Describe the “levels of evidence” and provide an example of the type of practice change that could result from each NRS 433

Describe the “levels of evidence” and provide an example of the type of practice change that could result from each NRS 433

A Sample Answer For the Assignment: Describe the “levels of evidence” and provide an example of the type of practice change that could result from each NRS 433

Title: Describe the “levels of evidence” and provide an example of the type of practice change that could result from each NRS 433

Describe the levels of evidence and provide an example of the type of practice change that could result from each NRS 433

Describe the “levels of evidence” and provide an example of the type of practice change that could result from each.

Replies

Health care profession requires professionals to be lifelong learners and educators to promote health, prevent disease and to bring the best possible outcome for their patient. Health care is drastically evolving and health care professionals such as the nurses are placed in the forefront of patient care and are expected to be the clinical expert in their area of nursing practice. In this pursuit of knowledge, they must become familiar with the health care research methods and process and continuously update their knowledge with the current evidence based practices (EBPs) that promote improved patient outcomes. Evidence-based practice (EBP) has been described as the integration of the best research evidence, expert clinical judgment, and the preferences and values of patients (Chan.,et,al2020).  The degree to which the health care professionals are evaluated as experts is based on their extent of knowledge that they bring to their clinical practice. Evidence-based medicine (EBM), is about finding evidence and using that evidence to make clinical decisions. The level of evidence is determined based on the confidence, validity and applicability and clinicians are encouraged to find the highest level of evidence to answer clinical questions. The level of evidence hierarchy is determined based on the confidence, validity and applicability. According to Burns,et al (2011), evidence from a systematic review or meta -analysis of all RCTs are considered as the level one level of evidence which is the highest level. At level 2, the evidence is collected through well designed RCT. Next is LOE (Level of evidence ) level 3 where the evidence is collected through controlled trails without randomization.  Case control or cohort studies are considered at level 4, while systematic reviews of descriptive and qualitative studies are under level 5 LOE. When evidence is collected through single descriptive or qualitative study it is considered as a level 6 LOE and lastly when the LOE is determined by evidence from an expert opinion it is considered as the lowest level of evidence. It is important that researcher have good understanding of the LOE while reviewing information needed for the study as it will help him/her to prioritize the information and guide them when interpreting the results.

One example of the practice change that I have seen in the hospital that I work is the utilization of fluorescent solution shining under ultraviolet light to test the effectiveness of hand hygiene and to reinforce good HH behavior to prevent infection. One of the article supporting the use of fluorescent material intervention to improve HH training was a randomized control study done in 2021  by Kisacik, et al(2021). The study confirm that there was a significant difference between the intervention and control groups in terms of the total post-test hand hygiene belief score and final hand washing skill score of the students in the intervention group increased significantly for the seven regions of hands . (Kisacik, et al, 2021

Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and reconstructive surgery128(1), 305–310. https://doi.org/10.1097/PRS.0b013e318219c171

Hariton, E., & Locascio, J. J. (2018). Randomised controlled trials – the gold standard for effectiveness research: Study design: randomised controlled trials. BJOG : an international journal of obstetrics and gynaecology125(13), 1716. https://doi.org/10.1111/1471-0528.15199

Kisacik, O. G., Cigerci, Y., & Gunes, U. (2021). Impact of the fluorescent concretization intervention on effectiveness of hand hygiene in nursing students: A randomized controlled study. NURSE EDUCATION TODAY97. https://doi-org.lopes.idm.oclc.org/10.1016/j.nedt.2020.104719

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Great response! I like how you explained the different levels of evidence and how they can be applied in certain ways to aid one’s research. In your response you mentioned how you’ve actually noticed practice change in your own place of work after utilizing the fluorescent solution + UV light test to see how effective hand hygiene practice was at your facility. I remember doing that test once and it was so interesting to see how parts of science that may not usually be used in the nursing field can still be used to better this profession. Looking back at it now, it was also a way to enforce the use of evidence based practice since there is a connection between proper hand hygiene and a decrease in infections/illnesses spread, and this test showed the quality of everyone’s hand hygiene. I think practices like this are a genius and fun way of showing just how important the little things are because they truly do go a long way, if i come across any more similar practices I will make sure to share them with the rest of the class and hopefully we can use them all in the future to better our places of work.

  • Replies

Evidenced based practices are important in every aspect of our role as nurses so it is important that we maintain high level of critical thinking and ensure we are using the best evidence. RCT are generally viewed as the best way to set up research to ensure that it can be used on many populations as well as ensure there is decreased bias and increased ability to be peer reviewed and redone (Grand Canyon University, 2018). It is important that nurses understand how to be critical of research and how to look at how certain research was conducted to ensure the best research is being utilized for our evidence based practices

Describe the “levels of evidence” and provide an example of the type of practice change that could result from each NRS 433  Reference

Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

  • Victoria Smith

replied toDhanya Poulose

Feb 28, 2022, 12:15 AM

  • Replies to Dhanya Poulose

Dhanya your answer to the discussion question was very informative it help me understand and broke down the question. healthcare has a big role in the level of evidence and research that is needed for evidence-based practice this is all necessary for our patient’s health and healing. Nurses have much on their plates and knowledge that is needed to ensure we are able to take care of patients, I wonder why we need research as nurses but without it how do we knowingly do things, without first researching on medication first or a treatment, for example, given Tylenol for fever or like your example we use chlorhexidine wipes on foleys and on new admits to cut down on infections this has been proven some how and it has worked from what I have seen.

  • Eleanor Milo

replied toDhanya Poulose

Feb 28, 2022, 6:53 PM

  • Replies to Dhanya Poulose

Excellent explanation on the levels of evidence and your example of the type of practice change that could result from each align with the research expectations for the evidence.

Victoria Smith

Posted Date

Feb 26, 2022, 1:20 AM

Replies to Dhanya Poulose

Levels of evidence are something used in research studies to help with determines patient care by making decisions based on strength of recommendations. The studies are used with RCTs randomized controlled trials and use EBP evidence-based practice as a guideline. (nvcc.edu 9/2021) There are five levels that move up like a pyramid starting from the bottom for research studies, it starts with foundational evidence. Starting from the bottom of the pyramid, animal research/ lab studies is usually the start of research where you are doing lab work and theory testing before it is introduced to people, during this research helps weed out non-factors. Background information/expert opinion- this is where you get information from literature or other research studies that have previously been done and proved. Case-control study-uses patients for research that have diagnosis needed studying and a control group. A cohort study uses two groups of people one that is exposed to what is being researched the other group is not. RCTs Randomized controlled trials- these patients were randomly picked for the experimental group and for the control group. Critically appraised articles/critically appraised topics. A systematic review, and meta-analysis. The higher the level studies are available. (nvcc.edu 9/2021)

 

 

Levels of Evidence – Evidence-Based Practice for Health Professionals – LibGuides at Northern Virginia Community College (nvcc.edu) September 2021

Describe the “levels of evidence” and provide an example of the type of practice change that could result from each NRS 433  Grading Rubric

Performance Category 100% or highest level of performance

100%

16 points

Very good or high level of performance

88%

14 points

Acceptable level of performance

81%

13 points

Inadequate demonstration of expectations

68%

11 points

Deficient level of performance

56%

9 points

 

Failing level

of performance

55% or less

0 points

 Total Points Possible= 50           16 Points    14 Points 13 Points        11 Points           9 Points          0 Points
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic topics.

Presentation of information was exceptional and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was minimally demonstrated in all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in one of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in two of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in three or more of the following elements

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
 16 Points  14 Points  13 Points 11 Points 9 Points  0 Points
Application of Course Knowledge

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

Presentation of information was exceptional and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was minimally demonstrated in the all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in one of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in two of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in three of the following elements

  • Applies principles, knowledge and information and scholarly resources to the required topic.
  • Applies facts, principles or concepts learned scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
   10 Points 9 Points  6 Points  0 Points
Interactive Dialogue

Initial post should be a minimum of 300 words (references do not count toward word count)

The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

Responses are substantive and relate to the topic.

Demonstrated all of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 3 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 2 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 1 or less of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
  8 Points 7 Points  6 Points         5 Points          4 Points  0 Points
Grammar, Syntax, APA

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

Error is defined to be a unique APA error. Same type of error is only counted as one error.

The following was present:

  • 0-3 errors in APA format

AND

  • Responses have 0-3 grammatical, spelling or punctuation errors

AND

  • Writing style is generally clear, focused on topic,and facilitates communication.
The following was present:

  • 4-6 errors in APA format.

AND/OR

  • Responses have 4-5 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is somewhat focused on topic.
The following was present:

  • 7-9 errors in APA format.

AND/OR

  • Responses have 6-7 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is slightly focused on topic making discussion difficult to understand.
 

The following was present:

  • 10- 12 errors in APA format

AND/OR

  • Responses have 8-9 grammatical, spelling and punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.
 

The following was present:

  • 13 – 15 errors in APA format

AND/OR

  • Responses have 8-10 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.

AND/OR

  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
The following was present:

  • 16 to greater errors in APA format.

AND/OR

  • Responses have more than 10 grammatical, spelling or punctuation errors.

AND/OR

  • Writing style does not facilitate communication
  0 Points Deducted 5 Points Lost
Participation

Requirements

Demonstrated the following:

  • Initial, peer, and faculty postings were made on 3 separate days
Failed to demonstrate the following:

  • Initial, peer, and faculty postings were made on 3 separate days
  0 Points Lost 5 Points Lost
Due Date Requirements Demonstrated all of the following:

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

Demonstrates one or less of the following.

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.