Question
In a 3 page paper, discuss the levels of evidence of the three articles you chose to support the solution to your problem. Use the table in the front of Polit and Beck (also in Chapter 2) labeled “Quick Guide to an Evidence Hierarchy of Designs for Cause-Probing Questions.
Remember, you need at least 4 references, minimally: your three articles and the Polit and Beck textbook.
Solution
Assessment of the level of evidence in nursing research is essential since it informs the quality of knowledge that nursing practitioners use to improve their practice. LoBiondo-Wood & Haber (2017) reveal the need for research critique to focus on the strengths and weaknesses of studies to include evidence-based practice. The process is critical when evaluating studies and the literature used to solve an identifying problem in nursing or health care in general. The writer should ensure that the available information is relevant to answer the research question. Furthermore, they use the data from other authors, which is the reason for critiquing their research methods, findings, and their interpretation of results.
The review of literature is also necessary to develop essential knowledge useful in practice. Houser (2016) adds that the evaluation of the level of evidence also plays a critical role in identifying the target audience in research. For example, researchers focus on a specific population when conducting their studies. Therefore, as a reviewer or critique, it is necessary to establish whether the target population is adequately addressed in the research. For example, whether a study has critical knowledge to solve an identified problem for the target population, such as hospitalized patients. The critique also helps the reviewer to combine numerous perspectives, whose strengths they can apply in their research and practice. They can also use the knowledge to address the limitations and fill gaps in their future studies. Generally, the critique if the beginning place for future research as it uses strengths and fills gaps identified in the review of literature and level of evidence.
The specific problem under the review is the shortage of nursing staff in healthcare. Staff shortage in health care is a severe problem because it affects the quality of care that patients receive. Therefore, it is essential to establish the level of evidence in the available research to address the specific healthcare issue.
Levels of Evidence
Studies have different levels of evidence depending on the design used to collect data to answer the research question of the test hypothesis. The levels range from I to VIII. Before is an analysis of the level of evidence for three sources used to study the issue of staff shortage in healthcare.
Level IV
The level IV evidence research includes studies conducted through well-designed case-control or cohort studies. Griffiths et al. (2019) conducted a retrospective longitudinal cohort observational study using routinely collected data. Since it is a cohort study, it fits well into the level IV level of evidence. The level of evidence indicates that the study has quality information that practitioners can use in practice.
Level V
Some researchers conduct a secondary review of studies conducted by others. Such analyses of descriptive and qualitative studies (meta-synthesis) belong to level V evidence. Griffiths et al. (2016) conducted a meta-synthesis to understand the issue of nurse shortage in healthcare settings. They collected relevant primary sources to review and collate the evidence to inform practice. Their study provides diverse perspectives from previous researchers to offer sufficient knowledge that can be translated into practice.
Level VI
Articles in level VI of evidence are researches conducted using a single descriptive or qualitative study. The study conducted by Bridges, Griffiths, Oliver, and Pickering (2019) is a level VI evidence. The researchers conducted an observational study to understand the nursing shortage in a hospital and its effect on the quality of care they provide to patients. They observed interactions between nurses and patients and calculated patient-to-staff ratios. Their study was effective in addressing the issue of staff shortage and contains information that nurses can use in practice to improve the quality of care they provide to their patients amid staff shortage.
Conclusion
Researchers review levels of evidence to establish the quality of knowledge that they can use in practice. The three articles are evaluated using the level of evidence criteria to determine the strengths and applicability of evidence in practice. In addition, they have different levels of evidence. Therefore, when they are integrated, they provide comprehensive research into the specific problem. Besides, they provide a solution to the problem from different perspectives. The reviewer can establish how different authors interpreted and understood the particular problem to solve it effectively. Consequently, they can find out the views that are stronger than others. Researchers admit that articles on different levels have diverse strengths in answering the research question or testing the hypothesis. Afterall, they collect data using different designs. For example, the first article collected data using a cohort study; the second one was a systematic review, while the third one was a qualitative observational study. Therefore, the quality of the evidence presented is also different. Regardless of the differences, the three articles have relevant evidence than nurses can use on practice to improve the quality of care provided to patients amid staff shortage. Nurses should always review evidence to identify the quality of the information they intend to use to inform their practice.
References
Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: An observational study. BMJ quality & safety, 28(9), 706-713.
Griffiths, P., Ball, J., Drennan, J., Dall’Ora, C., Jones, J., Maruotti, A., … & Simon, M. (2016). Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. International Journal of Nursing Studies, 63, 213-225.
Griffiths, P., Maruotti, A., Saucedo, A. R., Redfern, O. C., Ball, J. E., Briggs, J., … & Smith, G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study. BMJ quality & safety, 28(8), 609-617.
Houser, J. (2016). Nursing research: Reading, using and creating evidence. New York: Jones & Bartlett Learning.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing research-E-book: methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.
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