NURS 6052 Week 7 Assignment Evidence-Based Project Part 3 Critical Appraisal of Research Paper

NURS 6052 Week 7 Assignment Evidence-Based Project Part 3 Critical Appraisal of Research Paper

NURS 6052 Week 7 Assignment Evidence-Based Project Part 3 Critical Appraisal of Research Paper

Critical Appraisal of Research 

In health practice, clinical problems vary, prompting health care providers to adopt different interventions depending on the nature of a problem. Practice change based on current, relevant, and scientific research evidence is among the widespread interventions. However, not all research evidence is relevant in practice, necessitating research appraisal. According to Melnyk and Fineout-Overholt (2018), research appraisal involves systematically evaluating research evidence to determine its relevance and value. The primary aim is to assess the reliability and validity of the research. This paper appraises research on workplace incivility and analyzes the best practice that emerges from the reviewed research.

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Part 1: Evaluation Table

 

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
	Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461	Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106	Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966	Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709
Evidence Level * (I, II, or III)	III	I	III	II
Conceptual Framework   Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	The study is based on the premise that anxiety predicts workplace incivility, which generates job burnout among nurses. Resilience moderates the incivility-burnout connection.	No exact framework has been mentioned.	No theory has been mentioned.	Bandura’s social learning theory was used as the underpinning for introducing educational interventions and cognitive rehearsal techniques.
Design/Method   Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	The study was a cross-sectional survey through anonymous questionnaires. Participants included nurses with a maximum of three years in service. Irregular nurses, those who had served for more than three years, and unwilling participants were excluded.	Armstrong (2018) critiqued and summarized relevant evidence on workplace incivility and management. Only English articles were reviewed. Articles published before 2010 were excluded.	The descriptive study design was used to describe nurses’ perspective on workplace incivility. Nurses selected had at least one year practice experience and a bachelor’s degree in nursing.	The study was a mixed method, pilot study design. It involved conducting educational programs about incivility in practice and cognitive rehearsal techniques. All registered nurses in the PACU participated in the study. Ancillary personnel and those unable to read and write in English were excluded.
Sample/Setting   The number and characteristics of patients, attrition rate, etc.	696 nurses completed the questionnaire. The study took place in a hospital in China.	The final sample had 10 articles for systematic review and analysis.	Sampling was continuous as the analysis of interviews continued. The pilot study was conducted at educational hospitals of Tabriz University of Medical Sciences.	The study used a convenient sample of registered nurses. It was conducted in a community hospital (post-anesthesia care unit) in Virginia.
Major Variables Studied   List and define dependent and independent variables	The dependent variable was workplace incivility. Independent variables included anxiety, burnout, and resilience.	The dependent variable was workplace incivility whose levels can be reduced through education training, awareness training, and active learning behaviors (independent variables).	The structured interviews concentrated on nurses’ views on workplace incivility prevention.	The study variables included education on incivility and cognitive rehearsal techniques (independent variables) on workplace incivility (dependent variable).
Measurement   Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	Shi et al. (2018) explored the relationship between variables using descriptive statistical analysis. In particular, Pearson’s correlation coefficient and multiple linear regression analysis were used.	Intervention research about managing workplace incivility was the primary focus. Evidence strength was scored to determine information inclusion.	The MAXQDA software version 10 was used to analyze data on 36 interviews and 8 field notes.	Quantitative data for the Nursing Incivility Survey (NIS) was rated using 5-point Likert scale. Sources of incivility were divided into subscale. Data was analyzed using IBM SPSS website.
Data Analysis Statistical or Qualitative findings   (You need to enter the actual numbers determined by the statistical tests or qualitative data).	Workplace incivility was found to be positively correlated with anxiety and job burnout. Anxiety (r=0.371, p<0.01) Burnout ((r=0.238, p<0.01) Resilience moderated (β=−0.564, p<0.01) the workplace incivility-job burnout connection.	Education programs were ranked the highest followed by effective communication and active learning programs in workplace incivility prevention.	3 subthemes and 1 core theme emerged from the analysis. Subthemes- nurse, organization, and public. Core theme- a need for comprehensive attempt.	Items under nurse incivility subscale included hostile climate, gossip and rumors, and free-riding. Displaced frustration p=0.042 was found to be the most statistically significant factor.
Findings and Recommendations   General findings and recommendations of the research	Due to the prevalence nature of workplace incivility in nursing, administrators should consider resilience training to reduce incivility, particularly among new nurses.	Workplace incivility can be prevented by combining educational, awareness, and training programs. The emphasis should be civil behaviors.	Workplace incivility in nursing is complex and requires nurses, health care organizations, and the general public’s commitment to address effectively. It is an issue requiring concerted effort to minimize.	Nursing incivility can be effectively addressed by recognition and ability to confront it.
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 study is a useful and detailed resource for understanding workplace incivility from a cause-and-prevention viewpoint. The main strength includes the study innovatively examining the relationship between incivility and burnout and the moderating role of resilience. However, self-reports from participants were potential source of response bias. On risks associated with resilience training, it can lead to physical and mental exhaustion of some nurses. The approach can also lead to the normalization of workplace incivility. Overall, it is feasible for use in practice since it addresses a major problem in the current practice and practical solutions.	The study expands literature on workplace incivility by illustrating how it can be prevented in nursing practice.   Majority of the studies used in the systematic review used psychometrically tested instruments. However, which was a main limitation, low research quality characterized majority of the studies. No major risk is associated with implementing the suggested practices. They would be fairly convenient to reproduce without any risks to participants. It is crucial to address workplace incivility by improving communication and nurses’ self-efficacy regarding the same. Thus, the study is feasible for use in practice.	The study illustrates the need for concerted effort in workplace incivility management, which health care organizations should emulate. The study showed how workplace incivility can be prevented from a broadened perspective. Randomization of participants’ selection could have led to selection bias. No significant risk is associated with implementing the proposed intervention programs. The study explains the diverse nature of workplace incivility prevention strategies; thus, feasible in practice.	The study illustrates how job satisfaction can be improved by recognizing incivility and how to confront it. Regarding strengths, it is a mixed method study highly detailed on workplace incivility. However, the pilot study had a small initial sample size (limitation). No risks are associated with implementing the suggested practices in practice since the study proposes behavioral approaches. Its usefulness and convenience in applying the proposed strategies confirm its feasibility.
Key findings	Workplace incivility is prevalent among new nurses. Anxiety is a reliable predictor, leading to workplace burnout. The adverse outcomes of incivility can be moderated through resilience-based interventions, such as resilience training.	Education training on workplace incivility is among the most effective strategies in combating the prevalent nursing problem. However, it should be supplemented with other strategies to enhance outcomes.	Nursing administrators and nursing staff cannot succeed while working alone to address workplace incivility. A broadened focus is vital to address the problem successfully.	Enhanced awareness is vital in enabling nurses cope with workplace incivility. Cognitive rehearsal techniques can help nurses to confront workplace incivility.
Outcomes	Highly resilient nurses could buffer the negative influence of workplace incivility regardless of their experience. Therefore, resilience should be adopted in health care settings as a coping style.	Improving nurses’ ability to recognize and manage workplace incivility should be the guiding principle in education programs on workplace incivility.	Workplace incivility is preventable through a comprehensive and systematic attempt.  Nurses should improve their skills as the health care managers work on other strategies such as improving the image of the profession and position of nurses in organizations.	Highly aware and prepared nurses are excellently positioned to deal with workplace incivility. Awareness programs should be intensified in health care settings as buffers.
General Notes/Comments	The study is highly informative on workplace incivility, predictors, outcomes, and feasible solutions. It will be pivotal in developing the PICOT by illustrating the importance of resilient training as part of awareness programs for reducing workplace incivility.	The article is a useful resource to expand literature on workplace incivility management.	The study is highly informative on the need for a more comprehensive and systematic approach in workplace incivility management.	The study expands literature on workplace incivility recognition and prevention.

Part B: Best Practice

Research on workplace incivility is expansive and explores many strategies that can be used to prevent or buffer the prevalent nursing problem. Among the many practices suggested in the studies, enabling nurses to recognize and confront the problem through cognitive rehearsal is a highly effective strategy in incivility management. From a practice viewpoint, cognitive rehearsal involves imagining a situation that produces self-defeating behavior and applying the necessary coping mechanism (Clark, 2019). It is a strategy that admits a problem and its adverse impacts and prepares the affected group to adopt appropriate behavior when they face the same problem.

In nursing, cognitive rehearsal can help nurses cope with workplace incivility to a considerable extent. According to Clark and Gorton (2019), cognitive rehearsal involves equipping nurses with the relevant skills to respond to situations that can be emotionally and mentally harming such as workplace incivility. It is a practical intervention in preventing workplace problems since it prepares nurses mentally to face everyday issues dominating the nursing practice. To justify its relevance in practice, cognitive rehearsal enables nurses to protect themselves and the patients. However, nurses need to implement cognitive rehearsal with other strategies to enhance outcomes.

Generally, workplace incivility is prevalent among nurses and cannot be overlooked. New nurses are more vulnerable to the devastating effects of workplace incivility since they are not used to the problem, and their resilience is low (Mohamed & MahdyAttia, 2020; Muliira et al., 2017). To avoid frustration and possible turnover, nurses should be helped to recognize incivility and respond to it effectively. Awareness and educational programs are highly effective. Training nurses through cognitive rehearsal programs is also an effective intervention to prepare them to cope with the prevalent nursing problem mentally.

Conclusion

Workplace incivility has devastating effects on nurses’ well-being and ability to provide optimal care. In response, it is crucial to apply evidence-based interventions from current and relevant research. The above research appraisal evaluates the appropriateness of various research articles as evidence sources for addressing workplace incivility. The proposed interventions such as cognitive rehearsal have been proven effective in addressing workplace incivility and can be used across settings.

References

Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106

Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator, 44(2), 64-68. doi: 10.1097/NNE.0000000000000563

Clark, C. M., & Gorton, K. L. (2019). Cognitive rehearsal, HeartMath, and simulation: An intervention to build resilience and address incivility. Journal of Nursing Education, 58(12), 690-697. https://doi.org/10.3928/01484834-20191120-03

Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.).           Wolters Kluwer.

Mohamed, A., & MahdyAttia, N. (2020). Factors associated with incivility behaviors, coping strategies and level of engagement among post graduate nursing students. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 9(01), 2020. doi: 10.9790/1959-0901141727

Muliira, J. K., Natarajan, J., & Van Der Colff, J. (2017). Nursing faculty academic incivility: perceptions of nursing students and faculty. BMC Medical Education, 17(1), 1-10. doi: 10.1186/s12909-017-1096-8

Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461

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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.