LETTERS TO THE EDITOR Questions about the AORN evidence appraisal process I wish to respond to AORN President Rosemarie Schroeder’s message, “Increased influence through innovation in processes” (October 2013, Vol 98, No 4). While I applaud AORN’s ongoing commitment to providing evidence-based recommended practices, my concern lies in the recent decision to change from the Oncology Nursing Society Putting Evidence into Practice (ONS PEPÒ) schema to one that was developed by the AORN Nursing Department and approved by the Recommended Practices Advisory Board. As stated by President Schroeder, “The members of the AORN Nursing Department wanted to give perioperative nurses a clear vision of the levels of evidence that ground each practice recommendation.” However, in order to have a clear vision and understanding of the evidence-rating categories, each category should be operationally defined. For example, how is strong, moderate, or limited evidence defined? Does no evidence translate into published research not found on the topic? How do regulations equate with strong evidence? These are but a few questions I have on the new process, and I hope AORN will provide further information on the process in future issues. I believe in order for perioperative nurses to make best use of the recommended practices and defend said practices, we must be able to articulate how the interventions are measured, are applicable to our surgical patients, and address the most current evidence. Thank you for the opportunity to respond to the “President’s Message.” ROBIN CHARD PHD, RN, CNOR ASSOCIATE PROFESSOR, COLLEGE OF NURSING NOVA SOUTHEASTERN UNIVERSITY FORT LAUDERDALE, FL http://dx.doi.org/10.1016/j.aorn.2013.11.003

Ó AORN, Inc, 2014

Editor’s note: ONS PEP is a registered trademark of the Oncology Nursing Society, Pittsburgh, PA. Author response. The purpose of President Schroeder’s message was to briefly describe AORN’s innovative approach to the ongoing development of evidence-based practice recommendations. It was not intended to provide a detailed description of the new AORN Evidence Rating Model. Evidence rating is a new and exciting AORN initiative. As we learn and grow in this new approach to professional perioperative nursing, together we will continue to refine the AORN Evidence Rating Model. The ONS PEP schema and the Johns Hopkins Evidence-Based Practice Model provided the excellent foundation on which AORN could begin to build a systematic evidence review, an appraisal, and rating processes best suited to the unique needs of the AORN recommended practices (RP) documents. The AORN Evidence Rating Model is the result of the practical experience gained through implementation during the development of four evidence-rated RP documents. The AORN Evidence Rating Model was created through a yearlong effort, in consultation with nationally recognized experts in evidence review. The AORN evidence-rating processes, including the AORN Evidence Rating Model, were developed with the goal of meeting the National Guideline Clearinghouse Criteria for Inclusion of Clinical Practice Guidelines. All RP documents submitted to the National Guideline Clearinghouse meet the criteria and have been accepted. We can assure the reader that the AORN model does clearly define the criteria for each rating level. A detailed explanation and description of the AORN evidence review, appraisal, and rating process is scheduled to publish in the February issue of AORN Journal and also in the 2014 edition

January 2014

Vol 99 No 1


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