Implementation of EBP in the nursing practice provides scientifically proven evidence that allows nurses to provide quality and safe care to their patients. When searching for evidence-based information, nurses must consider the levels of evidence and select the highest level of evidence. The seven levels of evidence include:
Level I Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs. A systematic review that uses quantitative methods to summarize the results. Systematic evidence reviews of comparative effectiveness research to learn what is known and not known about the potential benefits and harms of alternative drugs, devices, and other healthcare services provide the best evidence to inform clinical decisions (National Library of Medicine, n.d.).
Level II – Evidence obtained from well-designed Randomized Controlled Trials (RCTs) include a randomized group of patients in an experimental group and a control group. These groups are followed up for the variables/outcomes of interest.
Level III – Evidence obtained from well-designed controlled trials without randomization.A controlled clinical trial that randomly (by chance) assigns participants to two or more groups. There are various methods to randomize study participants to their groups (LibGuides: Evidence-Based Practice: Levels of Evidence. (n.d.)).
Level IV – Evidence from well-designed case-control and cohort studies.A type of clinical trial comparing the effectiveness of one medication or treatment with the effectiveness of another medication or treatment. In many controlled trials, the other treatment is a placebo (an inactive substance) and is considered the “control.” A clinical research study in which people who presently have a certain condition or receive a particular treatment are followed over time and compared with another group of people who are not affected by the condition (LibGuides: Evidence-Based Practice: Levels of Evidence. (n.d.)).
Level V – Evidence from systematic reviews of descriptive and qualitative studies. A qualitative systematic review brings together research on a topic, systematically searching for research evidence from primary qualitative studies and drawing the findings together. There is a debate over whether the search needs to be exhaustive (Seers, K. 2015).
Level VI – Evidence from single descriptive or qualitative studies. Data from observation, interviews, or interaction with participants.
Level VII – Evidence from the opinion of authorities and/or reports of expert committees. It can be in an expert report, or the expert can give evidence (testify) at a hearing. Usually, the Tribunal will only receive evidence about facts, such as what happened and when it happened (Experts Evidence, n.d.)
References
LibGuides: Evidence-Based Practice: Levels of Evidence. (n.d.). https://libguides.mskcc.org/ebp/evidence
About Systematic Evidence Reviews and Clinical Practice Guidelines | NHLBI, NIH. (n.d.). NHLBI, NIH. https://www.nhlbi.nih.gov/node/80397#:~:text=In%202011%2C%20the%20Institute%20of,of%20similar%20but%20separate%20studies.
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