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1.

Find a minimum of ten peer-reviewed journal articles in regards to the frequent readmission of detox treatment center written in the last 5 years or less. Use the Appendix G Individual Evidence Summary Tool to synthesize and organize your findings (SEE APPENDIX G FORM ATTACHED BELOW). 

Submit the completed Appendix G table with the attached reference for all articles in APA format.

2.

When appraising the literature complete either Appendix E or F (SEE APPENDIX E and F FORM ATTACHED BELOW). Depending on whether your article is research or non-research. Do this for one of your final articles. 

Reference in APA format for the article \

Date:EBP Question:
Article NumberAuthor and DateEvidence TypeSample, Sample Size, SettingFindings That Help Answer the EBP QuestionObservable MeasuresLimitationsEvidence Level, Quality
· N/A
· N/A
· N/A
· N/A
· N/A
· N/A
· N/A

Attach a reference list with full citations of articles reviewed for this EBP question.

Date:EBP Question:
Article NumberAuthor and DateEvidence TypeSample, Sample Size, SettingFindings That Help Answer the EBP QuestionObservable MeasuresLimitationsEvidence Level, Quality
· N/A
· N/A
· N/A
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· N/A
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Johns Hopkins Nursing Evidence-Based Practice

Appendix G

Individual Evidence Summary Tool

Johns Hopkins Nursing Evidence-Based Practice

Appendix G

Individual Evidence Summary Tool

©2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing

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.

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 (e.g., 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.

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.

Johns Hopkins Nursing Evidence-Based Practice

Appendix E

Research Evidence Appraisal Tool

Evidence level and quality rating:
Article title:Number:
Author(s):Publication date:
Journal:
Setting:Sample (composition and size):
Does this evidence address my EBP question?YesNo-Do not proceed with appraisal of this evidence
Is this study:QuaNtitative (collection, analysis, and reporting of numerical data) Measurable data (how many; how much; or how often) used to formulate facts, uncover patterns in research, and generalize results from a larger sample population; provides observed effects of a program, problem, or condition, measured precisely, rather than through researcher interpretation of data. Common methods are surveys, face-to-face structured interviews, observations, and reviews of records or documents. Statistical tests are used in data analysis.Go to Section I: QuaNtitativeQuaLitative (collection, analysis, and reporting of narrative data) Rich narrative documents are used for uncovering themes; describes a problem or condition from the point of view of those experiencing it. Common methods are focus groups, individual interviews (unstructured or semi structured), and participation/observations. Sample sizes are small and are determined when data saturation is achieved. Data saturation is reached when the researcher identifies that no new themes emerge and redundancy is occurring. Synthesis is used in data analysis. Often a starting point for studies when little research exists; may use results to design empirical studies. The researcher describes, analyzes, and interprets reports, descriptions, and observations from participants.Go to Section II: QuaLitativeMixed methods (results reported both numerically and narratively) Both quaNtitative and quaLitative methods are used in the study design. Using both approaches, in combination, provides a better understanding of research problems than using either approach alone. Sample sizes vary based on methods used. Data collection involves collecting and analyzing both quaNtitative and quaLitative data in a single study or series of studies. Interpretation is continual and can influence stages in the research process.Go to Section III: Mixed Methods

Johns Hopkins Nursing Evidence-Based Practice

Appendix E

Research Evidence Appraisal Tool

Page 6 of 10

Johns Hopkins Nursing Evidence-Based Practice

Appendix E

Research Evidence Appraisal Tool

The Johns Hopkins Hospital/ The Johns Hopkins University

©2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing

Section I: QuaNtitative
Level of Evidence (Study Design)
Is this a report of a single research study?A· Yes· No Go to B
1. Was there manipulation of an independent variable?· Yes· No
2. Was there a control group?· Yes· No
3. Were study participants randomly assigned to the intervention and control groups?· Yes· No
If Yes to questions 1, 2, and 3, this is a randomized controlled trial (RCT) or experimental study.LEVEL I
If Yes to questions 1 and 2 and No to question 3 or Yes to question 1 and No to questions 2 and 3, this is quasi-experimental. (Some degree of investigator control, some manipulation of an independent variable, lacks random assignment to groups, and may have a control group).LEVEL II
If No to questions 1, 2, and 3, this is nonexperimental. (No manipulation of independent variable; can be descriptive, comparative, or correlational; often uses secondary data).LEVEL III
Study Findings That Help Answer the EBP Question
Skip to the Appraisal of QuaNtitative Research Studies section
Section I: QuaNtitative (continued)
Is this a summary of multiple sources of research evidence?· Yes Continue· No Use Appendix F
1. Does it employ a comprehensive search strategy and rigorous appraisal method?If this study includes research, nonresearch, and experiential evidence, it is an integrative review (see Appendix F).· Yes Continue· No Use Appendix F
2. For systematic reviews and systematic reviews with meta-analysis (see descriptions below):B
a. Are all studies included RCTs?LEVEL I
b. Are the studies a combination of RCTs and quasi-experimental, or quasi-experimental only?LEVEL II
c. Are the studies a combination of RCTs, quasi-experimental, and nonexperimental, or non- experimental only?LEVEL III
A systematic review employs a search strategy and a rigorous appraisal method, but does not generate an effect size.A meta-analysis, or systematic review with meta-analysis, combines and analyzes results from studies to generate a new statistic: the effect size.
Study Findings That Help Answer the EBP Question
Skip to the Appraisal of Systematic Review (With or Without a Meta-Analysis) section
Appraisal of QuaNtitative Research Studies
Does the researcher identify what is known and not known about the problem and how the study will address any gaps in knowledge?· Yes· No
Was the purpose of the study clearly presented?· Yes· No
Was the literature review current (most sources within the past five years or a seminal study)?· Yes· No
Was sample size sufficient based on study design and rationale?· Yes· No
If there is a control group:· Were the characteristics and/or demographics similar in both the control and intervention groups?· Yes· NoN/A
· If multiple settings were used, were the settings similar?· Yes· NoN/A
· Were all groups equally treated except for the intervention group(s)?· Yes· NoN/A
Are data collection methods described clearly?· Yes· No
Were the instruments reliable (Cronbach’s [alpha] > 0.70)?· Yes· NoN/A
Was instrument validity discussed?· Yes· NoN/A
If surveys or questionnaires were used, was the response rate > 25%?· Yes· NoN/A
Were the results presented clearly?· Yes· No
If tables were presented, was the narrative consistent with the table content?· Yes· NoN/A
Were study limitations identified and addressed?· Yes· No
Were conclusions based on results?· Yes· No
Complete the Quality Rating for QuaNtitative Studies section
Appraisal of Systematic Review (With or Without Meta-Analysis)
Were the variables of interest clearly identified?· Yes· No
Was the search comprehensive and reproducible?· Key search terms stated· Yes· No
· Multiple databases searched and identified· Yes· No
· Inclusion and exclusion criteria stated· Yes· No
Was there a flow diagram that included the number of studies eliminated at each level of review?· Yes· No
Were details of included studies presented (design, sample, methods, results, outcomes, strengths, and limitations)?· Yes· No
Were methods for appraising the strength of evidence (level and quality) described?· Yes· No
Were conclusions based on results?· Yes· No
· Results were interpreted· Yes· No
· Conclusions flowed logically from the interpretation and systematic review question· Yes· No
Did the systematic review include a section addressing limitations and how they were addressed?· Yes· No
Complete the Quality Rating for QuaNtitative Studies section (below)
Quality Rating for QuaNtitative Studies
Circle the appropriate quality rating below:A High quality: Consistent, generalizable results; sufficient sample size for the study design; adequate control; definitive conclusions; consistent recommendations based on comprehensive literature review that includes thorough reference to scientific evidence.B Good quality: Reasonably consistent results; sufficient sample size for the study design; some control, and fairly definitive conclusions; reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence.C Low quality or major flaws: Little evidence with inconsistent results; insufficient sample size for the study design; conclusions cannot be drawn.

Johns Hopkins Nursing Evidence-Based Practice

Appendix E

Research Evidence Appraisal Tool

Section II: QuaLitative
Level of Evidence (Study Design)
AIs this a report of a single research study?· Yes go to Level III· No go to II B
Study Findings That Help Answer the EBP Question
Complete the Appraisal of Single QuaLitative Research Study section(below)
Appraisal of a Single QuaLitative Research Study
Was there a clearly identifiable and articulated:· Purpose?· Yes· No
· Research question?· Yes· No
· Justification for method(s) used?· Yes· No
· Phenomenon that is the focus of the research?· Yes· No
Were study sample participants representative?· Yes· No
Did they have knowledge of or experience with the research area?· Yes· No
Were participant characteristics described?· Yes· No
Was sampling adequate, as evidenced by achieving saturation of data?· Yes· No
Data analysis:· Was a verification process used in every step by checking and confirming with participants the trustworthiness of analysis and interpretation?· Yes· No
· Was there a description of how data were analyzed (i.e., method), by computer or manually?· Yes· No
Do findings support the narrative data (quotes)?· Yes· No
Do findings flow from research question to data collected to analysis undertaken?· Yes· No
Are conclusions clearly explained?· Yes· No
Skip to the Quality Rating for QuaLitative Studies section
For summaries of multiple quaLitative research studies (meta-synthesis), was a comprehensive search strategy and rigorous appraisal method used?B· Yes Level III· No go to Appendix F
Study Findings That Help Answer the EBP Question
Complete the Appraisal of Meta-Synthesis Studies section (below)
Appraisal of Meta-Synthesis Studies
Were the search strategy and criteria for selecting primary studies clearly defined?· Yes· No
Were findings appropriate and convincing?· Yes· No
Was a description of methods used to:· Compare findings from each study?· Yes· No
· Interpret data?· Yes· No
Did synthesis reflect:· Yes· No
· New insights?· Yes· No
· Discovery of essential features of phenomena?· Yes· No
· A fuller understanding of the phenomena?· Yes· No
Was sufficient data presented to support the interpretations?· Yes· No
Complete the Quality Rating for QuaLititative Studies section (below)
Quality Rating for QuaLitative Studies
Circle the appropriate quality rating below:No commonly agreed-on principles exist for judging the quality of quaLitative studies. It is a subjective process based on the extent to which study data contributes to synthesis and how much information is known about the researchers’ efforts to meet the appraisal criteria.For meta-synthesis, there is preliminary agreement that quality assessments should be made before synthesis to screen out poor-quality studies1.A/B High/Good quality is used for single studies and meta-syntheses2.The report discusses efforts to enhance or evaluate the quality of the data and the overall inquiry in sufficient detail; and it describes the specific techniques used to enhance the quality of the inquiry.Evidence of some or all of the following is found in the report:· Transparency: Describes how information was documented to justify decisions, how data were reviewed by others, and how themes and categories were formulated.· Diligence: Reads and rereads data to check interpretations; seeks opportunity to find multiple sources to corroborate evidence.· Verification: The process of checking, confirming, and ensuring methodologic coherence.· Self-reflection and self-scrutiny: Being continuously aware of how a researcher’s experiences, background, or prejudices might shape and bias analysis and interpretations.· Participant-driven inquiry: Participants shape the scope and breadth of questions; analysis and interpretation give voice to those who participated.· Insightful interpretation: Data and knowledge are linked in meaningful ways to relevant literature.C Lower-quality studies contribute little to the overall review of findings and have few, if any, of the features listed for High/Good quality.

https://www.york.ac.uk/crd/SysRev/!SSL!/WebHelp/6_4_ASSESSMENT_OF_QUALIT A TIVE_RESEARCH.htm 2 Adapted from Polit & Beck (2017).

Section III: Mixed Methods
Level of Evidence (Study Design)
You will need to appraise both the quaNtitative and quaLitative parts of the study independently, before appraising the study in its entirety.
1. Evaluate the quaLitative part of the study using Section I.LevelQuality
Insert here the level of evidence and overall quality for this part:
2. Evaluate the quaLitative part of the study using Section II.LevelQuality
Insert here the level of evidence and overall quality for this part:
3. To determine the level of evidence, circle the appropriate study design:
· Explanatory sequential designs collect quaNtitative data first, followed by the quaLitative data; and their purpose is to explain quaNtitative results using quaLitative findings. The level is determined based on the level of the quaNtitative part.· Exploratory sequential designs collect quaLitative data first, followed by the quaNtitative data; and their purpose is to explain quaLitative findings using the quaNtitative results. The level is determined based on the level of the quaLitative part, and it is always Level III.· Convergent parallel designs collect the quaLitative and quaNtitative data concurrently for the purpose of providing a more complete understanding of a phenomenon by merging both datasets. These designs are Level III.· Multiphasic designs collect quaLitative and quaNtitative data over more than one phase, with each phase informing the next phase. These designs are Level III.
Study Findings That Help Answer the EBP Question
Complete the Appraisal of Mixed Methods Studies section (below)
Appraisal of Mixed Methods Studies3
Was the mixed-methods research design relevant to address the quaNtitative and quaLitative research questions (or objectives)?· Yes· No· N/A
Was the research design relevant to address the quaNtitative and quaLitative aspects of the mixed-methods question (or objective)?· Yes· No· N/A
For convergent parallel designs, was the integration of quaNtitative and quaLitative data (or results) relevant to address the research question or objective?· Yes· No· N/A
For convergent parallel designs, were the limitations associated with the integration (for example, the divergence of quaLitative and quaNtitative data or results) sufficiently addressed?· Yes· No· N/A
Complete the Quality Rating for Mixed-Method Studies section (below)

3 National Collaborating Centre for Methods and Tools. (2015). Appraising Qualitative, Quantitative, and Mixed Methods Studies included in Mixed Studies Reviews: The MMAT. Hamilton, ON: McMaster University. (Updated 20 July, 2015) Retrieved from http://www.nccmt.ca/ resources/search/232

Quality Rating for Mixed-Methods Studies
Circle the appropriate quality rating belowA High quality: Contains high-quality quaNtitative and quaLitative study components; highly relevant study design; relevant integration of data or results; and careful consideration of the limitations of the chosen approach.B Good quality: Contains good-quality quaNtitative and quaLitative study components; relevant study design; moderately relevant integration of data or results; and some discussion of limitations of integration.C Low quality or major flaws: Contains low quality quaNtitative and quaLitative study components; study design not relevant to research questions or objectives; poorly integrated data or results; and no consideration of limits of integration.
Evidence level and quality rating:
Article title:Number:
Author(s):Publication date:
Journal:
Setting:Sample (composition and size):
Does this evidence address my EBP question?YesNo- Do not proceed with appraisal of this evidence
· Clinical Practice Guidelines LEVEL IVSystematically developed recommendations from nationally recognized experts based on research evidence or expert consensus panel· Consensus or Position Statement LEVEL IVSystematically developed recommendations, based on research and nationally recognized expert opinion, that guide members of a professional organization in decision-making for an issue of concern
· Are the types of evidence included identified?· Yes· No
· Were appropriate stakeholders involved in the development of recommendations?· Yes· No
· Are groups to which recommendations apply and do not apply clearly stated?· Yes· No
· Have potential biases been eliminated?· Yes· No
· Does each recommendation have an identified level of evidence stated?· Yes· No
· Are recommendations clear?· Yes· No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.

Johns Hopkins Nursing Evidence-Based Practice

Appendix F: Non-Research Evidence Appraisal Tool

Johns Hopkins Nursing Evidence-Based Practice

Appendix F

Non-Research Evidence Appraisal

© 2017 The Johns Hopkins Hospital/Johns Hopkins University School of Nursing

5

· Literature review LEVEL VSummary of selected published literature including scientific and nonscientific such as reports of organizational experience and opinions of experts· Integrative review LEVEL VSummary of research evidence and theoretical literature; analyzes, compares themes, notes gaps in the selected literature
· Is subject matter to be reviewed clearly stated?· Yes· No
· Is literature relevant and up-to-date (most sources are within the past five years or classic)?· Yes· No
· Of the literature reviewed, is there a meaningful analysis of the conclusions across the articles included in the review?· Yes· No
· Are gaps in the literature identified?· Yes· No
· Are recommendations made for future practice or study?· Yes· No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.
· Expert opinion LEVEL VOpinion of one or more individuals based on clinical expertise
· Has the individual published or presented on the topic?· Yes· No
· Is the author’s opinion based on scientific evidence?· Yes· No
· Is the author’s opinion clearly stated?· Yes· No
· Are potential biases acknowledged?· Yes· No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.
Organizational Experience· Quality improvement LEVEL VCyclical method to examine workflows, processes, or systems with a specific organization· Financial evaluation LEVEL VEconomic evaluation that applies analytic techniques to identify, measure, and compare the cost and outcomes of two or more alternative programs or interventions· Program evaluation LEVEL VSystematic assessment of the processes and/or outcomes of a program; can involve both quaNtitative and quaLitative methods
Setting:Sample Size/Composition:
· Was the aim of the project clearly stated?· Yes· No
· Was the method fully described?· Yes· No
· Were process or outcome measures identified?· Yes· No
· Were results fully described?· Yes· No
· Was interpretation clear and appropriate?· Yes· No
· Are components of cost/benefit or cost effectiveness analysis described?· Yes· No· N/A
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.
· Case report LEVEL VIn-depth look at a person or group or another social unit
· Is the purpose of the case report clearly stated?· Yes· No
· Is the case report clearly presented?· Yes· No
· Are the findings of the case report supported by relevant theory or research?· Yes· No
· Are the recommendations clearly stated and linked to the findings?· Yes· No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating.
Community standard, clinician experience, or consumer preference LEVEL V· Community standard: Current practice for comparable settings in the community· Clinician experience: Knowledge gained through practice experience· Consumer preference: Knowledge gained through life experience
Information Source(s)Number of Sources
· Source of information has credible experience· Yes· No· N/A
· Opinions are clearly stated· Yes· No· N/A
· Evidence obtained is consistent· Yes· No· N/A
Findings That Help You Answer the EBP Question
Complete the corresponding quality rating section.
Quality Rating for Clinical Practice Guidelines, Consensus, or Position Statements (Level IV)
A High qualityMaterial officially sponsored by a professional, public, or private organization or a government agency; documentation of a systematic literature search strategy; consistent results with sufficient numbers of well-designed studies; criteria-based evaluation of overall scientific strength and quality of included studies and definitive conclusions; national expertise clearly evident; developed or revised within the past five years.B Good qualityMaterial officially sponsored by a professional, public, or private organization or a government agency; reasonably thorough and appropriate systematic literature search strategy; reasonably consistent results, sufficient numbers of well-designed studies; evaluation of strengths and limitations of included studies with fairly definitive conclusions; national expertise clearly evident; developed or revised within the past five years.C Low quality or major flawMaterial not sponsored by an official organization or agency; undefined, poorly defined, or limited literature search strategy; no evaluation of strengths and limitations of included studies; insufficient evidence with inconsistent results; conclusions cannot be drawn; not revised within the past five years.
Quality Rating for Organizational Experience (Level V)
A High qualityClear aims and objectives; consistent results across multiple settings; formal quality improvement or financial evaluation methods used; definitive conclusions; consistent recommendations with thorough reference to scientific evidence.B Good qualityClear aims and objectives; formal quality improvement or financial evaluation methods used; consistent results in a single setting; reasonably consistent recommendations with some reference to scientific evidence.C Low quality or major flawsUnclear or missing aims and objectives; inconsistent results; poorly defined quality; improvement/financial analysis method; recommendations cannot be made.
Quality Rating for Case Report, Integrative Review, Literature Review, Expert Opinion, Community Standard, Clinician Experience, Consumer Preference (Level V)
A High qualityExpertise is clearly evident, draws definitive conclusions, and provides scientific rationale; thought leader in the field.B Good qualityExpertise appears to be credible, draws fairly definitive conclusions, and provides logical argument for opinions.C Low quality or major flawsExpertise is not discernable or is dubious; conclusions cannot be drawn.