Evaluating The Level of Evidence Discussion Essay
Evaluating The Level of Evidence Discussion Essay
PICOT Question
In new nurse graduates, does a nurse residency program in the hospital setting improve retention rates over one year?
Instructions:
- Conduct a broach literature search of pertinent library database such as CINAHL, PubMed, Medline, etc. using the different search terms to retrieve many research articles/practice guidelines to choose from.
- Select four research articles and/or practice guidelines in the past 5 years from peer- reviewed nursing or medical journals that pertain to your clinical problem, population of interest and evidence-based interventions. Research articles can usually be identified by their inclusion of introduction/background, methods, findings, limitations, discussion/conclusion sections in the article.
- Develop an evidence synthesis table that summarizes 4 chosen research articles/practice guidelines using provided example and template.
- 2 articles to be on one page plus one evidence table presenting all four articles.
- Write an analysis of the chosen articles/guidelines, critically evaluate the appropriateness, thoroughness, and limitations of the studies/guidelines. Evaluating The Level of Evidence Discussion Essay The paper should include:
- Introduction: clinical problem and population significance
- Search strategy and results: key words, article inclusion criteria, number of articles found, your process for choosing articles/guidelines for your synthesis table.
- Synthesis of the evidence from 4 articles/guidelines: methods used in the studies, evidence-based practice interventions, major findings. Using the provided AGREE II 23-item Instrument to guide your practice guideline critiques.
- Determine scientific credibility of studies/guidelines: your overall judgement of adequacy, appropriateness and thoroughness and limitations of the studies reviewed.
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- References: At least five references in APA format and not older than five years old (2017- 2022).
- Appendix- Evidence Synthesis Table
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| 1. Synthesize the evidence from the four articles/guidelines using an Evidence Table and the information in the provided article on synthesis and other information in your text. What methods were used in the studies. (Provide your Evidence Table in an Appendix). Describe the evidence-based practice interventions recommended in your articles, and summarize the major findings in your 4 articles. Use the provided AGREE II 23-item Instrument to guide your practice guideline critiques. | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 2. Determine scientific credibility of studies/guidelines: your overall judgement of adequacy, appropriateness and thoroughness and limitations of the studies reviewed. Start by evaluating the level of evidence for each of the 4 papers, then characterize the overall level of evidence of the papers you found. Then describe the quality of the evidence—were the research papers from well done studies? Were they published in credible, peer reviewed journals? Did all or most of the papers agree or did you find a lot of disagreement in the findings, and/or conclusions and clinical implications among the papers?
–Write a summary of the amount of evidence you found, the levels of evidence available in the literature (overall, were there many research studies, or were they mostly expert opinion)? And include your evaluation of the quality of the papers in terms of whether or not they provided credible evidence. Evidence Appraisal Assignment The nursing staffing shortage is a significant clinical problem facing U.S. healthcare organizations. As a result, nurses currently working in U.S. healthcare organizations are assigned more patients, resulting in a high nurse-patient ratio and workload. According to Jennifer Dillon (2020), nurses’ workload determines their ability to provide high-quality, safe patient care. Therefore, a high workload among nurses compromises their capacity to provide high-quality, safe, effective, and efficient nursing care, resulting in adverse health outcomes. Consequently, nurses are dissatisfied with their work, making them quit their profession, which worsens the nursing shortage in the United States healthcare system. Therefore, an evidence-based intervention should be implemented in the U.S. healthcare system to reduce the high turnover rate among nurses. The proposed change will be based on the PICOT question, “In new nurse graduates, does a nurse residency program in the hospital setting improve retention rates over one year?” Search Strategy and Results A literature search was conducted electronically on various nursing databases, including CINAHL, PubMed, Ovid Nursing Journals, ProQuest Health, and Medline. The search process was guided by key phrases, including new nurse graduates, a nurse residency program in a hospital setting, nurses’ turnover and retention rates. The inclusion criteria were complete peer-reviewed journal articles on nurse residency programs written in English and published in the last five years (2018 to 2023). Sixteen articles were obtained during the initial search process. These articles were filtered to eliminate studies that consisted of abstracts only, those not written in English, and studies published before 2018. Four articles that met the search process were obtained following the review. These articles will be analyzed in the synthesis table, which is in the appendix. Synthesize the Four Peer-Reviewed Research Articles First, Ackerson and Stiles (2018) conducted a systematic literature review to evaluate the effectiveness of nurse residency programs on the retention of new graduate nurses and their impact on the nursing shortage. During the study, the researchers conducted a literature search on CINAHL, Ovid Nursing Journals, Medical Complete databases, and ProQuest Health. The evidence-based intervention used in this study is nurse residency programs. Data collected from twenty-six articles that met the inclusion criteria indicated that established programs lasting for a 12-months effectively enhanced nurse retention in healthcare organizations. Nonetheless, medical facilities needed to sustain the retention after two years. Secondly, Brook et al. (2019) conducted a systematic review to examine features of effective interventions for lowering nurse turnover and increasing retention levels among nurses in the early stages of their careers. During the study, data were collected through a review of literature obtained from several online databases, including Academic Search Complete, Health Policy Reference Centre, Medline, EMBASE, CINAHL, Psychinfo, and the Cochran Library. The evidence-based intervention utilized in the study involves residency or nurse transition programs. The study findings indicate that nurse residency programs enhanced nurses’ retention and reduced nurses’ turnover rate. Furthermore, Williams et al. (2018) conducted a study to explore the efficacy of residency mentoring among new nurse graduates. A retrospective cross-sectional research design was used to collect participant data during the study. The one-to-one mentoring program was used as an evidence-based intervention during the study. The study findings indicate that a one-to-one mentoring program enhanced new nurses’ professional development and stress management. Lastly, Wolford et al. (2019) conducted a study to assess the efficacy of an established nurse residency program in enhancing retention among new graduate nurses. A retrospective cross-sectional research design was used to collect data from new nurses during the study. A nurse residency program was utilized as the evidence-based intervention in this study. The study findings indicated that the nurse residency program effectively reduces the turnover rate and enhances work engagement in less than 1-year R.N.s. Scientific Credibility of Studies The credibility of the selected articles is based on data collection methodologies. Ackerson and Stiles (2018) and Brook et al. (2019) are highly reliable since data was collected through a systematic literature view. On the other hand, Williams et al. (2018) and Wolford et al. (2019) are highly reliable since a retrospective cross-sectional research design was used to collect data from the sample population. Therefore, studies’ findings can be used to address the clinical issue of concern, improving retention rates among new nurse graduates and reducing the high turnover rate among these nurses. Consequently, the nurse staffing shortage in healthcare organizations will be resolved.
References Ackerson, K., & Stiles, K. A. (2018). Value of nurse residency programs in retaining new graduate nurses and their potential effect on the nursing shortage. The Journal of Continuing Education in Nursing, 49(6), 282-288. Brook, J., Aitken, L., Webb, R., MacLaren, J., & Salmon, D. (2019). Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review. International Journal of nursing studies, 91, 47-59. Jennifer Dillon, M. P. A. (2020). Registered nurse staffing, workload, nursing care left undone, and their relationships to patient safety in hemodialysis units. Nephrology Nursing Journal, 47(2), 133-142. Williams, F., Scott, E., Tyndall, D., & Swanson, M. (2018). New nurse graduate residency mentoring: a retrospective cross-sectional research study. Nursing Economics, 36 (3), 121-127. Wolford, J., Hampton, D., Tharp-Barrie, K., & Goss, C. (2019). Establishing a nurse residency program to boost new graduate nurse retention. Nursing Management. 45-49. doi:10.1097/01NUMA.0000553497.40156.4e
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Appendices Appendix A: Evidence Synthesize Table
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