Nursing Evidence Analysis & Synthesis

This assignment requires students to critically analyze two nursing research papers. They must assess the methodology, validity of findings, and overall contribution of each paper to answering a pre-defined clinical question. Students will then synthesize the evidence from both papers, summarizing their findings in plain language as if explaining them to a patient.

Please complete the following the activities by filling in the spaces below. This is a word document so you can add
space as needed.
PART 1: PARTICIPATES IN THE FIRST AND THE SECOND ONLINE DISCUSSION FORUMS (4 marks).
PART 2.1: DEVELOPING A FOCUSED QUESTION AND ACQUIRING RELEVANT EVIDENCE (3 marks).
1. Use the following categories to help define your problem and what you are looking at in simple terms
PICO: Patient/Problem, Intervention, Comparison, and Outcome.
(Remember to use your readings to help you if you are unsure)
Patient/Problem: Stroke
Intervention: Compression stocking
Comparison: N/A
Outcome: Prevent embolism
2. Now use these terms from the question above to create your PICO research question so that you have a clear
purpose for your search:
In (P) stroke, does (I) compression stocking compared with (C) N/A reduce (O) embolism?
3. What type of clinical question do you think this PICO answers?
□ Therapeutic □ Aetiology □ Diagnostic □ Prevention □ Prognosis □ Others
4. The table below will help you to think of the other terms that you might also like to look up when searching for
evidence to help you answer your question – this is part of basic planning for a research search.
 We ask you to look up alternative terms because sometimes articles from different countries and health systems call things different
names – for example, in Australia we sometimes us the term ‘community nurses’, but in the UK they often talk about ‘district nurses’
– if you only searched under ‘district nurse’ you’d miss all the articles which happened to a different term – you would be missing
some of the picture!
Population Intervention Comparison
(not commonly used in actual
database search strategy)
Outcome
(not commonly used in actual
database search strategy)
What is your population?
Main search term:
 Stroke
What other terms might
have been used?
Alternative search terms:
 Apoplexy
 CVA
 Cerebral Stroke
 Cerebrovascular
Stroke
 Cerebrovascular
Apoplexy
What is your intervention?
Main search term:
 Compression
stocking
What other terms might
have been used?
Alternative search terms:
 Elastic Stocking
What is your comparison?
Main search term:
 N/A
What other terms might
have been used?
Alternative search terms:
 N/A
What is your outcome?
Main search term:
 Prevent Embolism
What other terms might
have been used?
Alternative search terms:
 Reduce Blood
clots
92318 Evidence for Nursing Assessment 3 Submission Template 1

5. Is there a particular group of people that you want to look at? List here any inclusion criteria you might use to
refine your search if you have too many papers:
Gender: Men & Women Age Range: Young Adult & Adult
Publication Dates: Last 5 years Language: English
6. What kind of study do you think would best answer your question? Select here which type of article you might
want to access. You can also use these to refine your search if you have a lot of papers.
□ Randomized Controlled Trial (RCT)
□ Cohort Study
□ Qualitative Study
□ Economic Evaluation
□ Case-control Study/Case Series
Systematic Search Strategy Worksheet
7. Now that you have decided on WHAT you will be searching, you need to put down a plan of HOW you will search
for your articles. This helps you and others to see how you got your evidence and how you made sure you got the
best evidence to help you decide on your clinical action.
 Using the PICO terms in your table, enter each term in a row (group them together under the PICO categories).
 The next step is to combine similar terms using ‘OR’ .
 The final step is to use ‘AND’ to combine your searches for different PICO elements.
Key terms:
1 Stroke
2 Apoplexy
3 CVA
4 Cerebral Stroke
5 Cerebrovascular Stroke
6 Cerebrovascular Apoplexy
7 Compression Stocking
8 Elastic Stocking
9 Prevent Embolism
10 Reduce blood clots
11 1 OR 2 OR 3 OR 4 OR 5 OR 6
12 7 OR 8
13 9 OR 10
14 11 AND 12 AND 13
OR = combine alternate terms for the same topic – to get as many potential papers as possible!
AND = combine the groups of topics to get papers which cover ALL the terms!
92318 Evidence for Nursing Assessment 3 Submission Template 2

PART 2.2: EVIDENCE OF APPLICATION OF SEARCH STRATEGY (PLAN) IN DATABASE SEARCHES (3 marks)
Enter your planned search into two different databases of your choice (such as Medline and CINHAL) using the skills
you have learnt in the library session, online library videos, and library workshops.
8. Place the screenshots/screengrabs/digital pictures of your two (2) database searchers here. Please ensure your
screenshots provide all steps of your search (see the example in Assessment one templet) and are clear enough to
be legible – these must be READABLE!!
Database search 1
Database search 2
9. Select a randomised controlled trial that can help you answer your PICO question and place the abstract here.
Please add this as a screenshot, do not retype this yourself. (The abstract must be readable)
92318 Evidence for Nursing Assessment 3 Submission Template 3

10. Choose a qualitative study that is relevant to your PICO from the list of provided articles in Assessment 3 folder
and place the abstract here. It is ok if your qualitative study does not exactly match your PICO, but it should be
relevant. Please add this as a screenshot, do not retype this yourself. (The abstracts must be readable).
92318 Evidence for Nursing Assessment 3 Submission Template 4

PART 3.1 APPRAISAL OF YOUR RANDOMISED CONTROLLED TRIAL (Please consider the word limit for each
question, 13 marks )
Assessing the quality of the available evidence has also been a key focus this semester. Use the CASP tool for RCTs
below to appraise the quality of your selected RCT.
Section A: Are the results of the trial valid?
Screening Questions
1. Did the trial address a clearly focused issue?
Yes No Can’t tell
Justify your answer: (Max 50 words)
It did not present because in all the trails, different responses and outcomes were acquired.
HINT: An issue can be ‘focused’ In terms of
 The population studied
 The intervention given
 The comparator given
 The outcomes considered
2. Was the assignment of patients to treatments randomised? (Max 50 Words)
Yes No Can’t tell
Justify your answer:
It was randomized as patients were selected on random basis. This was carried through selecting patients on
random basis.
HINT: Consider
 How was this carried out?
 Was the allocation sequence concealed from
92318 Evidence for Nursing Assessment 3 Submission Template 5
Randomised Controlled Trial
Appraisal Tool

3. Were all of the patients who entered the trial properly accounted for at its conclusion? (Max 50
words)
Yes No Can’t tell
Justify your answer:
The trail did not stop early; however the effect of compressed stockings seems to be changeable; therefore it
is not included accordingly.
HINT: Consider
 Was the trial stopped early?
 Were patients analysed in the groups to which they were randomised?
4. Were patients, health workers and study personnel ‘blind’ to treatment? (Max 50 words)
Yes No Can’t tell
Justify your answer:
No such information is available
HINT: Think about
 Patients?
 Health workers?
 Study personnel?
5. Were the groups similar at the start of the trial? (Max 50 words)
Yes No Can’t tell
Justify your answer:
No such information is available
HINT: Look at
 Other factors that might affect the outcome such as age,
 sex, social class
 researchers and patients?
6. Aside from the experimental intervention were the groups treated equally? (Max 50 words)
Yes No Can’t tell
Justify your answer:
Equal treatment was given to all the participants in the experiment. All the CLOTS trails have shown
different results and outcomes.
92318 Evidence for Nursing Assessment 3 Submission Template 6

Section B: What are the results?
7. How large was the treatment effect? (Max 150 words)
Justify your answer:
Comparison of Trail 1 and Trail 2, proportional hazard model was being researched that includes
minimization algorithm. It does not specify the impact of compressed stockings on stroke.
HINT: Consider
 What outcomes were measured?
 Is the primary outcome clearly specified?
 What results were found for each outcome?
8. How precise was the estimate of the treatment effect? (Max 100 words)
Justify your answer:
It was effective to an extent as the randomized controlled trails of venous thromboembolism prophylaxis is
focusing on reducing deep vein thrombosis.
HINT: Consider
 What are the confidence limits?
Section C: Will the results help locally?
9. Can the results be applied in your context? (or to the local population?) (Max 100 words)
Yes No Can’t tell
Justify your answer:
There is a difference between the patients as issues presented in all the patients vary as per the situations.
HINT: Consider whether
 Do you think that the patients covered by the trial
 are similar enough to the patients to whom you will
 apply this?, if not how to they differ?
10. Were all clinically important outcomes considered? (Max 50 words)
Yes No Can’t tell
Justify your answer:
The study was based on identifying on effects of compression stockings on stroke; hence focus has been laid
on the same.
HINT: Consider
 Is there other information you would like to have seen?
 If not, does this affect the decision?
11. Are the benefits worth the harms and costs? Yes Can’t tell No (Max 100 words)
Justify your answer:
Since, there was no statistically significant difference identified in such events; therefore no information is
available to regarding harms and costs.
92318 Evidence for Nursing Assessment 3 Submission Template 7

HINT: Consider: Even if this is not addressed by the review, what do you think?
PART 3.2 APPRAISAL OF YOUR QUALITATIVE ARTICLE (please consider the word limit for each question, 10 marks )
Use the CASP Appraisal for Qualitative Research below to decide whether the information presented in your paper is
trustworthy and truly reflective of the participant’s voice.
SCREENING QUESTIONS
1. Was there a clear statement of the aims? ☒Yes ☐ Can’t tell ☐ No
HINT: Consider
 What was the goal of the research?
 Why it was thought important?
 Its relevance
Your comment: (max 50 words)
The main aim of the research is to identify the effects of graduated compression stockings on long- term
outcomes after stroke. In this respect Clots trails 1 and 2 have been identified. It was important since
compression stockings are used for improving venous thromboembolism prophylaxis.
2. Is a qualitative methodology appropriate? ☒Yes ☐ Can’t tell ☐ No
HINT: Consider
 If the research seeks to interpret or illuminate the actions and/or subjective experiences of research participants
 Is qualitative research the right methodology for addressing the research goal?
Your comment: (max 50 words)
Yes, Qualitative methodology was appropriate as outcomes were expected to identify from different
controlled trails. The number of patients were also higher; hence Qualitative methods have been used in
such studies.
3. Was the research design appropriate to address the aims of the research? ☐Yes ☒ Can’t tell ☐ No
HINT: Consider
 If the researcher has justified the research design (e.g. have they discussed how they decided which method to use)?
Your comment: (max 50 words)
This is not sure as finding of the study also possess a question regarding the ability of stockings in
preventing VTE in different patient groups.
4. Was the recruitment strategy appropriate to the aims of the research? ☒Yes ☐ Can’t tell ☐ No
HINT: Consider
 If the researcher has explained how the participants were selected
 If they explained why the participants they selected were the most appropriate to provide access to the type of knowledge sought
by the study
 If there are any discussions around recruitment (e.g. why some people chose not to take part)
Your comment: (max 100 words)
92318 Evidence for Nursing Assessment 3 Submission Template 8

Participants were selected on the basis of randomized controlling trails; hence it can be said that research
strategy was appropriate in deriving suitable outcomes.
5. Was the data collected in a way that addressed the research issue? ☐Yes ☒ Can’t tell ☐ No
HINT: Consider
 If the setting for data collection was justified
 If it is clear how data were collected (e.g. focus group, semi-structured interview etc.)
 If the researcher has justified the methods chosen
 If the researcher has made the methods explicit (e.g. for interview method, is there an indication of how interviews were conducted,
or did they use a topic guide)?
 If methods were modified during the study. If so, has the researcher explained how and why?
 If the form of data is clear (e.g. tape recordings, video material, notes etc)
 If the researcher has discussed saturation of data
Your comment: (max 100 words)
Survey was conducted through assessing controlled trails; however no specific information is being
identified in any domain.
6. Has the relationship between researcher and participants been adequately considered ☒Yes ☐ Can’t tell ☐ No
HINT: Consider
 If the researcher critically examined their own role, potential bias and influence during
a) Formulation of the research questions
b) Data collection, including sample recruitment and choice of location
 How the researcher responded to events during the study and whether they considered the implications of any changes in the
research design
Your comment: (max 50 words)
Research question was suitably formulated; hence researcher has clear idea about the things which is ought
to be collected through conducting the research work.
7. Have ethical issues been taken into consideration? ☒Yes ☐ Can’t tell ☐ No
HINT: Consider
 If there are sufficient details of how the research was explained to participants for the reader to assess whether ethical standards
were maintained
 If the researcher has discussed issues raised by the study (e.g. issues around informed consent or confidentiality or how they have
handled the effects of the study on the participants during and after the study)
 If approval has been sought from the ethics committee
Your comment: (max 50 words)
Ethical standards have been followed prior conducting the research study and researcher has also acquired
consent from the participants before involving them in research work.
8. Was the data analysis sufficiently rigorous? ☐Yes ☐ Can’t tell ☒ No
HINT: Consider
 If there is an in-depth description of the analysis process
 If thematic analysis is used. If so, is it clear how the categories/themes were derived from the data?
 Whether the researcher explains how the data presented were selected from the original sample to demonstrate the analysis
process
 If sufficient data are presented to support the findings
 To what extent contradictory data are taken into account
92318 Evidence for Nursing Assessment 3 Submission Template 9

 Whether the researcher critically examined their own role, potential bias and influence during analysis and selection of data for
presentation
Your comment: (max 100 words)
The study helps in analysing effects of long term outcomes. It also involves complex calculation which
shows relative reduction in the hazard of death. This was carried out within the period of 6 months; hence
the use of thigh- length stocking have not defined appropriately.
9. Is there a clear statement of findings? ☒Yes ☐ Can’t tell ☐ No
HINT: Consider whether
 If the findings are explicit
 If there is adequate discussion of the evidence both for and against the researchers arguments
 If the researcher has discussed the credibility of their findings (e.g. triangulation, respondent validation, more than one analyst)
 If the findings are discussed in relation to the original research question
Your comment: (max 100 words)
In the study, clear statement of findings have been shown in both the Cloth trails which also shows the risk
of VTE even after using below- knee stockings.
10. How valuable is the research?
HINT: Consider
 If the researcher discusses the contribution the study makes to existing knowledge or understanding e.g. do they consider the
findings in relation to current practice or policy?, or relevant research-based literature?
 If they identify new areas where research is necessary
 If the researchers have discussed whether or how the findings can be transferred to other populations or considered other ways the
research may be used
Your comment: (max 100 words)
According to the unexpected findings collected from Clot 1 and 2, it is identified that thigh level stockings
are not much effective in preventing VTE; however, below knee stockings might even amend thrombosis.
PART 4 OVERALL SUMMARY
PART 4.1 PROVIDE AN OVERALL SUMMARY OF WHAT THESE TWO PAPERS CONTRIBUTE TO ANSWERING YOUR
RESEARCH QUESTION (400 words, 10 marks).
HINT: Consider
 What was your original clinical question?
 What information do you think is useful from these two articles?
 Do you think the information in the articles is unbiased?
 If the information from the articles helpful in answering your overall question?
PART 4.2 SYNTHESISING THE EVIDENCE (300 words, 7 marks).
Finally, you need to summarise the evidence that relates to your clinical questions in plain language as if you were
explaining the rationale for your clinical decision making to a patient within your care.
92318 Evidence for Nursing Assessment 3 Submission Template 10