Thank you for your response regarding AACN’s revised evidence hierarchy system.21 The EBPRWG’s goal was to provide researchers and clinicians with a valuable tool to support practice and capture valuable nonexperimental research. When a user is rating evidence or using an AACN resource such as Practice Alerts, this tool should effectively provide a clear understanding where the level of evidence exists or does not exist.

Thank you, too, for pointing out level “M.” The EBPRWG believed it was necessary to maintain this rating provided in the original levels of evidence to support statements that may exist from a manufacturer’s recommendation. However, keep in mind that this level is the lowest in strength and may not be supported by research, thus the clinician should not view it as an endorsement of any particular manufacturer’s product. This awareness can prove beneficial when evaluating practices where higher level evidence, such as...

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