Critical Appraisal Tool

Worksheet Template

Evaluation Table

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical
Appraisal of Research

Full APA formatted citation of Article #1 Article #2 Article #3 Article #4

selected article. Arnetz, J. E., Hamblin, Davey, K., Ravishankar, Harthi, M., Olayan, M., Palma, A.,
L., Russell, J., Upfal, M. V., Mehta, N., Ahluwalia, Abugad, H., & Wahab, Ansoleaga, E., &
J., Luborsky, M., T., Blanchard, J., Smith, M. A. (2020). Ahumada, M. (2018).
Janisse, J., & J., & Douglass, K. (2020). Workplace violence Workplace violence
Essenmacher, L. (2017). A qualitative study of among health-care among health care
Preventing Patient- workplace violence workers in emergency workers. Revista
toWorker Violence in among healthcare departments of public médica de
Hospitals: Outcome of a providers in emergency hospitals in Dammam, Chile, 146(2), 213-
Randomized Controlled departments in India. Saudi Arabia. Eastern 222.
Intervention. Journal of International Journal of Mediterranean health
occupational and Emergency Medicine, journal, 26(12).
environmental medicine, 13(1), 1– 9.
59(1), 18–27. https://doiorg.ezp.waldenu
https://doiorg.ezp.walde library.org/10.
nulibrary.org/10.109 1186/s12245-020-00290-0
7/JOM.
0000000000000909

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Evidence Level *
(I, II, or III)
Conceptual Framework
Describe the theoretical basis for
the study (If there is not one
mentioned in the article, say
that here).**
Design/Method
Describe the design and how the
study was carried out (In detail,
including inclusion/exclusion
criteria).
Level 1 Level III Level II Level II
No explicit conceptual This implied and not This is suggested rather The implication is
framework. Patient-to- explicit. It is that solving than expressed. It is an there, but it's not
worker violence and the workplace violence estimate of the stated directly. This is
other injuries associated among physicians and prevalence and related the key to preventing
with it may be reduced staff. determinants of healthcare worker
by the use of certain workplace violence violence in the
methods, it is inferred. among healthcare workplace.
employees.
Research was conducted Quantitative study design Cross-sectional survey Systematic review
using a mixed-methods that consists of an
strategy that included a observational and
randomized control retrospective research
group. design
The inclusion criteria
were as follows:
empirical research
that relate to VL in
health work settings,
published between
2011 and 2015,
written in English or
Spanish, published in
journals indexed by
ISI, Scopus, or
Scielo, and indexed
by either ISI or
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Sample/Setting
The number and characteristics of
patients, attrition rate, etc.
Major Variables Studied
List and define dependent and
independent variables
Measurement
Identify primary statistics used to
answer clinical questions (You
need to list the actual tests
done).
Scopus.
Exclusion criteria;
non-empirical papers,
other populations,
non-indexed
publications, and
unavailable articles.
The sample was 1500 The sample included 63 The data was collected 23 articles were
healthcare employees sample participants from 324 participants selected for review
Dependent - Violence Dependent – violence Dependent – workplace Dependent –
Independent – Gender, Independent – family, violence occupational violence
Age group, Job physical abuse, personal Independent – Independent –
category, and Unit block experience with work Occupation, sex, age, facilitators of
place violence, healthy marital status, occupational violence
literacy, death, Age, nationality, education,
communication challenges work experience,
multiple shifts, shift
time and number of
coworkers.
Chi-square tests were To identify overarching Logistic regression Descriptive statistics
used to compare the concepts, a mixture of analysis was used to
demographics of the thematic analysis methods assess factors
intervention group with was applied. independently
those of the control associated with the
group. occurrence of workplace
violence.
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Data Analysis Statistical or
Qualitative findings
(You need to enter the actual
numbers determined by the
statistical tests or qualitative
data).
Six months after the Seven hospitals'
intervention, the emergency rooms hosted
incidence rate ratio of 63 interviews. Eleven
violent occurrences was attending doctors, thirty-
considerably lower on six residents, ten nurses,
intervention units and five paramedics were
compared to controls. interviewed. It was noted
Intervention units had a that one interviewee did
decreased risk for not identify their
violence-related injuries occupation. The coding
at 24 months compared scheme's most prevalent
to controls. themes were explained,
and frequency and relative
frequency distributions for
each subtheme were
shown.
Only 324 out of a total Articles were picked
of 380 returned surveys. from the following
Over half of the databases: Web of
participants were Science, Scielo,
registered nurses, and PubMed, EBSCO,
women made up over and Scopus. There
two-thirds of the total. may be a barrier to
There were 155 obtaining research
healthcare professionals from Latin America
who reported since 91.3% of the
experiencing some kind publications are
of violent encounter in written in English
the previous 12 months. and the other 2.7%
Over half (52%) of all are written in
violent instances Spanish. The
included verbal abuse, majority of these
19% involved physical research are
assault, and just 5% quantitative and
involved sexual empirical in nature.
harassment. Only being
Saudi and working in an Most studies included
environment where participants from
reporting occurrences is many states; those
discouraged were shown conducted just with
to be significant physicians or other
predictors of workplace medical
violence. professionals; and
those conducted with
nursing staff utilized
the fewest
participants. Twenty
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Findings and Recommendations Six months after the
General findings and
recommendations of the research violent occurrences was
studies focused on
inpatient care, two on
outpatient care, and
one included both
settings.
Tragically, violence Research conducted at Previous studies have
intervention, the towards emergency room three public hospitals shown that verbal
incidence rate ratio of doctors and nurses is not found that the incidence abuse is the most
uncommon in India. More of violence against common form of VL;
considerably lower on than ninety percent of ED HCWs was 47.8%, this finding may be
intervention units doctors and nurses who much lower than the explained by a
compared to controls. were surveyed have 89.3% prevalence seen variable inclusion
Compared to control experienced violence on among nurses working bias. The majority of
units, intervention units the job. in emergency the research included
had a considerably Although verbal abuse is departments. We found in this review
decreased risk for more common, about 20% a frequency of 57.5 examine external
violence-related injury of caregivers have also percent among HCWs at violence rather than
at the 24-month follow- experienced physical 2 public hospitals. violence from inside
up. Compared to assault. Consequences of the workplace.
controls, the risk of both workplace violence on
incidents and injuries health care workers Because of their
decreased with time in included decreased heightened
the intervention group, productivity. vulnerability to
although this difference It is advised that EDs violence because of
was not statistically create a culture that their gender and the
significant. The fact that encourages HCWs to nature of their
violent crime rates did report acts of violence profession in care,
not rise in the and that HCWs be nurses have attracted
intervention group educated on the various a lot of attention as a
during the first six violence reporting demographic with
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Appraisal and Study Quality
Describe the general worth of this
research to practice.
What are the strengths and
limitations of study?
What are the risks associated with
months after the mechanisms in place. whom to study this
program began is It's crucial that all phenomenon.
indicative of its good violent occurrences be
impact. reported and that the
It will be important for right steps be taken in
future research to see response. It's important
whether the to have programs in
intervention's positive place that train and
effects can be sustained educate HCWs to better
using similar booster manage and prevent
techniques. Workers' occurrences.
health and safety
throughout the country
might benefit from
standardizing and
translating the technique
described here for
monitoring violence in
the workplace, risk
assessment, and
intervention.
The research is valuable This study is important The study's findings
for minimizing because it examines the provide important
workplace violence This study is helpful in variables that contribute context for
among healthcare understanding how to to workplace violence understanding the
workers. reduce the risk of violence among healthcare prevalence of
The large sample size in the emergency room employees. violence against
and randomization used workplace. healthcare workers.
in this research are two These patients were Results may not be Among the most
of its greatest strengths. treated in private hospitals generalizable outside the useful findings from
The research used the throughout the duration of study population due to these research are
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implementation of the suggested
practices or processes detailed in
the research?
What is the feasibility of use in
your practice?
Hazard Risk Matrix, the
worksite walkthrough,
and the worksite
checklist to identify risk
factors and preventative
actions for workplace
violence; all three of
these tools have been
shown to be effective in
the past.
Those involved were all
from the same hospital
system and geographical
region. As a
consequence, it's
possible that not all of
the findings may be
applied to other
healthcare facilities.
The scheduling of site
visits with unit
managers was a major
hurdle throughout
project rollout.
Given that the research
was conducted in a
single hospital, there is a
chance of bias.
The study is feasible in
practice
the research. Financial
concerns may have a
larger influence in
triggering ED violence at
private hospitals in India
than they do at public
hospitals. In addition, the
majority of those
interviewed were either
medical students or
clinicians working as
attendings or consultants.
It's possible that the
answers offered are
skewed toward
representing doctors'
perspectives and concerns.
There might be a bias in
the data wherein the
opinions and concerns of
doctors are
overrepresented in the
answers.
The study is feasible in
practice.
the small sample size. recommendations on
The questionnaire was how organizations
self-administered, may help prevent or
hence, as with most lessen the impact of
surveys of this kind, the occurrence. In
memory bias could not order to lessen and
be ruled out. eventually eliminate
The study is feasible in labor abuse, it is
practice. important to educate
workers and provide
them with
instructions and
training for
authorities on
personal protection
legislation.
One of the study's
flaws is that it didn't
look at Portuguese
manufacturing since
the search was only
done in English and
Spanish. In addition,
as most prior
evaluations had been
conducted in
specialized services,
it was not able to
compare the results
regarding the
sample's
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 demographic make-
up. Finally, the
results cannot be
extrapolated to other
populations due to
the health sector-
specific workplace
and the inclusion
criteria used in the
study.
Since the VL may
take many forms, the
United States has
chosen to concentrate
on psychological
forms of harassment.
The study is feasible
in practice.
data-driven, worksite- Violence in the workplace Workplace violence is a Occupational
based intervention was is unacceptable serious occupational violence in healthcare
Key findings effective in decreasing health problem.
risks of patient-to-
worker violence and
related injury.
Decrease in risks of There are several Health care employees Workplace violence
patient-to-worker workplace violence in emergency rooms are should be mitigated
Outcomes violence, incidences among the particularly vulnerable
healthcare providers in to verbal abuse, which is
India. one kind of pervasive
workplace violence.
Improving workplace

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 safety may be achieved
in part by encouraging
the reporting of violent
occurrences and
increasing knowledge
among health-care
employees about
violence reporting
mechanisms.
The study enriches The study provides an The study provides an The study provides
evidence-based practice evidence- based practice evidence- based practice an evidence- based
by providing evidence for the identification of for the identification of practice for the
for intervention and workplace violence cases workplace violence identification of
prevention. cases workplace violence
General Notes/Comments
cases

Part B – Critical Appraisal of Research

As opposed to conventional practice, evidence-based practice only employs methods that have been shown to be effective via
rigorous scientific study. Research that has been peer-reviewed and published in high-quality journals provides this proof
(Melnyk & Fineout-Overholt, 2019). Violence in the workplace is a major risk to workers' health. Workers in the emergency
medical field are more likely to experience violence, which may have serious repercussions for themselves.
Healthcare employees in emergency rooms are particularly vulnerable to verbal abuse, which is widespread in today's violent
workplaces. One effective way to reduce violence in the workplace is to encourage and facilitate the reporting of violent
episodes, as well as to increase health care employees' familiarity with existing violence reporting mechanisms. There are
harmful effects of workplace violence on HCWs' security and productivity. As a result of the lack of consensus on what

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constitutes an act of violence, it is impossible to provide an accurate assessment of the frequency with which HCWs are
victimized. It is advised that EDs create a culture that encourages HCWs to report acts of violence and that HCWs be educated
on the various violence reporting mechanisms in place. It's crucial that all violent occurrences be reported and that the right
steps be taken in response. In this situation, some of the tactics that are effective and capable of accomplishing the objective
are offered by four research that have been critically examined.
The studies propose the best practice (EBP) through the following measures; EDs should urge HCWs to report violence and
educate them on reporting processes. All violent incidents must be reported and properly handled. HCWs need more training in
incident prevention, response, and recovery.
Workplace violence affects healthcare professionals disproportionately. Individual, institutional, and national policies are
needed to report and handle workplace violence. To eliminate workplace violence and keep working environments safe,
provide preventive safety regulations, procedures, and training.

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