AACN Levels of Evidence: What’s New?

Evidence-based practice is an expected core competency of all health care clinicians regardless of discipline. Use of evidence-based practice means integrating the best research with clinical expertise and patient values to achieve optimal health outcomes. Evidence-based practice requires nurses to access and appraise evidence rapidly before integrating it into clinical practice. Role modeling and integrating the skills necessary to develop evidence-based practice into clinical and nonclinical courses is an important part in developing positive attitudes toward evidence-based practice, an essential first step to using evidence to guide practice decisions. The step-by-step approach to evidence-based practice proposed by Melnyk and colleagues provides an excellent organizing framework for teaching strategies specifically designed to facilitate nurses’ knowledge and skill development in evidence-based practice.

Section: Search For the Best Evidencementioning

confidence: 99%

Teaching Strategies to Support Evidence-Based Practice

Winters

Echeverri

2012

“…11 One essential step in examining the evidence is evaluating the strength of the evidence so that strong evidence (ie, research-based recommendations) is preferentially considered over lower levels of evidence (ie, opinion papers). 12 This article explores current evidence on 4 interventions within the nursing practice domain and asks nurses to review and apply best evidence to guide practice. The topics addressed are (1) turning critically ill patients, (2) sleep disruption in the intensive care unit (ICU), (3) feeding tube management in infants and children, and (4) prevention of venothromboembolism.…”

mentioning

confidence: 99%

Examining the Evidence to Guide Practice: Challenging Practice Habits

Makic

Rauen

Watson

et al. 2014

I n 2001, the Institute of Medicine challenged all health care professionals to decrease variation in practice through adoption of practice interventions based on best evidence to improve patients' outcomes.1 Current reviews of clinical practice suggest that only 10% to 15% of clinicians consistently implement evidence-based care 2 and indicate that it may take up to 2 decades for original research to be put into routine clinical practice.3 It is well established that evidence-based practice (EBP) is associated with higher quality care and better outcomes for patients than care that is steeped in tradition. 4 Yet at times, clinicians continue to practice on the basis of tradition.

“…M was used to represent the body of practice recommendations provided by industry. 14 When the 2008 hierarchy of evidence was published, AACN welcomed feedback from its members about the changes. Since then, members have asked for clarification on the hierarchy, particularly an explanation of the rating of systematic reviews.…”

Section: Aacn Evidence-rating Systemmentioning

confidence: 99%

Choosing the Best Evidence to Guide Clinical Practice: Application of AACN Levels of Evidence

Peterson

Barnason

Donnelly

et al. 2014

T he idea of sharing clinical experiences to improve patient care is not new to nurses. Florence Nightingale published her observations on cleanliness, nutrition, and fresh air in Notes on Nursing 1 in 1860. Her work was the start of evidence-based nursing practice. More than 150 years and thousands of research studies later, the use of evidence to guide nursing practice is the expected standard of practice for both individual nurses and health care organizations. Scope and Standards of Practice 2 and Code of Ethics 3 of the American Nurses Association both call for nurses to incorporate research evidence into clinical practice. Schools of nursing have added content on evidence-based practice to their curricula. 4 Despite these efforts, barriers inhibit implementation of changes based on published evidence into bedside patient care. Overall, the barriers involve the characteristics of the nursing profession, organizational dynamics, and the nature of the research.5,6 Studies 7,8 have consistently indicated that a nurse's inability to both determine what evidence is ready for implementation into practice and then successfully develop processes to sustain an evidence-based practice change is a barrier. Evidence-Based Practice Evidence-based nursing care is informed by research findings, clinical expertise, and patients' values, and its use can improve patients' outcomes. Use of research evidence in clinical practice is an expected standard of practice for nurses and health care organizations, but numerous barriers exist that create a gap between new knowledge and implementation of that knowledge to improve patient care. To help close that gap, the American Association of Critical-Care Nurses has developed many resources for clinicians, including practice alerts and a hierarchal rating system for levels of evidence. Using the levels of evidence, nurses can determine the strength of research studies, assess the findings, and evaluate the evidence for potential implementation into best practice. Evidence-based nursing care is a lifelong approach to clinical decision making and excellence in practice. (Critical Care Nurse. 2014;34[2]:58-68) 58 Choosing the Best