The evidence-based practice is the unification of the first research evidence with the most crucial clinical expertise as well as patient’s unique circumstances. Coming to terms with the levels of evidence and how reliable they are, plays a significant role in making correct and appropriate healthcare decisions. It is relevant for nurses to use the evidence-based practice because they are responsible for substantial judgments and decisions on a daily basis.
Level one of the evidence-based practice is the systematic reviews and meta-analysis. The systematic reviews can be described as the combination of all scientific studies on a specific topic according to predetermined criteria (Fernandez et al., 2014). Systematic reviews are ranked as the highest form of evidence because they include all the available evidence with regards to reliability. Meta-analysis is also at the top of the research because it is an analysis of different randomized controlled trials. The meta-analysis plays a significant role in that; it combines all the results in all the studies into a single interpretation of results ( Shorten, Wallace, & Crookes, 2015) . An example of a practice change in this level is a case where a medical practitioner generalizes the patient’s information without checking all the details, and this could lead to a misdiagnosis.
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Level two is the evidence synthesis where several journals elaborate the critically approved papers which inform how substantial the evidence is. It involves categorizing related studies, analyzing, interpreting and validating the studies (Dougherty & Lister, 2015) . An example of a practice change in this as would result in compromising a patient’s health if the interpretation and analysis are incorrect.
The third level entails critically appraised topics and article synopses where the authors evaluate individual research study’s effectiveness (Shin, Park, & Kim, 2015). In this case, the evidence obtained is from a well-controlled trial that has no randomization. A summary is the evidence and proof of an individual article where an expert identifies its strength.
Random control trials are on level four, where randomized groups of patients are in an experimental group and a control group where the two groups are followed up for the outcomes of interest. An example, in this case, is a healthcare report that finger ischemia would occur if a patient had epinephrine via an injection. This evidence has contributed to the nurse’s avoidance to give finger injections of epinephrine.
Level five is the cohort studies which involve identification of two groups of patients, one which receives the interest of exposure and one which does not. The cohorts are followed through for the outcome of interest. In an instance of practice change, there have to be measures taken so that the result can be positive.
The case-control study comes in at level six, and it involves identification of patients who have the outcome of interest and control patients without a similar result. The authors always compare all the patients to see if they had the exposure of interest. For example, one person, one family, a group of people or a social unit can be a subject to a case study which results in a different outcome.
The seventh level is the background information or expert opinion which includes; handbooks, textbooks, encyclopedias, which provides a proper foundation as well as the introduction of generalized information about a condition (Scott & McSherry, 2016) . The information in these materials is often available for the public view and scrutiny, and an individual can choose to either use the information or dismiss it.
In conclusion, the levels of evidence allow the nurse to appreciate and identify the information and research which is reliable. Nurses are required to be competent in the evaluation of the strengths and weaknesses of all the research studies as well as the applicability concerning their working environment.
References
Dougherty, L., & Lister, S. (Eds.). (2015). The Royal Marsden manual of clinical nursing procedures . John Wiley & Sons.
Fernandez, Anagnostou, E., Zwaigenbaum, L., Szatmari, P., Fombonne, E., , B. A., Woodbury- Smith, M., ... & Buchanan, J. A. (2014). Autism spectrum disorder: advances in evidence-based practice. Canadian Medical Association Journal , 186 (7), 509-519.
Scott, K., & McSherry, R. (2016). Evidence-based nursing: clarifying the concepts for nurses in practice. Journal of clinical nursing , 18 (8), 1085-1095.
Shin, S., Park, J. H., & Kim, J. H. (2015). Effectiveness of patient simulation in nursing education: meta-analysis. Nurse education today , 35 (1), 176-182.
Shorten, A., Wallace, C., & Crookes, P. A. (2015). Developing information literacy: a key to evidence-based nursing. International nursing review , 48 (2), 86-92.
