comment from post 5

Based on my research, there are several scales for levels for evidence and no standardization of them (American Nurses Association, n.d.). The American Nurses Association (ANA) gives several examples on their website. One example is the five level model adopted by Johns Hopkins Medicine. Here is an over view of that model:

Level I: Experimental study, randomized controlled trial (RCT); systematic review of RCTs, with or without meta-analysis

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        Example: Updates and improvements in ACLS,BLS,NRP guidelines based on research change the way we deliver high

                         quality nursing care in advanced life support  

Level II: Quasi-experimental study, systematic review of a combination of RCTs and quasiexperimental, or quasi-experimental

           studies only, with or without meta-analysis

        Example: Baby Friendly Hospital Initiative (BFHI) designation at my hospital has changed the way we support

                         breastfeeding  mothers.  

Level III: Non-experimental study, systematic review of a combination of RCTs, quasi-experimental and non-experimental studies,

             or non- experimental studies only, with or without meta-analysis,qualitative study or systematic review with or without a

             metasynthesis

        Example: adoption of a nursing theory by an institution as a framework for supporting and advancing nursing; in the case of

                        my hospital, Dr. Joanne Duffy’s Quality Caring Model  

Level IV: Opinion of respected authorities and/or nationally recognized expert committees/consensus panels based on scientific

             evidence

        Example: staffing guidelines and position statements developed by AWHONN  

Level V: Based on experiential and non-research evidence; includes: Literature reviews, Quality improvement, program or financial

           evaluation, case reports, opinion of nationally recognized experts(s) based on experiential evidence (Johns Hopkins, n.d.)

        Example: implementation of an algorithm for appropriate surgical site dressings after a team evaluates product use and

                        outcomes after a trial period

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