It is important to note that evidence-based practice emphasizes the use of a wide range of evidence, which can significantly vary in terms of quality and reliability. Sources of literature to support or refute a specific intervention can be generally categorized into two groups, such as filtered and unfiltered information. At the very bottom of the evidence-based pyramid, the chart is background information sources as well as expert opinions with the lowest quality rating, followed by case reports, cohorts, and randomized control studies with increasing qualities, respectively (Walden University Library, 2022). These belong to the unfiltered category of evidence or information, which means they are specific and precise, but not sufficiently comprehensive and systematic to use as evidence for interventions (Walden University Library, 2022). Filtered sources begin with critically appraised individual articles followed by critically appraised topics, and systematic reviews are of the highest quality at the top of the chart.
The PICOT Question: In an acute care setting, can purposeful hourly rounding by nurses and members of the interdisciplinary team help decrease falls during a patient’s hospital stay compared to not hourly rounding at all? An example of an unfiltered cohort is a study by Sun et al. (2020), where observational data was collected following nursing professionals over the course of time. Evidence of higher quality is an integrative literature review conducted by Ryan et al. (2018), which concluded that “intentional rounding has positive outcomes on patient satisfaction and safety” when conducted hourly (p. 1151). In the case of the PICOT question, Ryan et al. (2018) can be used as solid and comprehensive high-quality evidence to propose the hourly rounding intervention to prevent or reduce falls among patients. Therefore, it is critical to understand and distinguish between different categories of evidence.
References
Ryan, L., Jackson, D., Woods, C., & Usher, K. (2018). Intentional rounding – An integrative literature review. Journal of Advanced Nursing, 75(6), 1151-1161. Web.
Sun, C., Fu, C. J., O’Brien, J., Cato, K., Stoeger, L., & Levin, A. (2020). Exploring practices of bedside shift report and hourly rounding. Is there an impact on patient falls? The Journal of Nursing Administration, 50(6), 355-362. Web.
Walden University Library. (2022). Evidence-based research: Levels of evidence pyramid. Web.