Evidence-based practice guidelines are a group of developed statements or
recommendations that will improve the quality or the process of care that is collected from a
methodological review on a certain topic (Melnyk & Fineout-Overholt, 2015). Article Yao et al.
(2021) suggests that evidence-based clinical practice guidelines should include a systemic review
of literature. The Preferred Reporting Items for Systemic reviews and Meta-Analysis statement
recommends reporting checklist that requests that authors indicate if a protocol exists, provides
databases searched with the search dates, and a list of the full electronic search strategy for at
least one database. When it comes to the assigned reading Nursing Management of the Patient
with Multiple Sclerosis, guidelines are based on evidence because the publication used relevant
databases to support the recommended guidelines on how to care for patients with Multiple
Sclerosis (MS). The databases used were MEDLINE, Cochrane, and the Cumulative Index to
Nursing and Allied Health Literature.
Evidence-based practice experts rate levels of evidence along with its strengths which
will be a guide in healthcare decision making. Three domains that are used to rate the evidence
are quality, quantity, and consistency. Quality refers to internal validity; quantity is the number
of studies used to evaluate the clinical issue; and consistency evaluates if studies with both
similar and different study designs report similar results (Melnyk & Fineout-Overholt, 2015).
When applying the strength-of evidence pyramid, this article did meet the criteria of indicating
the levels of evidence that support the recommendations:
Level I- Randomized controlled trials
Level II- Observational studies (cohort or case-control)
Level III- Qualitative Studies (case study or series)
Level IV- Evidence from reports of expert opinions or committees (AANN)
The level of evidence pyramid ranks meta-analysis, systemic reviews, and randomized controlled
trials at the top, whereas case-control studies, case reports and opinion articles are rated lower
(Harvey, 2020), which this article was efficient in.
I would most likely use the guidelines presented based on the evidence provided because
it provides findings that describe appropriate care that was dependent on the best available
scientific evidence and evidence that are linked directly to recommendations via strength of the
recommendation rating system. I believe that implementing these recommendations for
providing care to a patient with MS will result in improved patient outcomes. Exodus 23:1 state,
“You shall not spread false report. You shall not join hands with a man to be malicious witness”
(ESV). I have found that many health care organizations are slow to change because they are
stuck in their culture, but with the evolution of health care and co-morbidities, healthcare is a
profession that requires evidence-based practices. This will result in the best possible outcome
for the patient along with benefitting the organization by being recognized as implementing the
most up-to-date care. Caring for patients without evidence can result in harm of the patient and
lacks quality care. The Christian healthcare professional will continue to research to find best
practices and share these teaching with others as Jesus Christ would.
For literature review paper, the evidence I choose will demonstrate quality, quantity, and
consistency by having the highest level of evidence rating possible.
References
Harvey, E., M.D. (2020). Can we use levels of evidence to make a decision? Canadian Journal of
Surgery, 63(1), E86-E87. http://dx.doi.org.ezproxy.liberty.edu/10.1503/cjs.001920
Melnyk, B., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A
guide to best practice (4th ed.). Wolters Kluwer.
Nursing Management of the Patient with Multiple ... - IOMSN. (n.d.). https://iomsn.org/wp-
content/uploads/2016/07/AANN-ARN-IOMSN-MS-Guideline_FINAL.pdf.
Yao, X., Vella, E. T., & Sussman, J. (2021). More thoughts than answers: What distinguishes
evidence-based clinical practice guidelines from non-evidence-based clinical practice
guidelines? Journal of General Internal Medicine : JGIM, 36(1), 207-
208. https://doi.org/10.1007/s11606-020-05825-y
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