The seven levels of research evidence, identified by Melnyk & Fineout-Overholt (2011) are listed below with examples of level of research evidence and how nurses can use them in practice.
Level I: Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCT), from evidence-based clinical practice guidelines that are based on systematic reviews of RCTs, or from three or more RCTs of good quality that have similar results. For example, reviews and updates to nursing certification courses ie. chemotherapy. Nurses use these certifications to become an expert in their field.
Level II: Evidence obtained from at least one well-designed RCT
For example, gathering evidence to support the initiative of nursing bundles and their effect on lowering the incidence of catheter associated urinary tract infections. Nurse educators can use this study to educate nurses on ways to prevent this hospital acquired infection.
Level III: Evidence obtained from well-designed controlled trials without randomization
For example, a study done on a specific group or culture. Nurses use information from these type of studies to be aware of what risk factors a certain culture may be more at risk thatn other cultures.
Level IV: Evidence from well-designed case-control or cohort studies For example, a study that follows a certain group of people over their life span and analyzes their risk factors for certain diseases. Nurses can use this to anlyze the area that they work in and see what people in their area of work may be more susceptible to.
Level V: Evidence from systematic reviews of descriptive and qualitative studies(often referred to as integrative or mixed-method)
For example, constant review of studies all related to treatment of pressure ulcers with use of Santly. Nurses use this research to use the best available treatment for pressure ulcers.
Level VI: Evidence from a single descriptive or qualitative study
For example, One study done by a surveying individuals on one specific treatment recieved. Nurses can use this information because it is in the patient’s own experience at times and how they felt a certain treatment was effective or not effective for a cure.
Level VII: Evidence from the opinion of authorities and/or reports of expert committee For example, the American Nurses Association lists studies and updates on eveidence-based practice. Nurses who are a part of larger committess can be made aware of up and coming or new studies that help us institute the best evidence-based practice in caring for our patients.
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