A design science research framework for evidence levels in the nursing interventions classification

Background: The Nursing Interventions Classification (NIC) is a comprehensive, researched-based classification of 614 interventions whose responses can be influenced by a complex range of physiological, psychological, social and cultural conditions which present a challenge to establishing a specific level of evidence when findings are from studies using varied research contexts and methods. Aims: To develop criteria for establishing evidence levels for interventions included in the NIC according to research designs commonly used in nursing. Methods: A Design Science Research (DSR) approach was developed in four stages: (a) problem awareness, (b) solution suggestion, (c) artefact development, and (d) conclusion with presentation of the solution. Results: Six criteria were established to determine the quality information produced by each paper: level of analysis, study design, temporality, unit of analysis, information capture strategy, and comparison strategy. An evidence level classification for the NIC based on the accumulation of qualified information identified for an intervention was established in relation to the four levels, each with four sublevels. Conclusions: This study develops criteria and a classification system to assess evidence levels for the NIC, enhancing knowledge on the reliability and effectiveness of interventions in clinical practice and patient care.