The evidence-based practice (EBP) is the quality of evidence broken down into seven levels

and revolves around the patient. A primary and secondary category identifies the filtered
information from the non-filtered evidence-based information. Nursing research, quality, and
safety provide the highest level of evidence-based practice known as systemic reviews. The use
of qualitative and quantitative studies provide more accurate evidence-based research to support
the data nursing professions need. A master prepared administration role would benefit from
knowing how to use evidence based data to make medical decisions will create the foundation of
improved safety and quality of care.
Evidence-Based Practice (EBP) is defined as a basis for high-quality healthcare, integrating
the levels of EBP as criteria for the nursing profession (ANA, 2010). There are seven levels in
the form of a pyramid used as guidelines for measuring the quality of evidence comprised
divided into two sections, the top three levels are the filtered information or known as a
secondary source, and the bottom four sections are considered the unfiltered information or
known as primary source information. The top levels include systematic reviews, meta-analysis,
and critically appraised articles and topics. The research information found in these filtered
levels has already been through an evaluation process, and is considered to be the strongest
supporting level of evidence (East Carolina University, 2014). This information is based off
RCT, using meta-synthesis and meta-syntheses to pull filtered information from controlled
studies producing the strongest level of evidence to use as guidelines for healthcare professionals
to make practice decisions.
While the bottom levels contain new research or unfiltered research such as, Randomized
Controlled Trials (RCTs), Cohort Studies, Case-Controlled Studies, and Expert Opinion. These
studies may be the most recent and considered to be the weakest form of evidence-based
information (East Carolina University, 2014). This information is also based off theories or

expert opinions, rather than controlled evidence information using meta-synthesis and
quantitative studies. Healthcare professionals will need to do more research to determine
validity of this information requiring more time and efforts.
The Fundamental Patterns of Knowing in Nursing (Carper, 1978), is similar to the levels of
evidence by having categories establishing a framework of the healthcare profession. The four
patterns of knowing, empirics, esthetics, component of personal knowledge and ethics, are
identified as theoretical models and pre-paradigm conceptual structures. Understanding these
fundamentals from theory or concept to an evidence-based would provide healthcare
professionals with more tools for improving patient outcomes.
The use of empirics in a nurturing based program from beginning to end is an example of
utilizing an evidence-based programing. In the Nurturing Parenting Program (NPP), empirics
are used in a facilitator training workbook guide by Dr. Stephen J. Bavolek (2010). The use of
his knowledge and research is the foundation of evidence-based information in assessing clients.
Most efforts for research and theory development are generated by systematic and controllable
evidence in categorizing knowledge (Carper, 1978, p. 14). The implementation of qualitative
and quantitative research for these patterns of knowing would benefit by proving an even
stronger foundation from evidence rather than a foundation theory. The healthcare industry
continues to move towards using EBP, transitioning these nursing fundamentals through
continued cohort studies and RCTs to create an even stronger evidence-based foundation to the
patterns of knowing.
Any major transformation in the healthcare field will be faced with many challenges.
Challenges such as having the ability to filter through an overwhelming amount of information
from nursing journals and appraise or synthesize evidence. Also, once evidence-based

information is acquired, there are challenges to implement the new evidence-based information
into the healthcare systems in a way of improving outcomes.
It is clear the use of evidence based information will improve the outcomes of health care. It
is imperative to continue building evidence based systems that are integrated in the daily
decision making abilities of the healthcare staff. Future administrators will need to have the
knowledge of creating, maintaining and how to utilize the evidence based information available
to provide a continuous improvement system in the healthcare industry.

References
American Nurses Association. (2010). Nursing: Scope and Standards of Practice. (2nd ed).
Silver Spring, MD: Nursesbooks.org.
Bavolek, S. J. (2010). Nurturing Parenting Programs. Facilitator Training Workbook and
Program Implementation Guide. (11th ed). Asheville, NC: Family Development
Resources, Inc.
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. ANS Advances in Nursing
Science, 1(1), 13-23.
East Carolina University (2014). Evidence-Based Practice for Nursing, Levels of Evidence
Retrieved from: http://libguides.ecu.edu/content.php?pid=449739&sid=3684894