A nurse is collecting research to revise the protocol for specimen collection on their unit.
From which of the following sources should the nurse retrieve the information?

Choice A rationale:

Systematic reviews are considered Level I evidence in the hierarchy of evidence in evidence-based practice (EBP). Systematic reviews involve the rigorous and comprehensive synthesis of multiple research studies on a specific topic. This approach minimizes bias and provides the highest level of evidence for making clinical decisions. Systematic reviews typically follow a structured methodology and offer a critical analysis of the existing literature, making them a strong foundation for EBP.

Choice B rationale:

Credible websites are not considered Level I evidence. While some websites may contain reliable information, they vary in quality, and the credibility of the source must be carefully assessed. Relying solely on websites is not the most robust approach in EBP, as it lacks the rigorous systematic review and critical appraisal process of Level I evidence.

Choice C rationale:

Expert opinions are not considered Level I evidence. While expert opinions can be valuable, they are often based on individual experiences and interpretations rather than systematic research. Expert opinions are generally considered lower in the hierarchy of evidence compared to systematic reviews and other forms of research evidence.

Choice D rationale:

Qualitative studies are not considered Level I evidence. Qualitative studies provide valuable insights into the experiences, perceptions, and meanings associated with a particular phenomenon. However, they are typically ranked lower in the hierarchy of evidence compared to systematic reviews and quantitative research studies. Qualitative studies are more appropriate for addressing research questions related to subjective experiences and understanding the "why" and "how" of a phenomenon.

The correct answer is: A

Choice A reason: Providing the nurse administering medications with an identifying vest can help reduce medication errors by making it easier for other staff and patients to identify the nurse responsible for medication administration. This can minimize interruptions and distractions, which are common causes of medication errors. It also serves as a visual reminder to the nurse of their critical role in medication safety.

Choice B reason: Removing medications from automatic dispensing systems before they are reviewed by pharmacists is not a recommended practice. Pharmacists play a crucial role in reviewing prescriptions for accuracy and potential drug interactions before dispensing. Therefore, medications should remain in the dispensing system until they have been properly reviewed and approved by a pharmacist.

Choice C reason: Waiting to document medications given to clients until the end of a shift is not advisable. Accurate and timely documentation is essential in healthcare, particularly when it comes to medication administration. Documentation should occur as soon as the medication is given to ensure that all healthcare providers have up-to-date information and to prevent errors such as omissions or duplications.

Choice D reason: Preparing medications for multiple clients at the same time increases the risk of errors, such as mix-ups between patients or incorrect dosing. It is best practice to prepare and administer medications for one client at a time, following the ‘five rights’ of medication administration: the right patient, the right drug, the right dose, the right route, and the right time.