fall prevention

Johns Hopkins Nursing Evidence-Based Practice Appendix F: Non-Research Evidence Appraisal Tool

© The Johns Hopkins Hospital/Johns Hopkins University. May not be used or reprinted without permission. Page 1

Article Title: Number:

Author(s):

Publication Date:

Journal:

Does this evidence address the EBP question?

Yes No Do not proceed with appraisal of this evidence

Clinical Practice Guidelines: Systematically developed recommendations from nationally recognized experts based on research evidence or expert consensus panel. LEVEL IV

Consensus or Position Statement: Systematically developed recommendations based on research and nationally recognized expert opinion that guides members of a professional organization in decision-making for an issue of concern. LEVEL IV

 Are the types of evidence included identified?  Were appropriate stakeholders involved in the development of recommendations?  Are groups to which recommendations apply and do not apply clearly stated?  Have potential biases been eliminated?  Were recommendations valid (reproducible search, expert consensus,

independent review, current, and level of supporting evidence identified for each recommendation)?

 Were the recommendations supported by evidence?  Are recommendations clear?

Yes

Yes Yes Yes Yes Yes Yes

No

No No No No No No

Literature Review: Summary of published literature without systematic appraisal of evidence quality or strength. LEVEL V

 Is subject matter to be reviewed clearly stated?  Is relevant, up-to-date literature included in the review (most sources within

last 5 years or classic)?  Is there a meaningful analysis of the conclusions in the literature?  Are gaps in the literature identified?  Are recommendations made for future practice or study?

Yes

Yes Yes

Yes

Yes

No

No No

No

No

Expert Opinion: Opinion of one or more individuals based on clinical expertise. LEVEL V

 Has the individual published or presented on the topic?  Is author’s opinion based on scientific evidence?  Is the author’s opinion clearly stated?  Are potential biases acknowledged?

Yes Yes Yes Yes

No No No No

Evidence Level & Quality:________________________

Johns Hopkins Nursing Evidence-Based Practice Appendix F: Non-Research Evidence Appraisal Tool

© The Johns Hopkins Hospital/Johns Hopkins University. May not be used or reprinted without permission. Page 2

Organizational Experience:

Quality Improvement: Cyclical method to examine organization-specific processes at the local level. LEVEL V

Financial Evaluation: Economic evaluation that applies analytic techniques to identify, measure, and compare the cost and outcomes of two or more alternative programs or interventions. LEVEL V

Program Evaluation: Systematic assessment of the processes and/or outcomes of a program and can involve both quantitative and qualitative methods. LEVEL V

Setting:

Sample (composition/size):

 Was the aim of the project clearly stated?  Was the method adequately described?  Were process or outcome measures identified?  Were results adequately described?  Was interpretation clear and appropriate?  Are components of cost/benefit analysis described?

Yes Yes Yes Yes Yes Yes

No No No No No No N/A

Case Report: In-depth look at a person, group, or other social unit. LEVEL V

 Is the purpose of the case report clearly stated?  Is the case report clearly presented?  Are the findings of the case report supported by relevant theory or

research?  Are the recommendations clearly stated and linked to the findings?

Yes Yes Yes

Yes

No No No

No

Community Standard, Clinician Experience, or Consumer Preference

Community Standard: Current practice for comparable settings in the community LEVEL V

Clinician Experience: Knowledge gained through practice experience LEVEL V

Consumer Preference: Knowledge gained through life experience LEVEL V

Information Source(s): Number of Sources:

 Source of information has credible experience.  Opinions are clearly stated.  Identified practices are consistent.

Yes Yes Yes

No No N/A No N/A

Findings that help you answer the EBP question:

Johns Hopkins Nursing Evidence-Based Practice Appendix F: Non-Research Evidence Appraisal Tool

© The Johns Hopkins Hospital/Johns Hopkins University. May not be used or reprinted without permission. Page 3

QUALITY RATING FOR CLINICAL PRACTICE GUIDELINES, CONSENSUS OR POSITION STATEMENTS (LEVEL IV) A High quality: Material officially sponsored by a professional, public, private organization, or

government agency; documentation of a systematic literature search strategy; consistent results with sufficient numbers of well-designed studies; criteria-based evaluation of overall scientific strength and quality of included studies and definitive conclusions; national expertise is clearly evident; developed or revised within the last 5 years.

B Good quality: Material officially sponsored by a professional, public, private organization, or

government agency; reasonably thorough and appropriate systematic literature search strategy; reasonably consistent results, sufficient numbers of well-designed studies; evaluation of strengths and limitations of included studies with fairly definitive conclusions; national expertise is clearly evident; developed or revised within the last 5 years.

C Low quality or major flaws: Material not sponsored by an official organization or agency; undefined,

poorly defined, or limited literature search strategy; no evaluation of strengths and limitations of included studies, insufficient evidence with inconsistent results, conclusions cannot be drawn; not revised within the last 5 years.

QUALITY RATING FOR ORGANIZATIONAL EXPERIENCE (LEVEL V) A High quality: Clear aims and objectives; consistent results across multiple settings; formal quality

improvement or financial evaluation methods used; definitive conclusions; consistent recommendations with thorough reference to scientific evidence

B Good quality: Clear aims and objectives; formal quality improvement or financial evaluation methods

used; consistent results in a single setting; reasonably consistent recommendations with some reference to scientific evidence

C Low quality or major flaws: Unclear or missing aims and objectives; inconsistent results; poorly

defined quality improvement/financial analysis method; recommendations cannot be made QUALITY RATING FOR LITERATURE REVIEW, EXPERT OPINION, COMMUNITY STANDARD, CLINICIAN

EXPERIENCE, CONSUMER PREFERENCE (LEVEL V) A High quality: Expertise is clearly evident; draws definitive conclusions; provides scientific rationale;

thought leader in the field B Good quality: Expertise appears to be credible; draws fairly definitive conclusions; provides logical

argument for opinions C Low quality or major flaws: Expertise is not discernable or is dubious; conclusions cannot be drawn