Critical Appraisal Tool Worksheet Template Part 4A

Critical Appraisal Tool Worksheet Template Part 4A

Evaluation Table

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

Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4
Whitcombe, A., Cooper K. & Palmer, E. (2016). The relationship between organizational culture and the health and wellbeing of hospital nurses worldwide: a mixed methods systematic review protocol. The Joanna Briggs Institute. DOI: 10.11124/JBISRIR-2016-002650 Shin, S., Park, J-H. & Bae, S-H. (2018). Nurse staffing and nurse outcomes: Asystematic review and meta-analysis. Nursing Outlook, 66(3), 273–282.


Pradas-HernaÂndez, L., Ariza T, Gomez-Urquiza J. L., Albendin-Garcia, L., De la Fuente E. I., & Cañadas-De la Fuente, G. A. (2018) Prevalence of burnout in paediatric nurses: A systematic review and meta-analysis. PLoS ONE, 13(4): e0195039.

Woo, T., Ho, R., Tang, A. & Tam, W. (2020). Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. Journal of Psychiatric Research, 123, 9-20.
Evidence Level *(I, II, or III)


ii iii i ii
Conceptual Framework

Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**

The basis of this study was to examine the relationship that exists between the health and the well-being of nurses and organizational culture. The authors sought to explore the relationship between organizational culture and the indicators of health such as: safe workplace, burnout, work-related injuries, and the general well-being of nurses In this study, the researchers sought to study the relationship between nurse outcomes and nurse staffing. In particular, the study sought to evaluate the factors that lead to burnout in nurses. The basis of this study was to analyze the characteristics of burnout in nurses. The researchers sought to find out the prevalence of burnout, the severity of burnout in nurses, and risk factors. In this article, the authors use the recent declaration by WHO of burnout as a serious health issue to examine the symptoms and the prevalence of burnout in nurses globally.

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

The authors used both published and unpublished studies to analyze the impact of burnout in nurses. The authors adopted a three-step search strategy in their systematic review of literature using databases such as MEDLINE, CINAHL and AMED. For this work, the researchers used systematic review of literature to assess the relationship between nurse outcomes and nurse staffing through a meta-analysis. The researchers reviewed articles published between January 2000 and November 2016 from databases such as: CINAHL, PubMed, PsycINFO, Cochrane Library, EBSCO, RISS, and DBpia The authors used a mixture of systematic review and meta-analysis of literature. The data bases used to acquire information include; CINAHL, LILACS, PubMed, the Proquest Platform (Proquest Health & Medical Complete), Scielo and Scopus In this work, the researchers conducted a systematic review together with a meta-analysis to evaluate the symptoms and prevalence of burnout in nurses. 8 academic research databases were used to acquire information.

The number and characteristics of

patients, attrition rate, etc.

Not defined

52 potential articles were identified. 13 cross-sectional studies met the inclusion criteria. The sample population was composed of 9,075 paediatric and neonatal nurses 113 studies were included for systematic review and 61 studies for the meta-analysis, consisting 45,539 nurses worldwide in 49 countries
Major Variables Studied 

List and define dependent and independent variables

Independent variables-nurse staffing and dependent variable-nurse outcomes Emotional exhaustion was examined as a variable that lead to burnout in nurses. An examination of depersonalization levels An assessment of barriers

Identify primary statistics used to answer clinical questions (You need to list the actual tests done).

1. Nurse shortages2. Longer working hours

3. Emotional exhaustion

4. The workplace environment

1. Physical and emotional exhaustion2. Work environment 1. Nurse shortage2. Longer working hours

3. Work environment

1. Long working hours2. Physical exhaustion
Data Analysis Statistical orQualitative findings

(You need to enter the actual numbers determined by the statistical tests or qualitative data).

The perception of nurses to the organizational culture of their organizations impacted on their well-being. From the selected studies, 92% quoted nurse to patient ratio as the major cause of burnout in nurses. From the 34 studies used, a majority found moderate-high values for 3 factors of burnout i.e. socio-demographic, psychological, and job-related factors as the biggest contributors to nurse burn-out The selected 113 studies selected for review revealed that nursing specialty and geographic location were the biggest contributors to burnout in nurses.
Findings and Recommendations 

General findings and recommendations of the research

Shortage of nurses lead to burnout as nurse-patient ratio becomes more unequal. Nurses who attended to many patients daily recorded highest levels of job dissatisfaction. Thus, nurse-patient ratio is a critical factor in burnout in nurses Pediatric nurses recorded moderate-high levels of emotional exhaustion leading to burnout Prevalence rate of nurse burnout differed depending with nurse specialty. High prevalence rate was recorded in intensive and critical care nurses.
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 implementation of the suggested practices or processes detailed in the research?

What is the feasibility of use in your practice?

This research is of high quality because it the authors reduced biasness in the study. The research and design methods used are appropriate for the study. This research uses a large number of population sample. 9000 participants participated in the study. This large number of participants ensure better results leading to better quality This research is of high quality because it the authors reduced biasness in the study.

Key findings




Work-place injuries has adverse impact on nurses leading burnouts Nurse-patient ratio is a critical contributor to burnouts in nurses Physical and emotional exhaustion cause burnout in nurses Nurses working in more demanding specialties have high burnout rate





The perception of nurses to the organizational culture of their organizations impacted on their well-being. Balancing the nurse-patient ratio is critical in curbing burnouts The level of physical and emotional exhaustion determines the rate of burnouts Nurses working in more demanding specialties have high burnout rate
General Notes/Comments

*These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide

  • Level I

Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis

  • Level II

Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis

  • Level III

Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis

  • Level IV

Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence

  • Level V

Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence

**Note on Conceptual Framework

  • The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link
  • Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
  • As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
  • Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
  • Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.