopedic ward in Arak town with a mean age of 42.34 ± 12.19 years. Attrition rate reported was 3.75%.

Article #2: The sample comprised 14 studies examining nursing interventions for pressure injury prevention among critically ill patients, with a total sample size not specified.

Article #3: The study included 15 studies, with an overall sample size of 6371. Attrition rate was 6.7%.

Article #4: The systematic review involved 45 studies selected from 2000 records, with no reported attrition rate.

Major Variables Studied:

Article #1:
– Dependent Variable: The occurrence of pressure ulcers
– Independent Variable: The application of Aloe Vera gel

Article #2:
– Dependent Variable: Pressure Injury Prevention
– Independent Variable: Nursing Interventions

Article #3:
– Dependent Variable: Pressure injury (incidence and prevalence)
– Independent Variable: Adult cardiac patients admitted to intensive care

Article #4:
– Dependent Variable: Pressure Injury Incidence
– Independent Variable: Intervention type

Measurement:

Article #1: Descriptive statistics, Chi-square tests, F-tests, and ANOVA were used.

Article #2: The primary statistic was the incidence of pressure ulcers.

Article #3: Descriptive statistics were used, and the study did not specify primary statistics.

Article #4: Primary statistics included risk ratio, p-value (p), and I-squared (I2).

Data Analysis Statistical or Qualitative Findings:

Article #1: The incidence of pressure ulcers was significantly different between groups (P = 0.047). The intervention group using Aloe Vera gel had a lower incidence than the control group.

Article #2: All included studies reported a decline in pressure injuries following interventions.

Article #3: The cumulative incidence of pressure injury in adult cardiac patients in intensive care varied, with significant heterogeneity observed between studies.

Article #4: Only Australian medical sheepskin surfaces were found to be effective in reducing pressure injury incidence. Support surfaces and heel protection devices also showed significant effects.

Findings and Recommendations:

Article #1: Aloe Vera gel is recommended to prevent pressure ulcers, though larger studies are needed to confirm results. Risks include potential skin irritation, allergic reactions, and infection.

Article #2: Effective nursing interventions for pressure injury prevention include bundles, repositioning, surface support, and access to expertise.

Article #3: Incidence of pressure injuries in adult cardiac patients in intensive care is similar to general intensive care, with further consistent studies recommended.

Article #4: Recommendations include larger, better-quality trials to establish the effectiveness of pressure injury preventative interventions in acute hospital settings.

Appraisal and Study Quality:

Article #1: Small sample size, potential for skin-related side effects.

Article #2: Valuable insight but moderate to very low overall evidence strength.

Article #3: Quality evidence, systematic review, and meta-analysis with large sample size. Data reported variably.

Article #4: Trials had unclear or high risk-of-bias, heterogeneity across trials, and trial outcomes. Larger, high-quality trials recommended.

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Key Findings:

Article #1: Aloe Vera gel can help prevent pressure ulcers.

Article #2: Nurses should lead in pressure injury prevention in critical care, with identified interventions.

Article #3: Incidence of pressure injuries in adult cardiac intensive care is similar to general intensive care.

Article #4: Only Australian medical sheepskin surfaces were effective; other interventions showed mixed results.

Outcomes:

Article #1: Application of Aloe Vera gel is highly recommended.

Article #2: Pressure injuries were reduced following the interventions.

Article #3: Pressure injury incidence in cardiac intensive care units is similar to general intensive care.

Article #4: Only one intervention was supported by intention-to-treat meta-analysis.

General Notes/Comments:

All four studies provide important insights into the prevention and management of pressure injuries, emphasizing the need for further research, evidence-based practices, and interventions tailored to specific patient populations.

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
	Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2018). The effect of aloe vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: A randomized triple-blind clinical trial. BMC Complementary and Alternative Medicine, 18(1), 1-11. https://doi.org/10.1186/s12906-018-2326-2	Alshahrani, B., Sim, J., & Middleton, R. (2021). Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. Journal of Clinical Nursing, 30(15-16), 2151-2168. https://doi.org/10.1111/jocn.15709	Fulbrook, P., Mbuzi, V., & Miles, S. (2021). Incidence and prevalence of pressure injury in adult cardiac patients admitted to intensive care: A systematic review and meta-analysis. International Journal of Nursing Studies, 114, 103826. https://doi.org/10.1016/j.ijnurstu.2020.103826	Lovegrove, J., Fulbrook, P., Miles, S., & Steele, M. (2022). Effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings: A systematic review and meta-analysis of randomized controlled trials. Australian Critical Care, 35(2), 186-203. https://doi.org/10.1016/j.ijnurstu.2021.104027
Evidence Level * (I, II, or III)	The level of evidence for this article is a Level II (Randomized Controlled Trial)   (The John Hopkins Hospital, n.d.).	Level of Evidence: Level I (Systematic Review)   (The John Hopkins Hospital, n.d.).	Level of Evidence: Level I (Systematic Review and Meta-Analysis)   (The John Hopkins Hospital, n.d.).	Level of Evidence: Level I (Systematic Review and Meta-Analysis)   (The John Hopkins Hospital, n.d.).
Conceptual Framework   Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	The theoretical basis of the study is that Aloe Vera gel may be effective in preventing the development of pressure ulcers due to its therapeutic properties, such as its ability to reduce inflammation, reduce pain, and improve wound healing. It is thought that the gel may help to maintain a normal temperature in the skin, thus reducing the risk of skin breakdown.	The theoretical basis for this study is rooted in the concept of evidence-based practice (EBP). EBP is an approach to clinical decision-making that involves the integration of best available evidence, clinical expertise, and the patient’s values and preferences. The goal of this study was to systematically review the literature to identify the most effective nursing interventions to prevent pressure injuries among critically ill patients. The study used an evidence-based approach to identify the most effective interventions and to assess the quality of the evidence supporting the interventions.	The theoretical basis for the study is that pressure injury is a common and preventable adverse event that occurs in healthcare settings, and cardiac patients admitted to intensive care are particularly at risk for developing pressure injuries.	The basis of this research is grounded in the concept of evidence-based practice, which is an approach to healthcare that considers the most up-to-date evidence, the expertise of healthcare professionals, and the values and preferences of the patient.
Design/Method   Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	Randomized, triple-blind clinical trial carried out on 80 participants who were purposefully selected from an orthopedic ward in Arak town in 2016. The participants were randomly grouped into two groups, intervention, and control, with the sampling method of choice being the blocking method. For the intervention and control groups, ordinary care aimed at preventing bed sores was being performed by the nurse practitioners. Pure Aloe Vera gel was administered twice a day on top of the routine measures on the intervention group. The specific hours when these were applied were hours 9 and 21. For the control group, placebo application, gel of water and starch, were administered. Evaluations were done on days 3, 7 and 10 to determine any presence of pressure ulcers.	This study was a systematic review of literature that was guided by the PRISMA and SWIM. The inclusion criteria for the studies were research relating to nursing interventions for pressure injury prevention among critically ill patients. The exclusion criteria for the studies were reviews and studies not related to nursing interventions for pressure injury prevention among critically ill patients.	This study is a systematic review and meta-analysis of incidence and prevalence. The authors performed a comprehensive search of the relevant literature from 2009 to 2018 and identified 15 studies that met the inclusion criteria.	This research was a thorough review and synthesis of randomized controlled trials, conducted to assess the effectiveness of interventions in stopping pressure injuries in adults admitted to acute care facilities. It included 2000 records which were searched in the databases CINAHL, MEDLINE, Scopus, Web of Science, and Embase. The inclusion criteria included randomized controlled trials that looked at the effectiveness of pressure injury preventative interventions on pressure injury incidence in adults admitted to acute care settings. Exclusions were trials focused on pressure injury treatment or specialty areas, and non-English reports. The screening, extraction, and risk-of-bias assessment were done independently by two reviewers with a third as an arbitrator. Meta-analyses were conducted when study interventions were similar.
Sample/Setting   The number and characteristics of patients, attrition rate, etc.	80 purposefully selected patients with the mean age being 42.34 ± 12.19 years. The attrition rate reported was 3.75 percent.	The sample of this study was comprised of 14 studies examining nursing interventions for pressure injury prevention among critically ill patients. The studies included in the sample were randomized controlled trials, quasi-experimental, case series and cross-sectional studies. The sample was limited to studies published in English and conducted in the last 10 years.	The number of patients varied across the 15 studies included in this systematic review and meta-analysis. The overall sample size was 6371. The attrition rate was 6.7% (1 study did not meet the systematic review criteria).	Number of Patients: 45 studies included in the systematic review Attrition Rate: Not reported in the article.
Major Variables Studied   List and define dependent and independent variables	Dependent Variable: The occurrence of pressure ulcers Independent Variable: The application of Aloe Vera gel	Dependent Variable: Pressure Injury Prevention – This is the outcome variable that is being examined by the study and is affected by the independent variable.   Independent Variable: Nursing Interventions – This is the variable that is manipulated by the researcher to evaluate the effect on the dependent variable.	Dependent Variable: Pressure injury (incidence and prevalence) Independent Variable: Adult cardiac patients admitted to intensive care	Dependent Variable: Pressure Injury Incidence Definition: The number of pressure injuries experienced by individuals in the study.   Independent Variable: Intervention type Definition: The type of intervention used to prevent pressure injuries, such as continence management, heel protection devices, medication, nutrition, positioning, prophylactic dressings, support surfaces, topical preparations, or bundled interventions.
Measurement   Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The study used descriptive statistics. Other tests include Chi-square tests, F-tests and ANOVA.   The primary statistic used to answer the clinical question is the incidence of pressure ulcers (P=0.047).	The authors did not use primary statistics in this article	14 studies from different sources. Sample size of patients was 6371.	45 studies selected from 2000 records.   The statistics used are risk ratio, p-value (p), and I-squared (I2).
Data Analysis Statistical or Qualitative findings   (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The results of this study showed that the incidence of pressure ulcers was statistically significantly different between the two groups (P = 0.047). The intervention group, which used Aloe Vera gel, had a lower incidence of pressure ulcers than the control group, which used a placebo gel.	The results of the review indicated that all the included studies reported a decline in pressure injuries following the interventions	The cumulative incidence of pressure injury in adult cardiac patients admitted to intensive care was found to be between 9.8% and 25.6%, while the incidence of all-stage pressure injury was between 8.3% and 28.3%. The prevalence of pressure injury, excluding Stage 1, was 8.8%. Significant heterogeneity was observed between the studies.	The results of the meta-analyses found that only one type of intervention was effective, with Australian medical sheepskin surfaces being more effective than other standard care surfaces (risk ratio 0.42, p = 0.006, I2 = 36%). Support surfaces (active versus other comparison surfaces and reactive versus other comparison surfaces) and heel protection devices compared to standard care were also found to be effective.
Findings and Recommendations   General findings and recommendations of the research	Aloe Vera gel can prevent the occurrence of pressure ulcers in patients at risk. Applying of Aloe Vera gel towards the prevention of pressure ulcers in patients at risk of pressure ulcer development is recommended.	Nurses are well-qualified to practically lead in pressure injury (PI) prevention in critical care units. Four effective interventions for PI prevention were identified and these include: PI prevention bundles, repositioning and the use of surface support, prevention of medical device-related pressure injuries, and access to expertise.	This research suggests that pressure injury is as likely to occur in adult cardiac patients in intensive care as it is in general intensive care patients, though it may be more common in those who have had cardiac surgery. The authors recommend that further studies be conducted using consistent methods of data collection and analysis.	The results indicate that only one type of intervention (Australian medical sheepskin surfaces) was found to effectively reduce the incidence of pressure injuries. Also, the meta-analyses for support surfaces and heel protection devices both showed a significant effect in comparison to standard care. However, all trials were at unclear or high risk-of-bias and there were several limitations in terms of heterogeneity across trials and trial outcomes.   It is recommended that larger, better-quality trials should be conducted to establish the effectiveness of pressure injury preventative interventions within acute hospital settings. Furthermore, attention should be paid to true intention-to-treat analysis, and acute and intensive care settings should be reported separately.
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?	This study provides evidence that Aloe Vera gel can be used to prevent the occurrence of pressure ulcers in patients at risk, however the sample size was small and further research with larger samples is needed to confirm the results. Potential risks associated with implementation of this practice include skin irritation, allergic reactions, and infection. The feasibility of use in practice depends on the availability of Aloe Vera gel and the individual patient’s needs.	The research offered valuable insight into the effective nursing interventions to prevent PI in critical care patients, with strengths of the study being that the systematic review of relevant studies and the identification of four broad categories of interventions. The key imitations include the overall strength of the evidence being rated from moderate to very low. Risks associated with the implementation of the suggested practices or processes include the potential for pressure injuries to occur if interventions are not implemented correctly. The feasibility of use in practice is dependent on the availability of resources and staff.	The research provides quality evidence for the incidence and prevalence of pressure injuries. The strength of this research is its systematic review and meta-analysis approach and has a large sample size. The limitation is that the data was collected and reported in various ways. The risks associated with implementation of the suggested practices or processes detailed in the research include potential harm to the patient due to inadequate data collection. The feasibility of use in practice depends on the availability of resources.	This research provides evidence for the effectiveness of pressure injury preventative interventions in adults admitted to acute hospital settings. Systematic review and meta-analysis of randomized controlled trials, as well as a thorough risk-of-bias assessment were conducted. The included studies were at unclear or high risk-of-bias, and there was heterogeneity across trials and trial outcomes. The risks of implementing the suggested interventions include potential for ineffective interventions due to lack of high-level evidence. Feasibility of use in practice depends on resources and practitioners’ willingness to implement the interventions.
Key findings	Aloe Vera gel can help prevent pressure ulcers in patients	Categories of pressure injury interventions were identified in the systematic review	This systematic review and meta-analysis suggest that the rate of pressure injuries in cardiac intensive care patients is roughly the same as other intensive care patients but may be higher among cardiac surgery patients.	The key finding of the research is that only one intervention (Australian medical sheepskin surfaces) was supported by intention-to-treat meta-analysis.
Outcomes	The application of Aloe Vera gel for at pressure ulcers patients is highly recommended.	Pressure injuries were reduced following the interventions.	Pressure injury in cardiac intensive care units and those in general intensive care was very similar	That only one intervention was supported by intention-to-treat meta-analysis.
General Notes/Comments	This research study offers important highlights on the management of pressure ulcers in patients.	Nurses should have a plan that includes the use of evidence-based care to prevent pressure injuries.	This finding is important as it highlights the need for further research into the incidence of pressure injury in cardiac intensive care patients to better understand and address this issue.	The results of the review showed that only one intervention (Australian medical sheepskin surfaces) was supported by intention-to-treat meta-analysis, while the meta-analyses for support surfaces and heel protection devices versus standard care both showed a significant effect. The trials included in the review were mostly at unclear or high risk-of-bias, and there were several limitations regarding heterogeneity across trials and trial outcomes. The authors concluded that further large-scale, high-quality trials testing pressure injury preventative interventions are needed to establish effectiveness within acute hospital settings. Attention should be paid to true intention-to-treat analysis, and acute and intensive care settings should be reported separately.

d

Part B: Best Practices

One of the optimal strategies derived from research on the prevention of pressure injuries involves the implementation of a thorough risk assessment. Ursavaş and İşeri (2020) elaborate on this approach, emphasizing the evaluation of individual risk factors for pressure injury development, encompassing age, gender, medical history, current health status, activity level, and skin integrity. Utilizing this assessment as a foundation, a comprehensive care plan can be formulated to mitigate the risk of pressure injuries. This necessitates the implementation of proactive measures such as regular repositioning, maintaining appropriate nutrition and hydration, and utilizing pressure-relieving devices (Kim & Lee, 2019).

Regular repositioning stands out as a critical practice in reducing the likelihood of pressure injuries. Ursavaş and İşeri (2020) point out that prolonged pressure on the skin contributes to skin breakdown, a precursor to pressure injuries. Consistently altering the patient’s position redistributes pressure, thereby diminishing the risk of skin breakdown. Repositioning also enhances circulation, minimizing the chances of complications such as pneumonia and thrombosis. Kim and Lee (2019) emphasize the significance of maintaining proper nutrition and hydration, as these factors are integral to skin integrity and support wound healing. Additionally, Ursavaş and İşeri (2020) caution that dehydration results in dry, brittle skin, increasing susceptibility to breakdown, while poor nutrition weakens the immune system and impedes wound healing. Adequate caloric intake is essential to fuel the energy required for regular repositioning, a key preventive measure against pressure injuries.

The utilization of pressure-relieving devices plays a pivotal role in diminishing the risk of pressure injuries. Kim and Lee (2019) underscore the importance of these devices, such as mattresses, cushions, and heel protectors, in distributing pressure evenly across the skin. By doing so, they effectively reduce the risk of skin breakdown in areas subjected to elevated pressure levels. Furthermore, pressure-relieving devices contribute to enhanced comfort, alleviating pain associated with prolonged pressure.

In conjunction with these preventive measures, routine skin assessments are imperative to identify areas of potential breakdown and enable early intervention. Moreover, educating both patients and staff about pressure injury prevention is paramount, ensuring awareness of risk factors and the implementation of preventive measures across the healthcare community.

References

Alshahrani, B., Sim, J., & Middleton, R. (2021). Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. Journal of Clinical Nursing, 30(15-16), 2151-2168. https://doi.org/10.1111/jocn.15709

Fulbrook, P., Mbuzi, V., & Miles, S. (2021). Incidence and prevalence of pressure injury in adult cardiac patients admitted to intensive care: A systematic review and meta-analysis. International Journal of Nursing Studies, 114, 103826. https://doi.org/10.1016/j.ijnurstu.2020.103826

Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2018). The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: A randomized triple-blind clinical trial. BMC Complementary and Alternative Medicine, 18(1), 1-11. https://doi.org/10.1186/s12906-018-2326-2

The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing evidence-based practice: Appendix C: Evidence level and quality guide. https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf

Kim, J. Y & Lee (2019). Medical device‐related pressure ulcer (MDRPU) in acute care hospitals and its perceived importance and prevention performance by clinical nurses. International Wound Journal, 16, 51-61. https://doi.org/10.1111/iwj.13023

Lovegrove, J., Fulbrook, P., Miles, S., & Steele, M. (2022). Effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings: A systematic review and meta-analysis of randomized controlled trials. Australian Critical Care, 35(2), 186-203. https://doi.org/10.1016/j.ijnurstu.2021.104027

Ursavaş, F. E., & İşeri, Ö. (2020). Effects of education about prevention of pressure ulcer on knowledge and attitudes of nursing students. Journal of Tissue Viability, 29(4), 331-336. https://doi.org/10.1016/j.jtv.2020.06.006

 

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.

BY DAY 7 OF WEEK 7

Submit Part 3A and 3B of your Evidence-Based Project.