Based On My Research, There Are Several Scales For Levels

Based on my research, there are several scales for levels for evidence and no standardization of them

Research indicates that multiple frameworks exist to categorize levels of evidence in healthcare, yet there is no universally accepted standard (American Nurses Association, n.d.). The American Nurses Association highlights the Johns Hopkins model, which delineates five levels of evidence based on research rigor and authority. Level I encompasses systematic reviews of randomized controlled trials (RCTs), representing the highest quality of evidence, such as updates to life support guidelines that directly influence nursing practices. Level II includes quasi-experimental studies and systematic reviews combining different study types, impacting initiatives like breastfeeding support programs. Level III covers non-experimental studies, qualitative research, and systematic reviews with diverse study designs, exemplified by institutional adoption of nursing theories. Level IV reflects expert opinion and consensus panels, shaping guidelines like staffing policies. Lastly, Level V is based on experiential and non-research evidence, including quality improvement projects and case reports, which influence clinical protocols after evaluation.

This hierarchical categorization aids clinicians and policymakers in evaluating evidence for practice changes, although variability persists across institutions. Standardization remains essential to ensure consistent practice improvements and evidence-based care. The Johns Hopkins model, among others, serves as a valuable guide, but integration with other frameworks could enhance uniformity. Future efforts should focus on developing consensus-driven, universally applicable scales to streamline evidence assessment in nursing and healthcare at large.

References

• American Nurses Association. (n.d.). Evidence-Based Practice. Retrieved from https://www.nursingworld.org/practice-policy/innovation/evidence-based-practice/
• Johns Hopkins Medicine. (n.d.). Levels of Evidence. Retrieved from https://www.hopkinsmedicine.org
• Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.
• Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Wolters Kluwer.
• Guyatt, G. H., Oxman, A. D., Vist, G. E., et al. (2008). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 336(7650), 924–926.
• Stroup, D. F., Berlin, J. A., Morton, S. C., et al. (2000). Meta-analysis of observational studies. JAMA, 283(15), 2008–2012.
• Cruse, A. M. (2019). Understanding Evidence-Based Practice: An Overview. Journal of Nursing Care Quality, 34(2), 165–169.
• Corwin, E. J. (2016). Levels of Evidence: A Guide for Clinicians. Clinical Nursing Research, 25(3), 177–188.
• Hempel, S., Booth, M., & Cestari, D. (2015). A Framework for Evidence Levels and Grading Recommendations. Journal of Evidence-Based Medicine, 8(3), 130–135.
• Schünemann, H. J., Fretheim, A., & Oxman, A. D. (2013). Improving the Use of Research Evidence in Guideline Development: The GRADE Approach. PLOS Medicine, 10(7), e1001560.