Johns Hopkins Nursing Evidence-Based Practice

Johns Hopkins Nursing Evidence-Based Practice

Evidence Level& Quality:

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Article Title: Number:
Author(s): Publication Date:
Journal:
DoesthisevidenceaddresstheEBPquestion?
Yes No
Donotproceedwithappraisalofthisevidence
 ClinicalPracticeGuidelines:Systematicallydevelopedrecommendationsfromnationallyrecognizedexpertsbasedonresearchevidenceorexpertconsensuspanel.LEVELIV
 ConsensusorPositionStatement:Systematicallydevelopedrecommendationsbasedonresearchandnationallyrecognizedexpertopinionthatguidesmembersofaprofessionalorganizationindecision-makingforanissueofconcern.LEVELIV
• Arethetypesofevidenceincludedidentified?
• Wereappropriatestakeholdersinvolvedinthedevelopmentofrecommendations?
• Aregroupstowhichrecommendationsapplyanddonotapplyclearlystated?
• Havepotentialbiasesbeeneliminated?
• Wererecommendationsvalid(reproduciblesearch,expertconsensus,independentreview,current,andlevelofsupportingevidenceidentifiedforeachrecommendation)?
• Weretherecommendationssupportedbyevidence?
• Arerecommendationsclear? Yes
Yes
Yes
Yes
Yes
Yes
Yes No
No
No
No
No
No
No
LiteratureReview:Summaryofpublishedliteraturewithoutsystematicappraisalofevidencequalityorstrength.LEVELV
• Issubjectmattertobereviewedclearlystated?
• Isrelevant,up-to-dateliteratureincludedinthereview(mostsourceswithinlast5yearsorclassic)?
• Isthereameaningfulanalysisoftheconclusionsintheliterature?
• Aregapsintheliteratureidentified?
• Arerecommendationsmadeforfuturepracticeorstudy? Yes

Yes
Yes
Yes
Yes No

No
No
No
No
ExpertOpinion:Opinionofoneormoreindividualsbasedonclinicalexpertise.LEVELV
• Hastheindividualpublishedorpresentedonthetopic?
• Isauthor’sopinionbasedonscientificevidence?
• Istheauthor’sopinionclearlystated?
• Arepotentialbiasesacknowledged? Yes
Yes
Yes
Yes No
No
No
No
Copyright The Johns Hopkins Hospital/The Johns Hopkins University
OrganizationalExperience:
 QualityImprovement:Cyclicalmethodtoexamineorganization-specificprocessesatthelocallevel.
LEVELV
 FinancialEvaluation:Economicevaluationthatappliesanalytictechniquestoidentify,measure,andcomparethecostandoutcomesoftwoormorealternativeprogramsorinterventions.LEVELV
 ProgramEvaluation:Systematicassessmentoftheprocessesand/oroutcomesofaprogramandcaninvolvebothquantitativeandqualitativemethods.LEVELV
Setting: Sample(composition/size):
• Wastheaimoftheprojectclearlystated?
• Wasthemethodadequatelydescribed?
• Wereprocessoroutcomemeasuresidentified?
• Wereresultsadequatelydescribed?
• Wasinterpretationclearandappropriate?
• Arecomponentsofcost/benefitanalysisdescribed? Yes
Yes
Yes
Yes
Yes
Yes No
No
No
No
No
No N/A
CaseReport:In-depthlookataperson,group,orothersocialunit.LEVELV
• Isthepurposeofthecasereportclearlystated?
• Isthecasereportclearlypresented?
• Arethefindingsofthecasereportsupportedbyrelevanttheoryorresearch?
• Aretherecommendationsclearlystatedandlinkedtothefindings? Yes
Yes

Yes
Yes No
No

No
No
CommunityStandard,ClinicianExperience,orConsumerPreference
 CommunityStandard:CurrentpracticeforcomparablesettingsinthecommunityLEVELV
 ClinicianExperience:KnowledgegainedthroughpracticeexperienceLEVELV
 ConsumerPreference:KnowledgegainedthroughlifeexperienceLEVELV
InformationSource(s): NumberofSources:
• Sourceofinformationhascredibleexperience.
• Opinionsareclearlystated.
• Identifiedpracticesareconsistent. Yes
Yes
Yes No
No N/A
No N/A
FindingsthathelpyouanswertheEBPquestion:
Copyright The Johns Hopkins Hospital/The Johns Hopkins University
QUALITYRATINGFOR CLINICALPRACTICEGUIDELINES,CONSENSUSORPOSITION STATEMENTS(LEVELIV)
AHighquality:Materialofficiallysponsoredbyaprofessional,public,privateorganization,orgovernmentagency;documentationofasystematicliteraturesearchstrategy;consistentresultswithsufficientnumbersofwell-designedstudies;criteria-basedevaluationofoverallscientificstrengthandqualityofincludedstudiesanddefinitiveconclusions;nationalexpertiseisclearlyevident;developedorrevisedwithinthelast5years.

BGoodquality:Materialofficiallysponsoredbyaprofessional,public,privateorganization,orgovernmentagency;reasonablythoroughandappropriatesystematicliteraturesearchstrategy;reasonablyconsistentresults,sufficientnumbersofwell-designedstudies;evaluationofstrengthsandlimitationsofincludedstudieswithfairlydefinitiveconclusions;nationalexpertiseisclearlyevident;developedorrevisedwithinthelast5years.

CLowqualityormajorflaws:Materialnotsponsoredbyanofficialorganizationoragency;undefined,poorlydefined,orlimitedliteraturesearchstrategy;noevaluationofstrengthsandlimitationsofincludedstudies,insufficientevidencewithinconsistentresults,conclusionscannotbedrawn;notrevisedwithinthelast5years.
QUALITYRATINGFORORGANIZATIONALEXPERIENCE (LEVELV)
AHighquality:Clearaimsandobjectives;consistentresultsacrossmultiplesettings;formalqualityimprovementorfinancialevaluationmethodsused;definitiveconclusions;consistentrecommendationswiththoroughreferencetoscientificevidence

BGoodquality:Clearaimsandobjectives;formalqualityimprovementorfinancialevaluationmethodsused;consistentresultsinasinglesetting;reasonablyconsistentrecommendationswithsomereferencetoscientificevidence

CLowqualityormajorflaws:Unclearormissingaimsandobjectives;inconsistentresults;poorlydefinedqualityimprovement/financialanalysismethod;recommendationscannotbemade
QUALITYRATINGFORLITERATUREREVIEW,EXPERTOPINION,COMMUNITYSTANDARD,CLINICIANEXPERIENCE,CONSUMERPREFERENCE(LEVELV)
A Highquality:Expertiseisclearlyevident;drawsdefinitiveconclusions;providesscientificrationale;thoughtleaderinthefield

BGoodquality:Expertiseappearstobecredible;drawsfairlydefinitiveconclusions;provideslogicalargumentforopinions

CLowqualityormajorflaws:Expertiseisnotdiscernableorisdubious;conclusionscannotbedrawn

Copyright The Johns Hopkins Hospital/The Johns Hopkins University