Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals
Research Evidence Appraisal Tool
Appendix E
Example you can modify this base on the article your reading
Does this evidence answer the EBP question?
Yes 🡪 Continue appraisal
Yes
No 🡪 STOP, do not continue evidence appraisal
Article Summary Information
Article Title: Sources of noise and their effects on nurses in intensive care units.
Author(s): Number:
Zahra Kooshanfar,, Sadra Ashra, Ezzat Paryad, Yalda Salmanghasem, NLM UID:
Tahereh Khaleghdoost Mohammadi, Ehsan Kazemnezhad Leili,
Accession Number:
Seyyed Mohammad Javad Golhosseini
Population, size, and setting: Publication date:
Population:
2022
● Nurses working in intensive care units (ICUs).
● Includes nurses caring for adult patients (specific unit types
included general surgery, neurosurgery, burn, gynecology,
ENT, medical, and open heart surgery ICUs).
● Sample Size:
● Total population: 163 nurses eligible (all ICU nurses at the
hospitals).
● Participants: 148 nurses (90.8% response rate)
● Setting:
● Conducted in seven intensive care units across all educational
hospitals in Rasht, Iran.
● Specific ICU types: General surgery, neurosurgery, burn,
gynecology, ENT, medical, and open heart surgery.
● The highest bed occupancy rate was 100% in general surgery
and neurosurgery ICUs.
©2022 Johns Hopkins Health System/Johns Hopkins School of Nursing Page | 1
, Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals
Research Evidence Appraisal Tool
Appendix E
● Nurses worked in rotating shifts (83.8%) with an average of
39.91 hours of overtime per month.
Complete after appraisal:
Evidence level and quality rating: Level III evidence
Study findings that help answer the EBP question:
Main internal noise sources: Monitoring alarms and ventilators (61.5%), telephone ringing (59.5%), and
patients’ groaning (43.9%).
Main external noise sources: Hospital renovation sounds (41.2%) and new patient admissions/patients’
groaning (24.3%).
Most affected health domain: Physiology (mean score 16.1 ± 4.8), followed by subjective perception (16 ±
4.3), emotion (15.65 ± 4.95), and performance (14.9 ± 5.25).
Type of ICU matters: General surgery ICUs had the highest negative noise effects; ENT ICUs had the lowest.
Conclusions: ICU noise adversely affects nurses’ physiology, emotions, perception, and performance; noise-
reduction strategies (quiet equipment, soundproofing, staff education) are needed
Article Appraisal Workflow
In this study:
QuaNtitative (collection, analysis, and reporting of numerical data)
Numerical data (how many, how much, or how often) are used to formulate facts, uncover patterns, and
generalize to a larger population; provides observed effects of a program, problem or condition. Common
methods are polls, surveys, observations and reviews of records or documents. Data are analyzed using
statistical tests.
➔ Go to Section I for QuaNtitative leveling: IA - single study, IB - multiple studies
QuaLitative (collection, analysis, and reporting of narrative data)
Rich narrative data to gain a deeper understanding of phenomena, meanings, perceptions, concepts, and
experiences from those experiencing it. Sample sizes are relatively small and determined by the point of
redundancy when no new information is gleaned, and key themes are reiterated (data saturation). Data are
analyzed using thematic analysis. Often a starting point for studies when little research exists may use results to
design empirical studies. Common methods are focus groups, individual interviews (unstructured or semi-
structure), and participation/observations.
©2022 Johns Hopkins Health System/Johns Hopkins School of Nursing Page | 2
Research Evidence Appraisal Tool
Appendix E
Example you can modify this base on the article your reading
Does this evidence answer the EBP question?
Yes 🡪 Continue appraisal
Yes
No 🡪 STOP, do not continue evidence appraisal
Article Summary Information
Article Title: Sources of noise and their effects on nurses in intensive care units.
Author(s): Number:
Zahra Kooshanfar,, Sadra Ashra, Ezzat Paryad, Yalda Salmanghasem, NLM UID:
Tahereh Khaleghdoost Mohammadi, Ehsan Kazemnezhad Leili,
Accession Number:
Seyyed Mohammad Javad Golhosseini
Population, size, and setting: Publication date:
Population:
2022
● Nurses working in intensive care units (ICUs).
● Includes nurses caring for adult patients (specific unit types
included general surgery, neurosurgery, burn, gynecology,
ENT, medical, and open heart surgery ICUs).
● Sample Size:
● Total population: 163 nurses eligible (all ICU nurses at the
hospitals).
● Participants: 148 nurses (90.8% response rate)
● Setting:
● Conducted in seven intensive care units across all educational
hospitals in Rasht, Iran.
● Specific ICU types: General surgery, neurosurgery, burn,
gynecology, ENT, medical, and open heart surgery.
● The highest bed occupancy rate was 100% in general surgery
and neurosurgery ICUs.
©2022 Johns Hopkins Health System/Johns Hopkins School of Nursing Page | 1
, Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals
Research Evidence Appraisal Tool
Appendix E
● Nurses worked in rotating shifts (83.8%) with an average of
39.91 hours of overtime per month.
Complete after appraisal:
Evidence level and quality rating: Level III evidence
Study findings that help answer the EBP question:
Main internal noise sources: Monitoring alarms and ventilators (61.5%), telephone ringing (59.5%), and
patients’ groaning (43.9%).
Main external noise sources: Hospital renovation sounds (41.2%) and new patient admissions/patients’
groaning (24.3%).
Most affected health domain: Physiology (mean score 16.1 ± 4.8), followed by subjective perception (16 ±
4.3), emotion (15.65 ± 4.95), and performance (14.9 ± 5.25).
Type of ICU matters: General surgery ICUs had the highest negative noise effects; ENT ICUs had the lowest.
Conclusions: ICU noise adversely affects nurses’ physiology, emotions, perception, and performance; noise-
reduction strategies (quiet equipment, soundproofing, staff education) are needed
Article Appraisal Workflow
In this study:
QuaNtitative (collection, analysis, and reporting of numerical data)
Numerical data (how many, how much, or how often) are used to formulate facts, uncover patterns, and
generalize to a larger population; provides observed effects of a program, problem or condition. Common
methods are polls, surveys, observations and reviews of records or documents. Data are analyzed using
statistical tests.
➔ Go to Section I for QuaNtitative leveling: IA - single study, IB - multiple studies
QuaLitative (collection, analysis, and reporting of narrative data)
Rich narrative data to gain a deeper understanding of phenomena, meanings, perceptions, concepts, and
experiences from those experiencing it. Sample sizes are relatively small and determined by the point of
redundancy when no new information is gleaned, and key themes are reiterated (data saturation). Data are
analyzed using thematic analysis. Often a starting point for studies when little research exists may use results to
design empirical studies. Common methods are focus groups, individual interviews (unstructured or semi-
structure), and participation/observations.
©2022 Johns Hopkins Health System/Johns Hopkins School of Nursing Page | 2
