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NURS 1111 Nursing Research and Evidence-Based Practice

This guide is developed for NURS 1111, Nursing Research and Evidence-based Practice.

Level of Evidence

Level of Evidence resources from University of Wisconsin Library: http://researchguides.ebling.library.wisc.edu/c.php?g=293229&p=1953406

Level of Evidence Pyramid

George Brown College LLC

Pyramid of Evidence

Evidence Table

Evidence Table - Format/Template

Question: Include the clear, focused question that the research aims to answer.

Author; Year

The author(s), as formatted for a citation, followed by the year of publication in parentheses.
Objectives The information the study aims to discover or confirm - the purpose of the study..
Level

The level of evidence (1-7) - as measured by the pyramid above.
 

Design

The type of study, as seen on the pyramid above (e.g., Single Randomized Controlled Trial)
 

Participants/Population
 

The subjects of the study - number, age, gender, location, other identifying characteristics. The 'P' in PICO.
 

Intervention

The treatment, procedure, or other intervention - what did the study do? The 'I' in PICO.
 

Outcome Measures

How does the study assess what the outcome is?
 

Outcome The results of the study. The 'O' in PICO.
Limitations Any shortcomings of the design of the study, the number of participants, the method of measuring the outcome, etc. (optional).
Implications The meaning of the outcome: what do the results of the study help us to know?

 

Evidence Table - Example

This table uses this article as an example.

Question: Would combining protocolized sedation and daily sedation interruption augment the benefits of each in order to reduce the duration of mechanical ventilation and ICU stay?

Author; Year Mehta, S. et al. (2012)
Objectives To compare protocolized sedation with protocolized sedation plus daily sedation interruption in critically ill patients.
Level 2
Design Randomized Controlled Trial
Participants/Population 430 critically ill, mechanically ventilated adults in 16 tertiary care medical and surgical ICUs in Canada and the United States between January 2008 and July 2011
Intervention

Continuous opioid and/or benzodiazepine infusions and random allocation to protocolized sedation (n = 209) (control) or to protocolized sedation plus daily sedation interruption (n = 214).

Using validated scales, nurses titrated infusions to achieve light sedation.

For patients receiving daily interruption, nurses resumed infusions, if indicated, at half of previous doses.

Patients were assessed for delirium and for readiness for unassisted breathing.

Outcome Measures Time to successful extubation. Secondary outcomes included duration of stay, doses of sedatives and opioids, unintentional device removal, delirium, and nurse and respiratory therapist clinical workload (on a 10-point visual analog scale [VAS]).
Outcome Median time to successful extubation was 7 days in both the interruption and control groups. Duration of ICU stay and hospital stay did not differ between the groups
Limitations None noted.
Implications The addition of daily sedation interruption did not reduce the duration of mechanical ventilation or ICU stay.

Glossary of Terms

Level of
Evidence

Article Type Description
1 Systematic Review of all Randomized Controlled Trials

Systematic Review: A structured method of critical appraisal of all available literature relevant to a specific research topic, using a rigorous statistical approach.

Note: see below for the definition of randomized controlled trial. Level 1 is a systematic review of many randomized controlled trials.

Reference, and further information: Systematic review. (2014). systematic review. In Martin, E., & McFerran, T.(Eds.), A Dictionary of Nursing. : Oxford University Press. Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199666379.001.0001/acref-9780199666379-e-10283.

2 Single Randomized Controlled Trials

Randomized Controlled Trial: An investigation in which subjects are randomly assigned to two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control group) receiving no intervention.

Reference :  Randomized controlled trial. (2010)l. In Ireland, R.(Ed.), A Dictionary of Dentistry. : Oxford University Press. Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199533015.001.0001/acref-9780199533015-e-3691.

3 Well-Designed Controlled Trials Without Randomization

Controlled Trial: A study method in which one group of participants (the experimental group) is subjected to the experimental procedure and the other group (the control group) receives a standard or accepted treatment or procedure (or no active treatment).

Reference: Martin, E., & McFerran, T. (2008). controlled trial. Oxford Reference.Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199211777.001.0001/acref-9780199211777-e-9958: 

4 Well-Designed Case Studies

Case Study: An account of a person's health problem or of a problem situation that purports or aspires to be comprehensive and contains all the information needed to make a rational decision about the actions required to achieve an optimum outcome

Reference and further information: Case study. (2007). In Last, J.(Ed.), A Dictionary of Public Health. : Oxford University Press. Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780195160901.001.0001/acref-9780195160901-e-622.

4 Cohort Studies

Cohort Study: An observational study of a group of people either by studying existing data  or by examining data for a defined period of time or until a specific event occurs.

Reference and further information: Cohort study. (2010). cohort study. In Ireland, R.(Ed.), A Dictionary of Dentistry. : Oxford University Press. Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199533015.001.0001/acref-9780199533015-e-905.

5 Systematic Review of Qualitative Studies

Systematic Review: A structured method of critical appraisal of all available literature relevant to a specific research topic, using a rigorous statistical approach.

Note: see below for the definition of qualitative research. Level 5 is a systematic review of a study produced with qualitative research.

Reference, and further information: Systematic review. (2014).. In Martin, E., & McFerran, T.(Eds.), A Dictionary of Nursing. : Oxford University Press. Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199666379.001.0001/acref-9780199666379-e-10283.

6 Single Qualitative Studies

Qualitative Research: A type of scientific enquiry ... that focuses on the why and how of behaviours and opinions. It often involves interviews or focus groups through which the researcher attempts to understand individuals’ experiences.

Reference and further information: Martin, E.(2015). qualitative research. In Concise Medical Dictionary. : Oxford University Press. Retrieved 7 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199687817.001.0001/acref-9780199687817-e-15403.

7 Expert Opinion

Expert Opinion: a belief or judgment about something given by an expert on the subject.

Reference: Expert Opinion(n.d.). Retrieved March 7, 2017, from https://www.merriam-webster.com/dictionary/expert opinion