To Prepare
Review the DNP Project Process Guide provided in the Learning Resources.
Review the Evidence Level and Quality Guide provided in the Learning Resources to help you in determining how you will appraise the evidence related to your DNP Project practice problem.
Review the Research Evidence Appraisal Tool and the Nonresearch Evidence Appraisal Tool provided in the Learning Resources. You will use these tools to assist you in your review of the evidence related to your DNP Project practice problem.
Review the Individual Evidence Summary Tool and the Synthesis and Recommendations Tool to focus on for completing this Assignment.
Be sure to review the Synthesis resources from the Walden University Writing Center in preparation for this Assignment.
The Assignment
Complete all components of the Individual Evidence Summary Tool. Be sure to follow the guidelines and recommendations from the Evidence Level and Quality Guide.
Complete all components of the Synthesis Process and Recommendations Tool. Be sure to consult your Research (or Nonresearch) Appraisal Tools in completing this part of the Assignment
For the project question on clinical guideline
Johns Hopkins Nursing Evidence-Based Practice
Appendix G
Individual Evidence Summary Tool
| Date: 10/03/2022 | EBP Question: “For adult obesity patients aged between 20 and 60 years (P), does the implementation of staff education on behavioral changes for obesity (I) compared to current practice (C), improve obesity management (O) within a period of 3 weeks (T)?” | ||||||
| Article Number | Author and Date | Evidence Type | Sample, Sample Size, Setting or Not Applicable | Findings That Help Answer the EBP Question | Observable Measures | Limitations | Evidence Level, Quality |
| 1 | Croghan et al. (2019) | Research | Sample: Nurses and primary care providers
Sample Size: (N=219)
Setting: 5 outpatient primary care clinics in the United States |
Nurses and PCPs support the need to educate staff on obesity management as a strategy to improve their knowledge, attitudes, and competencies concerning weight management and be able to address weight management issues with their obese patients.
|
-Training and knowledge score
-Time spent with obese/overweight patients -Factor patterns including opportunity and practices, knowledge and confidence, attitudes, and beliefs. |
-Data collection was limited to one healthcare system which limits generalizability.
-The fact that researchers used a convenience sample increased the influence of unmeasurable response bias. -Most of the respondents were non-Hispanic females. |
Evidence Level: II
Quality: Good quality |
| 2 | Critchlow et al. (2020) | Research | Sample: General Practitioners (GPs) and Practice Nurses (PNs)
Sample Size: (n=220)
Setting: Primary care facilities in the United Kingdom (UK) |
-Obesity management education provides healthcare providers with the knowledge and skills to offer appropriate weight management advice to their patients, including those with obesity. | -Primary care practitioner characteristics
-The provision of weight-management advice in a mock consultation -The frequency of calculating body mass index (MBI) for all patients -Provision of weight management advice to patients with an obese BMI -Provision of advice and referrals in weight management. |
-The use of convenience sampling limits generalizability of findings to other GPs and PNs.
-There is a possibility of inconsistencies in patient outcomes when the study findings are applied to other practice settings and in times of the year other than 2017. -Since the study findings are based on self-reported data, their reliability is questionable due to the high risk of recall bias. |
Evidence Level: II
Quality: Good quality |
| 3 | Earnest & Church (2020) | Research | Sample: Employees across healthcare facilities in Dallas, Texas.
Sample Size: (n=196,058)
Setting: Databases of employees across healthcare facilities in Dallas Texas. |
-Participation in weight management programs equipped healthcare providers with knowledge that they can apply to influence patients to effectively manage obesity. | -Knowledge of weight management
-Percent weight loss -Patient referral to weight management programs. |
–The lack of a control group prevented comparison.
-Incomplete records caused challenges in the retrospective study. -The data was collected through self-reporting before being stored in the databases. Its reliability might be affected by false responses.
|
Evidence Level: I
Quality: High quality |
| 4 | Fruh et al. (2019) | Research | Sample: Nurse Practitioner students.
Sample Size: (n=45)
Setting: Women’s Health NP course at a College of Nursing in the Southeastern United States |
Weight management educational interventions increased staff competency regarding obesity management. These nurses can use their knowledge to influence patients to effectively manage obesity. | –Knowledge regarding obesity management
-Comfort levels when managing patients with obesity |
-Data was gathered for female students enrolled in the Women’s Health NP course but not men
-Concentration at one college limits generalizability of findings. |
Evidence Level: I
Quality: Good quality |
| 5 | Jaka et al. (2021) | Research | Sample: Employees from an integrated health system
Sample Size: (n=140)
Setting: Health System from Sanford Health and Profile |
-Obesity management educational programs offered to healthcare providers are effective weight management tools for both staff and patients. | -Weight-related behaviors
-Behavioral mechanisms -Workplace outcomes such as having the energy to sustain work throughout the day -Well-being outcomes such as physical health and emotional health -Satisfaction with program activities. |
-Limited variability among study participants might limit generalizability of findings
-The study involved participants with prior weight management attempts. This might affect the responses given. |
Evidence Level: I
Quality: High quality |
| 6 | Osmundsen et al. (2019) | Research | Sample: General Practitioners (GPs), head physicians, and staff
Sample Size: (n=13)
Setting: Center for Obesity Research in Central Norway |
– Obesity management educational program strengthened healthcare delivery competence and knowledge among practitioners in relation to obesity management. | –The level of integrated obesity care to patients
-Knowledge and competence regarding obesity management -Shared practice using clinical practice standards. |
-A fragmented decision-making process between GPs and their respective municipalities hindered decision-making.
-Educational program did not include clear expectations for establishing work plans. |
Evidence Level: III
Quality: Good quality |
| 7 | Sanchez-Ramirez et al. (2018) | Research | Sample: Front-line healthcare workers
Sample Size: (n=67)
Setting: Healthcare settings in Manitoba |
-Obesity training enhanced the participants’ professional attitudes regarding weight management. Participants were motivated to teach patients about weight management, healthy eating practices, and behavior modifications | -Perceived skills regarding obesity management
-Professional attitudes on working with patients to manage obesity -Perceived challenges with obesity management |
-The observed improvements might have occurred as a result of Hawthorne effect or a feeling by the participants that they were being observed.
-The use of younger practitioners with few years of experienced could have affected the study results. -The study used participants with as a particular interest in the study topic and this might have affected their responses. -The study lacked normal piloting. |
Evidence Level: I
Quality: High quality |
| 8 | Walsh et al. (2019) | Research | Sample: Systematic review of randomized controlled trials (RCTs)
Sample Size: 13 articles
Setting: Emcare, Ovid, Embase, The Cochrane library, Proquest family health, Health source (nursing academic), Joanna Briggs Institute EBP database, Medline, PubMed, Rural and remote, Proquest (nursing and allied health) and TRIP. |
-Adequately trained primary care nurses and doctors have increased capacity to offer appropriate health education and advice to overweight patients thereby enabling them to engage in relevant weight management activities | –Ability to be involved in giving patients advice about healthy lifestyle
-Perceived barriers to giving advice to obese patients. |
-The strict 10 years inclusion criteria locked out some relevant articles from being reviewed.
-The use of articles only published in the English language means that some relevant articles published in languages other than English were not reviewed. -Reliance on published/secondary evidence might affect the reliability of findings due to possible biases in the reviewed studies. |
Evidence Level: I
Quality: High quality |
References
Critchlow, N., Rosenberg, G., Rumgay, H., Petty, R., & Vohra, J. (2020). Weight assessment and the provision of weight management advice in primary care: a cross-sectional survey of self-reported practice among general practitioners and practice nurses in the United Kingdom. BMC Family Practice, 21(1), 111. https://doi.org/10.1186/s12875-020-01184-z
Croghan, I. T., Ebbert, J. O., & Njeru J.W. (2019). Identifying opportunities for advancing weight management in primary care. Journal of Primary Care & Community Health, 10(1), doi:10.1177/2150132719870879.
Earnest, C. P., & Church, T. S. (2020). A retrospective analysis of employee education level on weight loss following participation in an online, corporately sponsored, weight loss program. Journal of Occupational and Environmental Medicine, 62(10), e573–e580. https://doi.org/10.1097/JOM.0000000000001990
Fruh, S. M., Golden, A., Graves, R. J., Minchew, L. A., Platt, T. H., Hall, H. R., Williams, S. G., Mehari, K., Sims, B. M., Hauff, C., & Cheese, C. (2019). Competency in obesity management: An educational intervention study with nurse practitioner students. Journal of the American Association of Nurse Practitioners, 31(12), 734–740. https://doi.org/10.1097/JXX.0000000000000218
Jaka, M. M., Dinh, J. M., Rivard, R. L., Herrmann, S. D., Spoonheim, J., Pronk, N. P., & Ziegenfuss, J. Y. (2021). Pragmatic evaluation of a health system-based employee weight management program. International Journal of Environmental Research and Public Health, 18(11), 5901. https://doi.org/10.3390/ijerph18115901
Osmundsen, T.C., Dahl, U. & Kulseng, B. (2019). Enhancing knowledge and coordination in obesity treatment: a case study of an innovative educational program. BMC Health Services Research, 19, 278. https://doi.org/10.1186/s12913-019-4119-9
Sanchez-Ramirez, D. C., Long, H., Mowat, S., & Hein, C. (2018). Obesity education for front-line healthcare providers. BMC Medical Education, 18(1), 278. https://doi.org/10.1186/s12909-018-1380-2
Walsh, K., Grech, C., & Hill, K. (2019). Health advice and education given to overweight patients by primary care doctors and nurses: A scoping literature review. Preventive Medicine Reports, 14, 100812. https://doi.org/10.1016/j.pmedr.2019.01.016