Evidence-Based Project, Part 3A: Critical Appraisal of Research Paper

Evidence-Based Project, Part 3A: Critical Appraisal of Research Paper

Evidence-Based Project, Part 3A: Critical Appraisal of Research Paper

 Evaluation Table

The use of evidence-based practice (EBP) interventions in healthcare is essential in addressing healthcare associated infections (HAIs). A critical appraisal of resources to implement these interventions ensures that researchers have the best evidence and practice to incorporate in their settings to counter HAIs (Kakkar et al., 2021). The use of peer-reviewed articles ensures that providers recommend the best practices to mitigate the occurrence of HAIs in care settings. The purpose of this critical appraisal paper is to identify best EBP practice to reduce HAIs in care settings among provider by focusing on four peer-reviewed journal articles used in other program and earlier modules.


Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4
Jin, Y. H., Huang, Q., Wang, Y. Y., Zeng, X. T., Luo, L. S., Pan, Z. Y., … & Wang, X. H. (2020). Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey. Military Medical Research, 7(1), 1-13. DOI:https://doi.org/10.1186/s40779-020-00254-8 Ford. C., & Park, L. J. (2018). Hand hygiene and handwashing: key to preventing the transfer of pathogens. British Journal of Nursing, 27(20), 1164-1166. https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.20.1164 Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337.

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Kingston, L. M., O, C. N. H., & Dunne, C. P. (2018). A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students. Nurse

Education Today, 63, 112–118. https://doi-org.ezp.waldenulibrary.org/10.1016/j.nedt.2018.01.022

Evidence Level *

(I, II, or III)


III-Non-experimental study on COVID-infected participants Level V as it entails quality improvement initiatives’ recommendations. I-Experimental study II-Quasi-experimental study on hand hygiene practices among nursing and medical students
Conceptual Framework


Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**


The conceptual framework entails the contexts of infection route, factors causing infections and management of the infected individuals like during the COVID-19 pandemic and their relationships.




The article has no conceptual framework. The conceptual framework is the comparison of the efficacy of alcohol-based hand rubs (ABHRs) and handwashing with soap and water based on WHO guidelines in reducing hospital acquired infections (HAIs). The conceptual framework highlights the concept of hand hygiene among nursing and medical students in Ireland to reduce HAIs.


Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

Study uses a cross-sectional design in a single facility The study uses a systematic review of literature where by giving evidence on hand hygiene practices and information by basing on the previous findings and evidence. The study uses a systematic review of literature from existing evidence and previous findings. The inclusion criteria involved three articles that met the requirements for review on the topic. The observational study uses a cross-sectional self-report model through the administration of questionnaires


The number and characteristics of

patients, attrition rate, etc.

The setting was a single hospital where 105 healthcare workers were recruited to participate in the program. Only 103 participants completed a valid questionnaire offered by the researchers. No sample is provided as the article gives guidelines and raises awareness on the need for better techniques to wash hands among healthcare providers. The article does not use sampling or show the setting as it is a systematic review meaning that evidence came from different studies based on the used search criteria and databases like Medline and CINAHL. The setting for the study was a university comprising of nursing and medical students. The nursing students (BSN) were 342 and medical students were 530. The response rate was 37% implying that they are the ones who submitted their filled questionnaires. All the four cohorts of the programs were included as sample.
Major Variables Studied


List and define dependent and independent variables

The major variables included the route of infections, factors leading to infections, psychosocial change and management procedures to reduce susceptibility to infections among infected healthcare providers.


No dependent and independent variables exist in the study as it only offers guidelines and information on enhancing hand hygiene practices. No dependent and independent variables were used as it was a systematic review of literature on the benefits of handwashing against rubs. The main variables studied included compliance rates to hand hygiene practices among the two types of healthcare students in the university. The dependent variable was the level of compliance while the independent variable was the type of intervention to stop or prevent infections.


Identify primary statistics used to answer clinical questions (You need to list the actual tests done).

The primary statistics came from data collected during the study at a single hospital where participants volunteered based on the inclusion criteria as healthcare workers. The main statistics used by the article in answering clinical questions is data from healthcare organizations like the World Health Organization (WHO). It does apply actual tests. The test done in this article entailed assessing the impact of hand rubs against the effects of handwashing using soap and water as recommended by the WHO. The researchers employed the Pearson Chi Square test of independence in testing the variables’ association
Data Analysis Statistical or

Qualitative findings


(You need to enter the actual numbers determined by the statistical tests or qualitative data).

The qualitative findings suggest that most of the infections were transmitted through close contacts, the use of protective equipment and use of common equipment like gloves and masks. The qualitative findings from the guidelines based on NICE framework shows that effective handwashing using liquid soap is the most effective way of decontaminating one’s hands. The qualitative findings show that use of water and soap for handwashing was more effective that hand rubs that contain different types of alcohol. The researchers used a statistical package for social science (SPSS) version 24 to analyze a host of aspects from the study. They also employed descriptive statistics based on the frequencies and percentages.
Findings and Recommendations


General findings and recommendations of the research

The findings suggest that the primary mode of transmission was lack of protection while working closely with the infected patients. It also included intimate contacts with the infected individuals. The researchers recommend the implementation of positive psychological intervention to address the issue. The study recommends healthcare workers and other people to adhere to the protocols that it offers to enhance handwashing and reduce infections, especially in healthcare settings.  The findings show that use of liquid soap is the most effective way to reduce infections in healthcare facilities among providers. The findings show that despite the wide belief that ABHRs caused skin damages than handwashing with soap and water, these rubs can reduce infections in a significant manner and lead to lower incidences of poor outcomes. The findings suggest the need for providers to use both approaches as the best way to reduce possibility of infections in their settings. The findings from the study shows that students complied to hand hygiene more when exposed to body fluids as oppose to when in contact with a patient’s surroundings. The study also demonstrates that most of the participants in both disciplines had a positive attitude towards the use of hand hygiene measures like handwashing and hand rubs.

The findings also show that more medical students (46%) complied with the use of alcohol-base hand rub to decontaminate their hands than nursing students (22%). The study recommends a review of curricula based on the knowledge gaps, deficiencies in practice settings and barriers to utilization of ABHR.

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?

The article is valuable as it can be applied in practice to increase protection against infectious diseases like COVID-19 and other types of flu. The study’s strengths include wide scope, use of a significant sample based on the care setting and effective analysis. However, its limitations include focusing on one condition and having a limited sample of only infected healthcare workers.

The risks associated with the implementation of suggested processes include limited resources and training as well as sufficient time.

The feasibility of using the study is high based on the benefits that it offers to the facility and providers.

The article is valuable to practice as it shows and models the most effective way of attaining hand hygiene for healthcare workers and patients to reduce hospital acquired infections.

The strengths of the study include being simple and easy to apply because of illustrations used and language. However, it does not include comprehensive overview of the issue and relies mainly on evidence from past studies.

No risks exist in implementing the suggested practices and processes as detailed in the research. It is feasible to use the recommended practices as they are not costly to implement. The NICE guidelines are fundamental in enhancing overall patient safety.

The article is valuable to practice because it shows that providers can use hand rubs alongside handwashing to reduce infections among patients. The strengths of the study include its level of evidence as level I since it is a systematic review that pieces evidence from various sources. The only limitation is that it does not occur in real setting to show the outcomes and compare them to previous studies.

No risks exist in the implementation of the suggested practices or processes as they lead to a reduction in infections.

There is a high possibility of using these recommendations in practice since they lead to better outcomes.

The article is very valuable to practice as it implores organizations to entrench hand hygiene measures among healthcare professionals like nurses and physicians. The strengths of the article include a wide sample, better analysis and inclusion criteria. The researchers also comply with ethics and demonstrate credibility. However, it only occurs in teaching setting as opposed to real healthcare environment or setting.

No risks exist in implementing these recommendations and that it is feasible to enroll them in our facility.



Key findings




Key findings from the study show that hospitals can use different approaches to reduce and prevent the occurrence of infections, even deadly one like the COVID-19 pandemic. Key findings from the study is that most people, including healthcare providers do not know effective way to wash hands and decontaminate them to reduce infections The core findings show that infection control is fundamental and requires different interventions by providers and organizations to improve quality of care. The key findings demonstrate that increased education is essential to enhance compliance among nursing students and nurses to embrace hand hygiene measures.






The outcomes from the research offer hope for healthcare workers who are susceptible to infections because of the nature of their work. The outcomes of the study show that healthcare providers can be more effective when implementing hand hygiene measures to reduce infections in their settings. The outcomes from the study demonstrate the need to invest in different approaches to lower infection rates among providers and patients in health facilities. The outcomes show that having sufficient educational awareness among students improves the likelihood of using hand hygiene measures in health care settings.
General Notes/Comments  

The research illustrates the need to invest in protective equipment, better training for patients and developing infection control and prevention protocols, especially to counter emerging infectious conditions like the COVID-19.



The study is categorical that hand hygiene is an effective way of reducing and preventing hospital acquired infections, especially among healthcare providers by using liquid soaps or hand rubs. The study underscores the need to raise awareness about the efficacy of different health strategies to reduce and prevent infections in healthcare settings. The research is elaborative that health care students in different settings should embrace hand hygiene measures as way of reducing infections among nurses and patients.


Part B: Critical Appraisal of Research

The critical analysis approach is essential in appraising evidence from different research studies on the use of EBP interventions in healthcare settings. The reviewed articles demonstrate that infection control and prevention is an important aspect of attain patient and providers’ safety in any healthcare practice and profession. the studies show that the best practice in preventing and reducing the prevalence of hospital associated infections (HAIs) is having effective hygiene and patient safety measures like hand hygiene and use of protective equipment (Haque et al., 2020). Hand hygiene measures among healthcare providers like nurses and physicians improves their safety standards and reduces susceptibility to infections.

The study by Kingston et al. (2018) shows that both nursing and medical students and providers require effective infection prevention knowledge and use of hand hygiene measures to reduce the rates of infections. The study also observes that medical students and practitioners are more likely to use hand rubs than nursing students and nurses in healthcare practice. Above all, the study is categorical that none of the professions uses hand hygiene measures by over fifty percent with physician probability or likelihood being at 46% and nurses at 22%. These findings as corroborated with the other studies like Ford and Park (201) and Halm and Sandau (2018) show that hand hygiene measures are critical in addressing hospital associated infections. The peer articles are also categorical that using hand hygiene measures through handwashing and deployment of alcohol-based hand rubs (ABHRs) allows healthcare professionals to reduce and prevent the occurrence of HAIs (Kakkar et al., 2021). The implication is that these measures are important and should be picked as the best practice to lower, and prevent hospital associated infections.


The use of critical appraisal is important to help nurses and other providers understand the application of evidence-based practice (EBP) interventions to address healthcare challenges like infections. The critical appraisal process ensures that nurses get the best evidence and ascertain best approach to clinical issues to improve care delivery. The paper shows that the most effective EBP intervention to reduce and prevent hospital acquired infections (HAIs) is hand hygiene that include handwashing and use of hand rubs.


Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., … & Charan, J. (2020). Strategies to prevent

healthcare-associated infections: a narrative overview. Risk management and healthcare policy, 13, 1765.

DOI https://doi.org/10.2147/RMHP.S269315

Kakkar, S. K., Bala, M., & Arora, V. (2021). Educating nursing staff regarding infection control practices and assessing its

impact on the incidence of hospital-acquired infections. Journal of Education and Health Promotion, 10(40). https://www.jehp.net//text.asp?2021/10/1/40/308146

Macho, A. Y., Mayens, A. L. W., Valverde, E. M. P., Ordaz, R. G., Méndez, J. A. J., Iglesias, J. L. P., … & Parreira, P.

(2021). Nursing Students’ Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.701208


Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research
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.

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