Essentials of Testing and Assessment:

/in /by

NO PLAGIARISM!

READ ENTIRE POST BEFORE CONTACTING ME-

Attached are the two chapter power points to choose from. Study them and then create a question coming from your thoughts for me to post as his instructions ask for. Also, be sure it has to do with the chapters and you give me follow-up information on your question as other students will be chiming in to my question and I need to have something to say in return.

If you have access to online books, the book chapters are from this book:

Essentials of Testing and Assessment: A Practical Guide for Counselors, Social Workers, and Psychologists by – Edward S. Neukrug

Instructor’s instructions: Please post a thoughtful question in this forum from one of the chapters assigned for this week. You will be evaluated on your ability to discuss topics, give examples, and explain the information covered in the chapter.

Your response may also involve asking follow-up questions. It is expected that you will have read the chapters.

Urinary tract infections (UTIs) occur when bacteria invade the normally sterile urinary system, causing inflammation to the epithelium

/in /by

Urinary tract infections (UTIs) occur when bacteria invade the normally sterile urinary system, causing inflammation to the epithelium. If the infection is found in the urethra and bladder, it is considered a lower urinary tract infection. When the infection goes above the level of the bladder and into the ureters and kidney, it is considered an upper urinary tract infection or pyelonephritis (Huether & McCance, 2017). Risk factors for UTIs include female gender, diabetes, sexual intercourse, urinary incontinence and/or retention, and immobility (Arcangelo, Peterson, Wilbur, & Reinhold, 2017).

Lower urinary tract infections are most commonly caused by intestinal microbes like E. Coli. These pathogens bind to the urinary epithelium and create an inflammatory response. This response created edema and stretching of the bladder wall, which signals the stretch receptors to relay the feeling of fullness. This created the urgency, frequency, dysuria, and low back pain that are commonly felt. If left untreated, the epithelial wall will become more and more damaged, eventually leading to bleeding, ulcerations, and even gangrene (Huether & McCance, 2017).

Upper urinary tract infections, or pyelonephritis, can be caused by the pathogen climbing and spreading into the upper part of the urinary system. Unlike lower urinary infections, upper urinary infections can also be caused by contaminated blood flowing through the kidneys. If left untreated, abscesses can form in the adrenal medulla and cortex. Back or flank pain and costovertebral tenderness are symptoms that are more unique to the upper urinary infection and can help differentiate along with diagnostic testing. Fibrosis formation in the tubules can form after the initial infection (Huether & McCance, 2017).

Females are far more likely to suffer from urinary tract infections because of the shorter urethra and closer proximity to the rectum (Huether & McCance, 2017). Age is also a factor, as immobility, dehydration, and urinary incontinence increase the risk of developing UTIs. A UTI in an older adult can have different symptoms and manifestations, such as delirium, hallucinations, sudden decrease in mobility, and subsequent falls. These symptoms can be dangerous and may cause significant injury (Armstrong, 2015).

Along with antibiotics, urinary analgesics can help with the discomfort associated with urinary tract infections. Urised is a common urinary analgesic that is prescribed which often has anticholinergic side effects. Patients should be educated on the chance for urinary and/or bowel retention and when to seek treatment (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Encouraging fluid and fiber intake may help offset these side effects.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Armstrong, K. (2015). Diagnosing and treating urinary tract infections in older people. British Journal of Community Nursing, 20(5), 226-230. doi:10.12968/bjcn.2015.20.5.226

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

“Genetic Drift And The Founder Effect”

/in /by

Your assignment should be 250-500 words in length.

“Genetic Drift and the Founder Effect”

There are two types of genetic drift. Describe and give an example of both the bottle neck effect and the founder effect.

Your assignment should be 250-500 words in length.

TURNITIN will be used to check for originality

Scope-Of-Practice (SoP) Laws That Govern The Practice Of Nurse Practitioners (NPs)

/in /by

Much of the ongoing debate over scope-of-practice (SoP) laws that govern the practice of nurse practitioners (NPs) across the country focuses on the cost of and access to health care and on whether these laws legitimately promote patient safety or are simply anticompetitive restrictions on NPs’ ability to compete with physicians. After completing the following CE activity at Medscape https://www.medscape.org/viewarticle/506277_1 ( sign for the free account), please answer the following questions:

Should an NP who is educationally prepared as an acute care NP work in an adult primary care setting?

Is it within the scope for an FNP to diagnose and treat uncomplicated mental health conditions like depression, anxiety, and ADHD?

Are there any restrictions for the FNP to treat patients with mood disorders and to prescribe them antipsychotics or SSRIs ?

Use APA Style and appropriated references.

BUSINESS PROJECT

/in /by

Scenario: You have just started work as the new Human Resources Manager for Acme Manufacturing, a Fortune 1,000 company. The job has been vacant for six months now. You have been wondering about this, especially since reading about employee harassment incidents and fights recently in the news.

The General Manager (GM) calls you into his office the minute you arrive. He shuts the door after saying a quick word of welcome, and begins to tell you about an incident that happened last week that needs your immediate attention. The company’s manufacturing operations runs three shifts of production workers so the plant is operating 24/7. Over the past six months hostilities have arisen between employees on the third and first shifts. What started out as jeering and criticisms by the first shift, claiming they have to clean up the mess and complete all of the work left undone by the third shift, has escalated to physical confrontations and altercations. Although the GM said that aggressive bantering back-and-forth is common for shift workers in manufacturing, he admitted he was worried after seeing a gun on one of the employees last week that was concealed, or so the employee thought, in a shoulder holster under this jacket. The GM said he needs your help. Specifically, he asked that you:

Determine and explain the appropriate disciplinary action for the employees involved in this situation and identify motivational alternatives that can help turn the situation around;

Draft policies and procedures that could be used in the guidance and performance management of the shift workers; and

Develop performance standards for the shift workers, identify appropriate methods of performance appraisal, and develop appropriate training to help get them back on track.

Feeling overwhelmed by the enormity of the situation, you go back to your office and begin devising a plan to help get employee relations back on track, realizing that human resource policies and practices may help avert potentially dangerous situations in the future if implemented correctly.

Write a 5-7 pages memo to the GM responding to the three concerns listed above. Include a title page , reference page- Be sure to cite any references used in proper APA format.

Your assignment will be graded in accordance with the following criteria

Individual Project Rubric

Grading Criteria

Percentage

Deliverable requirements addressed; understanding of material and writer’s message and intent are clear.

35%

Scholarly research supports the writer’s position and is properly acknowledged, and cited direct quotations may not exceed 10% of the word count of the body of the assignment deliverable (excluding title page, abstract, table of contents, tables, exhibits, appendices, and reference pages). Inclusion of plagiarized content will not be tolerated and may result in adverse academic consequences.

20%

Critical thinking: Position is well-justified, there is logical flow, and there are examples.

20%

Structure: Includes introduction and conclusion, proper paragraph format, and reads as a polished, academic paper or professional presentation, as appropriate for the required assignment deliverable.

10%

Mechanical: No spelling, grammatical, or punctuation errors.

10%

APA: Deliverable is cited properly according to the APA Publication Manual (6th ed.).

5%

You can choose either an organism that has recently become extinct or one that has recently been described.

/in /by

Instructions

You can choose either an organism that has recently become extinct or one that has recently been described.

Using a short PowerPoint (4–7 slides), describe that organism to your classmates. Explain why the organism might have gone extinct or why the new organism has recently been described. Be sure to include a description of the organism, its habitat, the environmental pressures on your organism, and a final interesting story or fact about your organism.

By 04/17, your PowerPoint should be posted by the third day of the discussion opening to allow time for interaction. Your initial post should be between 75–100 words.

Evaluating Pressures For Change

/in /by

The assignment is as follows. I prefer Comcast ( technology field)as the Organization of choice ….

Being able to recognize potential pressures that require an organization to change its practices or processes is a vital for its success. Examine an organization in the field or industry in which you work, or are planning to work. In 1,000-1,250 words, evaluate the pressures the organization currently faces and discuss the potential effects these pressures could have on the organization. You will use your evaluation of this organization for your Implementing Change assignment.

Include the following:

Identify and describe the organization you are evaluating. Provide an overview of the industry within which the organization operates.
Identify the environmental and organizational pressures currently driving organizational change in your field or industry. Explain the origin or reason for these pressures, and explain how they directly affect the viability of your organization.
Predict what type of organizational changes (first-order/second-order) these pressures may cause within the organization.
Provide support for your analysis and prediction.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.Save Link

Assignment Benchmark : Evaluating Pressures for Change

View Rubric

Due Date: Apr 15, 2018 23:59:59 Max Points: 200 Details:

Being able to recognize potential pressures that require an organization to change its practices or processes is a vital for its success. Examine an organization in the field or industry in which you work, or are planning to work. In 1,000-1,250 words, evaluate the pressures the organization currently faces and discuss the potential effects these pressures could have on the organization. You will use your evaluation of this organization for your Implementing Change assignment.

Include the following:

1. Identify and describe the organization you are evaluating. Provide an overview of the industry within which the organization operates.

2. Identify the environmental and organizational pressures currently driving organizational change in your field or industry. Explain the origin or reason for these pressures, and explain how they directly affect the viability of your organization.

3. Predict what type of organizational changes (first-order/second-order) these pressures may cause within the organization.

4. Provide support for your analysis and prediction.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.Benchmark : Evaluating Pressures for Change

1 Unsatisfactory 0.00%

2 Less than Satisfactory 65.00%

3 Satisfactory 75.00%

4 Good 85.00%

5 Excellent 100.00%

70.0 %Content

10.0 %Describe Organization and Industry

A specific organization is not identified. The industry of the organization is not described.

A specific organization is identified; little to no detail is provided to give insight into the organization. A partial description of the industry of the organization is presented.

A specific organization is identified and generally described. A summary of the industry of the organization is presented. More detail is needed to provide a comprehensive look at the organization and industry.

A specific organization is identified and described. A description of the industry of the organization is presented. Some detail is needed to provide a comprehensive look at the organization or industry.

A specific organization is identified; the organizational description provides insight into the organizational attributes (vision, mission, goals, etc.) and goals. A clear description of the industry is presented that illustrates the current state of the industry and where it is heading. The overall narrative provides objective insight into the organization and the industry.

25.0 %Identification of Environmental and Organizational Pressures Driving Change

Environmental and organizational pressures are not identified.

At least one environmental or organizational pressure is referenced. It is unclear how the pressures identified relate to the organization or industry. There is no indication that these pressures are driving organizational change.

Environmental and organizational pressures are generally described. The pressures identified generally relate to the organization or industry; it is unclear how the pressures drive organizational change.

Key environmental and organizational pressures are described. The pressures described relate to the organization and industry. A general correlation between the pressures and how they drive organizational change is established.

Major and minor environmental and organizational pressures are described. The pressures described clearly relate to the organization and industry. A very strong correlation between the pressures and how they drive organizational change is established.

25.0 %Predict Type of Organizational Changes Caused by Pressures

A prediction of organizational change is not presented. The prediction is not based on the environmental or organizational pressures presented in the paper.

A prediction for organizational change is referenced. It is unclear how this prediction relates to the organization and industry. The types of organizational change likely to occur are absent.

A general prediction of organizational change is summarized. Key aspects of the prediction are vague. More information is needed in order to present a viable prediction.

A prediction of organizational change is presented. A correlation between the pressures and the prediction has been established. First-order and second-order change have been identified. Some detail is needed for clarity.

A well-developed prediction of organizational change likely to occur is described. A strong correlation between the pressures and the prediction has been established. First-order and second-order change are clearly identified and described. The prediction demonstrates insight into organizational change.

10.0 %Support for Analysis and Predictions

No support is provided to support the analysis or predictions presented.

Significant evidence is needed to establish support for both the analysis and prediction.

Some evidence is needed to fully establish support for the analysis and prediction.

Adequate evidence is provided to establish support for the analysis and prediction. Some minor detail is needed for clarity.

The analysis and prediction are well developed. Strong evidence is used to create support for the findings.

20.0 %Organization and Effectiveness

7.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

20.0 %Organization and Effectiveness

8.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

20.0 %Organization and Effectiveness

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

Writer is clearly in command of standard, written, academic English.

10.0 %Format

5.0 %Paper Format (use of appropriate style for the major and assignment)

Template is not used appropriately, or documentation format is rarely followed correctly.

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

Appropriate template is used. Formatting is correct, although some minor errors may be present.

Appropriate template is fully used. There are virtually no errors in formatting style.

All format elements are correct.

5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %Total Weightage

Bones make good fossils.

/in /by

Chapter 6

1) Bones make good fossils. While the soft tissue of a once living organism will decay and fall away over time, bone tissue will, under the right conditions, undergo a process of mineralization, effectively turning the bone to stone. A well-preserved fossil skeleton can give us a good sense of the size and shape of an organism, just as your skeleton helps to define your size and shape. Unlike a fossil skeleton, however, your skeleton is a structure of living tissue that grows, repairs, and renews itself. The bones within it are dynamic and complex organs that serve a number of important functions, including some necessary to maintain homeostasis.

2)functions of the skeletal system into 2 groups (physical and metabolic)

Physical function

· Support – holds your vital organs in place when playing sport. The vertebral column holds the body upright.

· Movement – muscle are attached to bones, which are jointed. When the muscles contract the bones move.

· Shape – gives shape to the body and makes you tall or short.

Metabolic function

· Protection – the cranium and ribs protect the brain and vital organs in the chest.

· Blood production – red blood cells (to carry oxygen) and white blood cells (to protect against infection) are produced in the bone marrow of some bones.

3)3 types of bone cells and their functions

· Osteoblasts -secrete matrix (mineral salts and collagen) holds everything together form new tissue

· Osteoclasts -bone remodeling, healing, release calcium into blood

· Osteocyte -mature bone cells trapped in their own matrix deeper in compact bone

4)Sketch and label of a typical long bone

https://upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Structure_of_a_Long_Bone.png/533px-Structure_of_a_Long_Bone.png

5)

Bone type

Function and description

Example of bones in this category

Long bones

are longer than they are wide, i.e. length > diameter.

They consist of a shaft – which is the main (long) part and variable number of endings (extremities), depending on the joints formed at one or both ends of the long bone. Long bones are usually somewhat curved – contributing to their mechanical strength.

Femur

Tibia

Ulna

Radius

Short bones

can be approximately cube-shaped, i.e. length is similar to width / depth / diameter.

The most obvious examples are the carpal (of the hands / wrists) and the tarsal (of the feet / ankles) bones.

Scaphoid

Lunate

Hamate

Cuboid

Flat bones

have a thin shape and, in some cases, provide mechanical protection to soft tissues beneath or enclosed by the flat bone e.g. cranial bones that protect the brain. Flat bones also have extensive surfaces for muscle attachments e.g. scapulae (shoulder) bones.

Cranial

Frontal

parietal

7 types of synovial joints;

· Planar joints have bones with articulating surfaces that are flat or slightly curved. These joints allow for gliding movements; therefore, the joints are sometimes referred to as gliding joints. The range of motion is limited and does not involve rotation. Planar joints are found in the carpal bones in the hand and the tarsal bones of the foot, as well as between vertebrae.

· In hinge joints, the slightly-rounded end of one bone fits into the slightly-hollow end of the other bone. In this way, one bone moves while the other remains stationary, similar to the hinge of a door. The elbow is an example of a hinge joint. The knee is sometimes classified as a modified hinge joint.

· Pivot joints consist of the rounded end of one bone fitting into a ring formed by the other bone. This structure allows rotational movement, as the rounded bone moves around its own axis. An example of a pivot joint is the joint of the first and second vertebrae of the neck that allows the head to move back and forth. The joint of the wrist that allows the palm of the hand to be turned up and down is also a pivot joint.

· Condyloid Joints – consist of an oval-shaped end of one bone fitting into a similarly oval-shaped hollow of another bone. This is also sometimes called an ellipsoidal joint. This type of joint allows angular movement along two axes, as seen in the joints of the wrist and fingers, which can move both side to side and up and down.

· Saddle Joints-Each bone in a saddle joint resembles a saddle, with concave and convex portions that fit together. Saddle joints allow angular movements similar to condyloid joints, but with a greater range of motion. An example of a saddle joint is the thumb joint, which can move back and forth and up and down; it can move more freely than the wrist or fingers.

· Ball-and-socket joints possess a rounded, ball-like end of one bone fitting into a cup-like socket of another bone. This organization allows the greatest range of motion, as all movement types are possible in all directions. Examples of ball-and-socket joints are the shoulder and hip joints.

9)Sketch and label the major components of a synovial joint

https://upload.wikimedia.org/wikipedia/commons/thumb/8/8b/907_Synovial_Joints.jpg/722px-907_Synovial_Joints.jpg

10) ​Point out and/or identify the following joints:

Related image

11)

Flexion – occurs when the angle between the bones decreases. Moving the forearm upward at the elbow or moving the wrist to move the hand toward the forearm are examples of flexion.

Extension – angular movement in which the angle between the bones of a joint increases.

Adduction – is the movement of a bone toward the midline of the body.

Abduction -occurs when a bone moves away from the midline of the body

Rotation – is the movement of a bone as it rotates around its longitudinal axis.

Pronation – the action of rotating the forearm so that the palm of the hand is turned down or back

Supination – the action of rotating the forearm so that the palm of the hand is turned up or forward

The anatomy and physiology

/in /by

• Describe the anatomy and physiology of the hip joint.
• Briefly discuss the physical assessments that should be performed on arrival to the ward post-operatively. Using critical thinking, state why you have included these assessments.
• Discuss your post-operative plan of care when prioritising nursing management of Molly on her return to the ward. Discuss rationales for each nursing intervention based upon evidence based practice.
• Outline strategies for ongoing care and discharge planning for Molly upon leaving hospital.

What Does “Pre-Appraised Evidence” Mean in Evidence-Based Practice?

/in /by

When looking for evidence – where should you start? Well at the top of course! At the top of the hierarchy of evidence quality is pre-appraised evidence (Haynes, 2007).

If you go through your university or medical library, there are multiple databases to search, such as MEDLINE or CINAHL. You can also search from home using PUBMED. But as a busy clinician needing answers NOW, you don’t want to search databases that may have you wading through hundreds, if not thousands, of search results. Nor do you have the time to critically appraise the reports of primary or original research studies you find. To make your search process more efficient, you want to search pre-appraised evidence first!

Search Pre-Appraised Evidence for Answers to Clinical Questions!
Search Pre-Appraised Evidence for Answers to Clinical Questions! Photo credit: (c) Tashatuvango; Shutterstock.com

What is Pre-Appraised Evidence?
When I say the evidence source contains pre-appraised evidence that means that someone else (an expert) has critically appraised the studies contained in the database for you and put them in a summary format. Summary literature, also called secondary literature, includes systematic reviews, meta-analyses, clinical practice guidelines, and critically appraised topics (CATs). Evidence-based practice summaries are also found in the form of online textbooks. These resources may be accessed for free or by individual or institutional subscriptions.

Pre-appraised evidence, also known as pre-filtered evidence or summarized evidence, is collected in databases – for example, rigorously conducted systematic reviews (SR) and meta-analyses (MA) can be found in the Cochrane Collaboration Library.

Pre-appraised evidence that is accessed from a credible source can be trusted by the clinician to have undergone a standardized process of evaluation.

Trusted evidence will save the clinician time because the source is updated with new evidence regularly and the appraisal work has already been done. In other words, you can count on the fact that the authors of this pre-appraised work have been rigorous in its development.

For sources that are not pre-appraised, YOU will have to determine whether the source can be trusted. So you will have to critically appraise any original research study you find because you want to make sure that you can believe the research findings. The same with other sources of evidence you use. For example, if you are using data from internal chart audits, you want to know how those data were collected and what oversight was used to ensure accurate data entry; and then how the data were analyzed.

Summaries, Syntheses, and Synopses
Summaries, syntheses, and synopses are considered pre-appraised evidence. These products are secondary analyses of primary research studies (AKA original research) and systematic reviews. In a secondary analysis, the researcher(s) analyzes published research studies to examine the data more closely or answer a research question different from the one asked in the primary studies. The secondary analysis can be of one research study or of many. A secondary analysis is a research method and the final product may be in the form of a synopsis, synthesis, or a summary.

A synopsis is a brief summary or overview of an original research study or of a systematic review. Synopses give the clinician a rapid read of the original research article (i.e., a critically appraised topic), of multiple research studies on a specific topic (synopses of studies), or of systematic reviews (synopses of syntheses), along with a commentary of the rigor of the information.

Synthesis is a process of taking multiple components and combining them into a new product. A synthesis, in evidence-based practice, is a systematic, comprehensive, critical review of high-quality research studies on a specific clinical question that then compiles the data from those studies into an “answer” to the clinical question posed. A systematic review, meta-analysis, and rapid review (Munn, Lockwood, & Moola, 2015) are types of syntheses.

A summary encompasses all the “lower” levels of evidence (i.e., original research, systematic reviews, and synopses) to produce the best evidence for clinical practice, such as a clinical practice guideline (DiCenso, Bayley, & Haynes, 2009). A summary ideally contains evidence from more than one systematic review (Munn et al., 2015).

All Evidence is NOT Created Equal!
A common misconception is that if a research study is published, it must be excellent. But that is false. Just because a research study is published doesn’t mean that the methods the researchers used are valid.

Having someone else do the work of critical appraisal is great, especially for busy clinicians, but before you trust these sources, be vigilant! I don’t want you to think that just because you find a systematic review that it is automatically good! Anyone can conduct and publish a systematic review!

Also, don’t make assumptions that because a synopsis, synthesis, or summary comes from a professional organization or national group (e.g., American Heart Association, National Kidney Foundation, etc.) that the document was assembled with the highest standards — unless you vet their process first!

Haynes (2007) warned that many sources claim to be evidence-based, but are not. The clinician should assess any source claiming to be evidence-based for the “underlying methods of assembly and assure [yourself] that these methods are sound. At each level [of evidence sources], the standards for evidence generation, retrieval, selection, and analysis should be explicit and at the highest evidence standard possible” (Haynes, 2007, p. 6).

Look for information on the organization websites or in the specific secondary study for how the reviews were developed. Once satisfied that the process is rigorous, then you can feel confident in the results of the review without having to get out your appraisal worksheets.

Pre-Appraised Evidence Databases
Point-of-care resources are vital to contemporary evidence-based practice. These resources allow you to quickly find evidence summaries on-the-go from your smartphone or tablet device.

There are a number of credible databases for finding pre-appraised evidence. Some of the databases are free and others are only available through a subscription. Check the databases available to you in your medical or university library.

Summary Evidence: Online, evidence-based textbooks or summary services include Clinical Evidence, Physician’s Information and Education Resource (PIER), UpToDate, MDConsult, First Consult, Nursing Consult, DynaMed Plus, Best Evidence Topics, and Essential Evidence Plus.

Clinical practice guidelines (CPGs) are evidence sources that fit in this layer, also. One of the best-known sources of CPGs is the National Guidelines Clearinghouse (www.guidelines.gov). Check out my post on EBP Resources specific to CPG sites for a list of helpful databases.

Synthesis Evidence: The Cochrane Library should be your FIRST stop to find summary evidence, in the form of systematic reviews, for clinical questions about clinical treatment. Evidence from the Cochrane Collaboration is considered the gold standard “for high quality, trusted information.” This is where you want to look first for systematic reviews about clinical treatment! Many libraries also provide access to Cochrane.

The DARE database (Database of Abstracts of Reviews of Effects) is a resource for synopses of syntheses and can be found in the Cochrane Library. For syntheses on education and other social topics, you can search the Campbell Collaboration.

Synopsis Evidence: There are a variety of journals that are known for summarizing high-quality original research evidence and clinical topics. Evidence-based abstraction journals that provide synopses include ACP Journal Club, Evidence-Based Mental Health, and Evidence-Based Nursing. Again, many of the evidence-based summary services noted above provide synopses also.

How to Quickly Determine Validity of Pre-Appraised Evidence
I will provide future blog posts on how to critically appraise different studies, but for now, here are some quick tips.

In a synopsis, synthesis, or summary, the research studies included in those publications would have been already appraised by the author. So you won’t have to appraise each study they included.

What you want to know is HOW the authors assembled their synopsis, synthesis, or summary.

What was the methodology used to search for the included studies, determine the methodological quality of each included study, and how did the author even choose the studies for inclusion? The author needs to tell you exactly what they did in the introduction section of their research report – that’s what is meant by transparency. You need to know the methods so that you can decide if you can believe the results.

There are groups and organizations that mandate a rigorous process for doing this kind of work. That kind of standardization is gold because once you understand the process used, you shouldn’t have to reappraise the methodology of every publication you read using that systematic standardized methodology.

For example, when the American Heart Association (AHA) puts out new or updated clinical practice guidelines, they are clear about how the working group assembled the guidelines at the beginning of the document.

I’ve read the standardized methodology for systematic reviews published on the Cochrane Collaboration library website. All authors writing for the Cochrane Collaboration follow their guidelines for writing a systematic review. When I read a systematic review from that site, I know the methods are rigorous, I can see how the author(s) reported their methods, and, therefore, have confidence in the reported results.

Because the processes outlined by these organizations are transparent, I don’t go through the work of appraising every AHA clinical practice guideline or Cochrane Review I read!

Bottom Line: If you find the synopsis, synthesis, or summary from a credible source, then the hard work of critical appraisal is done for you and you can use the results without a further methods critique on your part. But if the synthesis is done by a single author or a group of authors not associated with known credible databases, you will still have to determine how rigorous their methods were before you want to rely on their research results.

References
DiCenso, A., Bayley, L., & Haynes, R. B. (2009). Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Evidence Based Nursing, 12(4), 99-101. doi:10.1136/ebn.12.4.99-b

Haynes, R. B. (2007). Of studies, syntheses, synopses, summaries, and systems: The “5S” evolution of information services for evidence-based health care decisions. Evidence-Based Nursing, 10(1), 6-7.

Munn, Z., Lockwood, C., & Moola, S. (2015). The development and use of evidence summaries for point of care information systems: A streamlined rapid review approach. Worldviews on Evidence-Based Nursing, 12(3), 131-138. doi 10.1111/wvn.12094