Evidence-Based Nursing Practice in Advanced Care

This assignment delves into the crucial role of evidence-based practices in advanced nursing. It defines evidence-based practice as a method integrating research, clinical knowledge, and patient preferences to guide healthcare decisions. The document outlines the hierarchy of evidence levels (1-7) based on study design and analytical quality. It also explains the grading system for evidence (A-C) and highlights how different types of research address various clinical queries. Finally, it emphasizes the importance of problem-solving and analytical reasoning in correlating results from diverse studies to inform effective nursing practice.

Running head: ADVANCED NURSING PRACTICE ENVIRONMENT
ADVANCED NURSING PRACTICE ENVIRONMENT
Name of the Student
Name of the University
Author Note

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One of the most important foundations of scientific for effective nursing practice is
knowledge, skills and integrative capabilities related to evidence based practices. Evidence based
practice can be understood as a method of combining research, clinical knowledge and the
preferences of the patient in order to decide the healthcare practice (DiCenso, Guyatt & Ciliska,
2014). The levels of evidence can also be understood as a hierarchy of evidence are used is
studies due to their analytical quality of the layout, effectiveness and appropriateness towards the
care provided to the patient.
Given below are the levels of evidence based of the Grade/Strength of Recommendation:
Level 1: collected from meta analysis of all pertinent randomized controlled trials (RCT)
or evidence based clinical practices based on organized analysis RCT or three or more RCT of
accepted quality having comparable outcomes.
Level 2: Collected from at least one well planned RCT
Level 3: Collected from well designed controlled trials but with no randomization (quasi
experiential)
Level 4: Collected from well designed case control or cohort analysis
Level 5: Collected from systematic reviews of descriptive and qualitative analysis
Level 6: Collected from a single descriptive qualitative analysis
Level 7: Collected from opinions or reports
Different clinical queries can be addressed by different types of research analysis, and a
single highest level of evidence might not always be applicable to address the query. In such

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circumstances, the next level of evidence should be selected. A certain level of problem solving
and analytical reasoning is also needed to correlate results from different studies (Hamric,
Hanson, Tracy & O’Grady, 2013).
Grading of evidence allows a deeper dive into the knowledge; skills and integrative
abilities required for evidence based nursing practices.
Grade A: Systematic Reviews, Critically appraised topics, critically appraised individual
articles
Grade B: Randomized control trials, Cohort Studies, Case controlled studies
Grade C: Background information/ expert opinion
[Figure 1: Grading Pyramid. Glover, Odato and Wang, 2006]

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REFERENCES:
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to
Clinical Practice. Elsevier Health Sciences. Pp 4-17
Glover, J., Odato, K. and Wang, L. (2006). Research Guides: Evidence-Based Medicine Subject
Guide: EBM Pyramid. [online] Guides.lib.uci.edu. Available at:
https://guides.lib.uci.edu/ebm/pyramid [Accessed 10 Nov. 2017].
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O'Grady, E. T. (2013). Advanced Practice
Nursing-E-Book: An Integrative Approach. Elsevier Health Sciences.pp 67-84