Intensive and Critical Care Nursing

Running head: NURSING
CRITICAL APPRAISAL
Name of the Student
Name of the University
Author Note

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APPENDIX C
Appraisal Guide:
Conclusions of a Systematic Review with Narrative Synthesis
Citation:
Boyce, J. M., Polgreen, P. M., Monsalve, M., Macinga, D. R., & Arbogast, J. W. (2017).
Frequency of use of alcohol-based hand rubs by nurses: a systematic review. infection
control & hospital epidemiology, 38(2), 189-195.
Synopsis
What organization or persons produced the systematic review (SR)?
Answer: The organization responsible for the SR is Infect Control Hosp Epidemiol 2 done by
Boyce et al., (2017).
How many persons were involved in conducting the review?
Answer: Five persons were involved in the conduction of the review.
What topic or question did the SR address?
Answer: The topic selected for the study was the frequency of alcohol wash by nurses during
their handwashing process.
How were potential research reports identified?
Answer: PubMed was used as the primary database for the identification of research reports.
English language reports were collected from the database and systematic review was
conducted
What determined if a study was included in the analysis?
Answer: The results section showed that that study included an analysis of WHO hand
hygiene and electronic hand hygiene monitoring studies were performed in the research
study.
How many studies were included in the review?
Answer: 326 articles were finally reviewed after screening them from 3487 nonduplicate
articles.
What research designs were used in the studies?
Answer: Retrospective review of the literature was the study design used for the study.
What were the consistent and important across-studies conclusions?
Answer: The most important feature of the conclusion was that the nurses and other HCWs
focus on the use of alcohol wash for hand hygiene varying with levels of exposure.

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Credibility
Was the topic clearly defined? ✓Yes  No  Not clear
Was the search for studies and other
evidence comprehensive and unbiased? ✓ Yes  No  Not clear
Was the screening of citations for
inclusion based on explicit criteria? ✓ Yes  No  Not clear
*Were the included studies assessed
for quality? ✓ Yes  No  Not clear
Were the design characteristics and
findings of the included studies displayed
or discussed in sufficient detail?  Yes ✓ No  Not clear
*Was there a true integration (i.e., synthesis) of the findings—not
merely reporting of findings from
each study individually? ✓ Yes  No  Not clear
*Did the reviewers explore why differences
in findings might have occurred? ✓ Yes  No  Not clear
Did the reviewers distinguish between
conclusions based on consistent findings
from several good studies and those
based on inferior evidence (number or quality)?  Yes ✓ No  Not clear
Which conclusions were supported by
consistent findings from two or more
good or high-quality studies? List
Answer: The hand hygiene ECM system has been used to observe the varying frequency of
alcohol washing among the nurses. This process has been supported by various pieces of
literature (Labrague et al., 2018). Alcohol wash is frequent for various hospitals is also a
factor in the conclusion which has been supported by another existing literature (Kingston et
al., 2018).
ARE THE CONCLUSIONS
CREDIBLE? ✓ Yes All  Yes Some 
No
Clinical Significance
*Across studies, is the size of the
treatment or the strength of the
association found or the
meaningfulness of qualitative findings
strong enough to make a difference
in patient outcomes or experiences of care? ✓ Yes  No  Not clear