Evidence Synthesis and Tables

Purpose

The purpose of this assignment is to document sources of research evidence and non-research evidence that address a national practice problem, including the level and quality of each source of research evidence. A synthesis of the evidence is conducted to determine the overall strength and quality of the evidence. The development of an evidence table and synthesis are foundational to inform actions and decisions to improve practice outcomes. Construction of an evidence table and synthesis supports professional formation of the DNP-prepared nurse. Evidence Synthesis and Tables

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Course Outcomes

This assignment enables the student to meet the following course outcomes.

Compare and contrast differences and similarities of qualitative, quantitative, and mixed method designs. (POs 3, 9)
Analyze qualitative and quantitative data for the purposes of critical appraisal of evidence. (POs 3, 9)
Appraise systematic reviews for translation science. (POs 3, 5, 9)
Evaluate selected statistical methods for the purposes of critical appraisal of evidence. (POs 3, 5, 9)
Synthesize literature relevant to practice problems. (POs 3, 5, 9)

DUE DATE: Saturday, 11:59 p.m. MT at the end of the Week. The late assignment policy applies to this assignment.

TOTAL POSSIBLE POINTS: 300

Preparing The Assignment

Follow these guidelines when completing each component of this assignment. Contact your course faculty if you have questions. It is each student’s responsibility to save and maintain all artifacts. Evidence Synthesis and Tables

The assignment will include the following components.

Title Page
Introduction
1. Purpose Statement
2. Practice Problem Identification (Synthesis of research study evidence and non-research evidence.)
3. Sources of Research Evidence (identified in Weeks 1, 2, and 3 Discussion as in-text citations)
Implications of the Practice Problem at the National Level and Local Level (Synthesis of research study evidence and non-research evidence.)
1. Significance
2. Prevalence
3. Economic Ramifications
Conduct a synthesis of research evidence and non-research evidence to address:
1. Main points/salient messages that emerge from the sources (Synthesis of 3 research study evidence and 3 non-research evidence.
2. Compare and contrast main points from all sources (Synthesis of 3 research study evidence and 3 non-research evidence.)
3. Objective discussion of facts (Synthesis of 3 research study evidence and 3 non-research evidence.)
Appraisal of the evidence to address the selected practice problem (1–2 paragraphs)
1. Level of Evidence
2. Quality Rating of Evidence
3. Suitability of the Evidence to Address the Practice Problem
Summary Tables of Evidence to Address the Selected Practice Problem Using theJohns Hopkins Nursing Evidence-Based Practice Evidence Summary Tool (Links to an external site.)
1. 1 Qualitative Research Study (identified in Week 1 Discussion)
2. 1 Quantitative Research Study (identified in Week 2 Discussion)
3. 1 Systematic Reviews (identified in Week 3 Discussion)
Conclusion
1. Summation of the impact of the practice problem at the national level and local level
2. Summation of the appraisal of evidence to address the practice problem
3. Summation of the evidence synthesis
References
1. Reference page with complete references for the 3 sources of research evidence and a minimum of 3 sources of non-research evidence
APA Style and Organization
1. APA Standards for scholarly papers
2. Grammar and mechanics
3. Level I Headings are included

All policies related to plagiarism must be observed. This written assignment will be screened for originality by Turnitin.

Introduction

Requirements
1. Includes a focused purpose statement
2. Identifies selected practice problem using a synthesis of research evidence and non-research evidence
3. Identifies sources of research evidence

Implications of the Practice Problem at the National Level and Local Level

Requirements
Using a synthesis of research evidence and non-research evidence.
1. Describes the significance of the practice problem at the national level and local level
2. Discusses the prevalence of the practice problem at the national level and local level
3. Discusses the economic ramifications of the practice problem at the national level and local level

Evidence Synthesis

Requirements
Using a synthesis of research evidence and non-research evidence to
1. Describes scope of the evidence synthesis
2. Discusses the main points / themes across research evidence and non-research evidence
3. Describes the relationship of sources to other selected sources
4. Discusses facts using a synthesis if research and non-research evidence objectively
5. Presents ideas and claims objectively

Evidence Appraisal

Requirements
1. Describes the levels of research evidence
2. Discusses the quality of research evidence
3. Discusses the suitability of the research evidence to address the practice problem

Evidence Summary Tool

Requirements
1. Provides complete summary for the qualitative research study
2. Provides complete summary for the quantitative research study
3. Provides complete summary for the systematic review

Conclusion

Requirements
Using a synthesis of research evidence and non-research evidence to
1. Includes a summation of the impact of the practice problem at the national level
2. Includes a summation of the evidence appraisal
3. Includes a summation of the evidence synthesis

References

Requirements
1.Cites and references for 3 selected sources of research evidence and non-research evidence

APA 7 Style and Organization

Requirements
1. Uses APA 7 standards for scholarly papers
2. Grammar and mechanics are free of errors
3. Uses required evidence summary table
4. Uses required Level I Headings

Recommendationfromprofessorwk123.docx

Recommendation from professor wk 1

I enjoyed reading your selected research study which addresses hospitalized patients with substance abuse disorders. You have offered some pertinent points in your discussion (good job!), but a few areas are still incomplete and will need to be better addressed for this week’s assignment. Allow me to offer some helpful guidance. For example, it is important to provide more specifics about the actual study, such as what type of qualitative study was conducted or at a minimum, how the data collection process occurred. There also appears to be an omission of the actual data findings which need to be added. You do accurately note that a data analysis occurred, but the details of this are missing. As you likely know, in qualitative studies, the findings are confirmed with the pertinent themes and/or patterns which emerged from the completed data analysis. In your selected article, three major themes were identified and discussed. Of these, which one do you believe was the most relevant and why? Your thoughts are important and will fully answer how the research design answered the scientific question(s). Additionally, more details of the limitations of the study should be discussed. Please refer to your Polit & Beck textbook for guidance. Another helpful suggestion…When you are discussing details of the study, please be sure to reference the authors’/researchers’ names as in-text citations for the sake of clarity in the sentences which will also meet APA requirements.

JH Evidence Summary Tool

You are off to a nice start, but a few of the columns are still incomplete. One helpful recommendation is that in the second column, be sure to add the doi locator number and the name of the database where you retrieved the article after it. Second, be sure your font and font size are consistent throughout the tool. Please be sure to watch the Course Orientation presentation by Dr. Olson that has been posted in the Announcements area this week. That information shows some excellent examples of what this tool should look like for a successful grade in this course. Please add the required information and repost this tool as soon as possible and let me know if you have questions. Evidence Synthesis and Tables

APA Formatting

Your APA formatting is good with a few minor errors noted. Continue to use the APA resources located under the Resource tile on the course homepage to assist you with discussions and the important week 6 paper.

Wk 2 comments from professor

Thank you for a nicely written analysis of the Week 2 discussion assignment. You correctly identified a quantitative study that investigates alcohol consumption pattern and HIV suppression among individuals who are receiving care in Florida. This particular study generally relates to your chosen national topic from Week 1. Overall, this is a very good study and the breakdown of the demographics of the study participants using several tables is excellent. The sample was very large.

There are a few concerns about this article. As I have noted with other student submissions this week, the theoretical model is not properly identified. Second, the pertinent reliability information of the survey instruments is missing. The other concern is about the wide-ranging confidence intervals (CI) in the data…it is a little too wide. So, I went back to look at the results a little more closely and I noted a MAJOR red flag when the researchers discussed that approximately 9% of participants did not report or partially reported the use of illegal drugs in the past year. Instead of deleting those surveys from their study (which is what is expected), they note that to address the potential for biased estimates, multiple imputations were performed using fully conditional specification (FSC) method to generate 20 completed datasets. In other words, they filled in the missing responses themselves using other data. Wow! Can you appreciate that there could be an ethical concern with the actual findings? Remember that a survey must be completed by the participant in its entirety. That means they must answer every question themselves. If they leave questions blank and choose not the fully answer the survey, then that means that we (as the researchers) must completely discard that survey. We cannot use it. Yes, it is frustrating because our sample will be smaller. But we have an ethical obligation to discard an incomplete survey so that our results will be as accurate as possible. Evidence Synthesis and Tables

JH Evidence Summary Tool

Your Johns Hopkins Evidence Summary tool is off to good start, but there are multiple issues with spacing, font size, etc. Additionally, the doi locator has been placed in the wrong column. Please refer to the samples provided by Dr. Olson and make the needed corrections to this tool as soon as possible. This will be very important as you prepare for your upcoming Week 6 paper.

APA Formatting

The APA formatting (both in-text and reference list) is mostly acceptable. Be sure capitalize the names of journal titles in the References list. Please continue to use your APA resources for all weekly discussions.

Wk 3 comments from professor

You have provided a wonderful, analytical analysis of a systematic review which collectively studies factors associated with mindfulness-based interventions in substance abuse disorders (SUDs) and behavioral addictions (BAs). This was a very interesting study to read. Evidence Synthesis and Tables

One of the key concerns that the authors identify early is the clear criteria for inclusion and exclusion criteria for the selected studies. I cannot stress enough how important this aspect is when conducting research. If inclusion and exclusion criteria are not clearly specified, then serious problems with extraneous variables which were not accounted for in the methodological plan, can almost corrupt the final study results of a systematic review. The author undertook the task of assessing findings from numerous pilot studies involving trials (54 studies reported) which is a major challenge for any researcher. However, the final insights offered by the authors are significant. Overall, great work!

JH Evidence Summary Tool

Your summary tool is robust and commendable. You are doing great work populating the columns with needed information. The Times New Roman font and size are consistent throughout the document. As you continue to build your final summary tool, it will serve as an excellent resource of collated information for this class and in your future work.

APA Formatting

The use of in-text citations and reference list look good overall. You are doing very well with this requirement but remember (as a helpful hint) to capitalize the first word that follows a colon in a journal title. Please refer to your APA Manual for guidance as needed. Evidence Synthesis and Tables

wk1correctedJohnsHopkinsIndividualEvidenceSummaryToolqualitative1.docx

Practice Question: What is the cause of frequently hospitalization for addict patients?

Date:01/06/2021

Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
DOI: 10.1007/s11606-016-3919-4 ©	Velez, C. M., Nicolaidis, C., Korthuis, P. T., & Englander, H. (2017). “It’s been an experience, a life learning experience”: a qualitative study of hospitalized patients with substance use disorders. Journal of general internal medicine, 32(3), 296-303. doi: 10.1007/s11606-016-3919-4 J Gen Intern Med. 2017 Mar; 32(3): 296–303. Published online 2016 Dec 12.	Qualitative evidence for building knowledge	There were 32 participants who reported high to moderate use of alcohol (39%), amphetamine (46%), and opioids (65%). The study was conducted in an urban medical Center. N/A	Addiction is a common issue in society and hospitalization of addicts is a wake up for call. Hospitalization provides an opportunity to initiate coordinated care for addicts (Velez et al., 2017). Most of the victims attribute their addiction to homelessness, pain, trauma, and other social chaos. The participants revealed that they prefer healthcare providers who understood SUD and initiate the best treatment options that support change and enhance patient outcomes. From the interviews, effective strategies include involving peers in the treatment process, coordinated care after patient discharge, and access to medical-assisted intervention strategies (Velez et al., 2017). The themes that emerged from the analysis are categorized into three factors: patient level factors, provider level factors and health-system factors. Patient-Level Factors The first finding is that hospitalization of addicts is a wake-up call because some of them regret putting themselves in situation that makes them end up in hospitals. As most patients narrated, they wish they would never end up in the same situation again. Another revelation is that hospitalization is also an opportunity to stop taking drugs. The patients also reveals that pain complicates care and influences them to take drugs more to manage the pain. Provider-level factors The patients identified factors that may affect providers’ approach to care for the addicts. The first one is that care is more effective if the patient has a choice and takes part in decision-making. Patients also revealed that having health providers who are not judgmental encourages them to stay in hospital. For example, care givers who are ex addicts are more understanding, flexible and are likely to influence change. The participants openly mentioned that withdrawal is not easy and effective withdrawal management strategies would be helpful in the process. Treated withdrawal is necessary to prevent suffering and a feeling that the care was inadequate. Health-system factors The patients identified the health system as a great influence in care and management of addicts. They identified that hospitals do not offer basic needs such as jackets which makes the lives of addicts more miserable. They also mentioned that health systems fail to address the issues of trauma and stressors, since most of the people around them are hostile. They also emphasized the need of having peers with first-hand experience to take them through the journey. Lastly, they were interested in medication-assisted therapy which they believed was effective. In my opinion, the patient-factors are the most relevant and plays a greater role in addressing the problem. The system and provider factors are secondary elements can only be incorporated when the patient factors are implemented. For example, providers can only be effective if the patients have identified the need to change. Similarly, effective withdrawal strategies can be impactful if addicts are willing and ready to withdraw.	Interview questions that targeted observations, thoughts experiences, and opinions were used to collect data from the participants.	The first limitation is that the study may lack generalizability because the interview was conducted in a single site and all the patients/participants were insured. Since the interviews were conducted in a hospital for real-time information, the interviews may have been limited in a way. Real time interviewing may not allow deeper conversations hence limiting respondents from revealing useful information. The study assesses patient perspectives only, leaving out the perspectives of significant stakeholders such as health care providers and health administrators. This implies that useful inputs that may be incorporated will be left out. There is influence of personal biases from respondents. Since interviews are less anonymous, they may be a concern for respondents who may conceal useful information.	Good quality evidence. Level II.1
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Reference

Velez, C. M., Nicolaidis, C., Korthuis, P. T., & Englander, H. (2017). “It’s been an experience, a life learning experience”: a qualitative study of hospitalized patients with substance use disorders. Journal of general internal medicine, 32(3), 296-303.

doi: 10.1007/s11606-016-3919-4

Johns Hopkins Nursing Evidence-Based Practice

Appendix G: Individual Evidence Summary Tool

The Johns Hopkins Hospital/ The Johns Hopkins University

Directions for Use of the Individual Evidence Summary Tool

Purpose

This form is used to document the results of evidence appraisal in preparation for evidence synthesis. The form provides the EBP team with documentation of the sources of evidence used, the year the evidence was published or otherwise communicated, the information gathered from each evidence source that helps the team answer the EBP question, and the level and quality of each source of evidence. Evidence Synthesis and Tables

Article Number

Assign a number to each reviewed source of evidence. This organizes the individual evidence summary and provides an easy way to reference articles.

Author and Date

Indicate the last name of the first author or the evidence source and the publication/communication date. List both author/evidence source and date.

Evidence Type

Indicate the type of evidence reviewed (for example: RCT, meta-analysis, mixed methods, quaLitative, systematic review, case study, narrative literature review).

Sample, Sample Size, and Setting

Provide a quick view of the population, number of participants, and study location.

Findings That Help Answer the EBP Question

Although the reviewer may find many points of interest, list only findings that directly apply to the EBP question.

Observable Measures

QuaNtitative measures or variables are used to answer a research question, test a hypothesis, describe characteristics, or determine the effect, impact, or influence. QuaLitative evidence uses cases, context, opinions, experiences, and thoughts to represent the phenomenon of study. Evidence Synthesis and Tables

Limitations

Include information that may or may not be within the text of the article regarding drawbacks of the piece of evidence. The evidence may list limitations, or it may be evident to you, as you review the evidence, that an important point is missed or the sample does not apply to the population of interest.

Evidence Level and Quality

Using information from the individual appraisal tools, transfer the evidence level and quality rating into this column.

wk2quantitativeJohnsHopkinsIndividualEvidenceSummaryTool1.docx

Practice Question:

Date:

Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
DOI 10.1186/s13722-017-0090-0	Cook, R. L., Zhou, Z., Kelso-Chichetto, N. E., Janelle, J., Morano, J. P., Somboonwit, C., … & Bryant, K. (2017). Alcohol consumption patterns and HIV viral suppression among persons receiving HIV care in Florida: an observational study. Addiction science & clinical practice, 12(1), 22.Retrieved from https://ascpjournal.biomedcentral.com/track/pdf/10.1186/s13722-017-0090-0.pdf	Quantitative Evidence.	The participants of the study were recruited from community setting clinics across Florida and others from a collaborative network of health departments across the state. There were 619 participants, 63 % of whom were male and 37 % were female. In terms of race, 22% were non-Hispanic whites, 56 % were non0hisanic blacks, 16 % were Hispanic, and 4 % represented others. The researchers also analyzed the participants in terms of the level of education in four categories: less than high school (33%), high school or equivalent (31%), and above high school (36%). 84 % of the participants experienced homelessness, while 16 % did not (Cook et al., 2017).	The research revealed that heavy and binge drinking was common among participants with less than high school education, smokers and illicit drugs users, homeless people, and participants with anxiety and depression. The rate of adherence reduces with an increase in the rate of alcohol consumption. Optimal adherence was reported by 80% of non-drinkers, 68 % of low-level drinkers, 58 % of binge drinkers, and 51% of heavy drinkers. When compared to abstinence, heavy drinking There is a direct effect between heavy drinking and suboptimal ART suppression, and an indirect, smaller, but a significant effect that is mediated via poor ART adherence. Generally, the findings suggest that the relationship between heavy drinking and suboptimal HIV viral suppression could be due to other factors such as the effects of alcohol on the immune system, behavior, such as persistence on therapy and engagement in care. Like other studies, this study revealed that the rate and not patterns of alcohol drinking leads to poor HIV viral suppression. An increase in the consumption of alcohol leads to poor viral suppression and vice versa. Therefore, researchers recommend the implementation of alcohol consumption strategies in HIV clinical and public health routine. The findings also reinforce the benefits of screening and brief intervention for alcohol-related problems in HIV care settings (Cook et al., 2017). A further proposal is to identify drinkers who are in dire need of intervention and come up with the most effective strategies.	Through the anonymous self-reported questionnaire, the participants answered questions that measured four observable characteristics: Alcohol consumption, Covariates, Antiretroviral adherence, and viral suppression.	Self-reported adherence may over-estimate adherence, especially from dishonest participants. Although it was anonymous, it is normal for a participant to overestimate adherence. Another limitation is that the sampling was based on convenience and may not represent the entire population of people living with HIV/AIDS in Florida (Cook et al., 2017). The researchers based on people who were under care for the previous one year only. The sample was lower compared to other studies involving people living with HIV/AIDS, and since the number of questions was limited, there is a likelihood of an underestimation of the actual consumption. However, the researcher tried to address these limitations by obtaining information on HIV viral suppression from the state HIV surveillance. The representation of diverse demographic groups could also address the sample limitations.	Level-III Quality-Good.
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Attach a reference list with full citations of articles reviewed for this Practice question.

Johns Hopkins Nursing Evidence-Based Practice

Appendix G: Individual Evidence Summary Tool

The Johns Hopkins Hospital/ The Johns Hopkins University

Directions for Use of the Individual Evidence Summary Tool

Purpose

Article Number

Assign a number to each reviewed source of evidence. This organizes the individual evidence summary and provides an easy way to reference articles.

Author and Date

Indicate the last name of the first author or the evidence source and the publication/communication date. List both author/evidence source and date.

Evidence Type

Indicate the type of evidence reviewed (for example: RCT, meta-analysis, mixed methods, quaLitative, systematic review, case study, narrative literature review). Evidence Synthesis and Tables

Sample, Sample Size, and Setting

Provide a quick view of the population, number of participants, and study location.

Findings That Help Answer the EBP Question

Although the reviewer may find many points of interest, list only findings that directly apply to the EBP question.

Observable Measures

Limitations

Evidence Level and Quality

Using information from the individual appraisal tools, transfer the evidence level and quality rating into this column.

JohnsHopkinsIndividualEvidenceSummaryToolwk3SystematicReview.docx

Practice Question: How to address substance abuse disorders

Date: 18th January, 2021.

Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
3	Sancho, M., De Gracia, M., Rodriguez, R. C., Mallorquí-Bagué, N., Sánchez-González, J., Trujols, J., … & Menchón, J. M. (2018). Mindfulness-based interventions for the treatment of substance and behavioral addictions: a systematic review. Frontiers in psychiatry, 9, 95. https://doi.org/10.3389/fpsyt.2018.00095 Permalink https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00095/full?report=reader Database Ebscohost.	Evidence: Systematic Review Type: Narrative synthesis. Purpose: The purpose of the review is to assess the efficiency of Mindfulness-based interventions (MBI) in substance and behavioral addictions. Objective: The objective of this systematic review is to compare MBI s with other interventions to inform future Decisions.	Sample: 54 randomized controlled trials published in English between 2009 and April 2017 were used in the study. Search terms were used to get the articles from different databases including PubMeb, Cochrane, and web of science. Sample size: The total number of participants were 4, 916 from the 54 studies. Setting: Two independent reviewers conducted an online library search at the comfort of their zones and later met for a review of the studies upon which they eliminated some studies and remained with relevant studies.	Generally, mindfulness-based evidence proved to be effective in addressing substance abuse and behavioral addiction such as gambling. These interventions reduce dependence, cravings and other addiction symptoms. MBIs are more effective when combined with Treatment as Usual (TAUs). When compared with TAU, MBRP reduced alcohol dependence and depressive mood more significantly than TAUs. MBI patients recorded significantly the same satisfaction, retention and frequency of substance use with Cognitive Behavioral Therapy CBT patients. MBRP was found to be more significant and directly related to mindfulness while Relapse Prevention (RP) related inversely to mindfulness. Mindfulness-Based Relapse Prevention (MBRP) is also more effective in reducing psychiatric severity such as anxiety and depression. MBI interventions such as Mindful Training for Smokers (MTS) enhanced emotional regulation and MBIs are more effective that lack of treatment. Interventions such as yoga is more effective than physical education. MBIs are also effective in reducing the craving for smoking among college students.	The first group received interventions that is tested. The control group received alternative interventions.	The first limitation is that there was inconsistencies in number of patients, comparators, MBIs, and outcome measures across studies reviewed. Another limitation is that only 54 trials were included in the study hence could not integrate all the information needed.	Level: I Quality: B
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Attach a reference list with full citations of articles reviewed for this Practice question.

Johns Hopkins Nursing Evidence-Based Practice

Appendix G: Individual Evidence Summary Tool

The Johns Hopkins Hospital/ The Johns Hopkins University

Directions for Use of the Individual Evidence Summary Tool

Purpose

Article Number

Assign a number to each reviewed source of evidence. This organizes the individual evidence summary and provides an easy way to reference articles.

Author and Date

Indicate the last name of the first author or the evidence source and the publication/communication date. List both author/evidence source and date.

Evidence Type

Indicate the type of evidence reviewed (for example: RCT, meta-analysis, mixed methods, quaLitative, systematic review, case study, narrative literature review). Evidence Synthesis and Tables

Sample, Sample Size, and Setting

Provide a quick view of the population, number of participants, and study location.

Findings That Help Answer the EBP Question

Although the reviewer may find many points of interest, list only findings that directly apply to the EBP question.

Observable Measures

Limitations

Evidence Level and Quality

Using information from the individual appraisal tools, transfer the evidence level and quality rating into this column.