Using the ?Levels of Evidence? chart provide in the attachment below, read each abstract and then identify the level of evidence of the study. In a brief comment, explain your answer.

Using the ?Levels of Evidence? chart provide in the attachment below, read each abstract and then identify the level of evidence of the study. In a brief comment, explain your answer.

Learning Activity for Identifying Levels of Evidence

Level Description

Level I Systematic Reviews (Integrative/Meta-analyses) CPGs (Clinical practice guidelines) based on Systematic Reviews/Large Multi-Center Clinical Trials

Level II Single Experimental Study (RCTs)

Level III Quasi-Experimental Studies

Level IV Non-Experimental Studies

Level V Case Report/Program Evaluation/Narrative Literature Reviews

Level VI Opinions of Respected Authorities

@ 2010 by Rona F. Levin and Jeffrey M. Keefer
Adapted from the work of Stetler, Morsi, Rucki, Broughton, Corrigan, Fitzgerald, et al. (1998); Melnyk and Fineout-Overholt (2011); Levin (2008).

Using the ?Levels of Evidence? chart above, read each abstract and then identify the level of evidence of the study. In a brief comment, explain your answer.
1. McDonald, M. V., Pezzin, L. E., Feldman, P. H,, Murtaugh, C. M., & Peng, T. R. (2005). Can just-in-time, evidence-based ?reminders? improve pain management among home health care nurses and their patients. Journal of Pain & Symptom Management, 25(5), 474-488.

Abstract: The purpose of this randomized, controlled home care intervention was to test the effectiveness of two nurse-targeted e-mail-based interventions to increase home care nurses? adherence to pain assessment and management guideline, and to improve patient outcomes. Nurses from a large urban nonprofit home care organization were assigned to usual care or one to two interventions upon identification of an eligible cancer patient with pain. The basic intervention consisted of a patient-specific, one-time e-mail reminder highlighting six pain-specific clinical recommendations. The augmented intervention supplemented the initial e-mail reminder with provider prompts, patient education material, and clinical nurse specialist outreach. Over 300 nurses were randomized and outcomes of 673 of their patients were reviewed. Data collection involved clinical record abstraction of nurse care practices and patient interviews completed approximately 45 days after start of care. The intervention had limited effect on nurse-documented care practices but patient outcomes were positively influenced. Patients in the augmented group improved significantly over the control group in ratings of pain intensity at its worst, whereas patients in the basic group had better ratings of pain intensity on average. Other outcome measures were also positively influenced but did not reach statistical significance. Our findings suggest that although reminders have some role in improving cancer pain management, a more intensive approach is needed for a generalized, nursing workforce with limited recent exposure to state-of-the-art pain management practices.
a. Level I

Explanation & Answer

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