Make Nursing Evidence Based Practice (EBP)
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JHNEBP EVIDENCE RATING SCALES
© The Johns Hopkins Hospital/The Johns Hopkins University
SSTTRREENNGGTTHH of the Evidence Level I Experimental study/randomized controlled trial (RCT) or meta analysis of RCT Level II Quasi-experimental study Level III Non-experimental study, qualitative study, or meta-synthesis. Level IV Opinion of nationally recognized experts based on research evidence or expert
consensus panel (systematic review, clinical practice guidelines) Level V Opinion of individual expert based on non-research evidence. (Includes case
studies; literature review; organizational experience e.g., quality improvement and financial data; clinical expertise, or personal experience)
QQUUAALLIITTYY of the Evidence
A High
Research consistent results with sufficient sample size, adequate control, and definitive conclusions; consistent recommendations based on extensive literature review that includes thoughtful reference to scientific evidence.
Summative reviews
well-defined, reproducible search strategies; consistent results with sufficient numbers of well defined studies; criteria-based evaluation of overall scientific strength and quality of included studies; definitive conclusions.
Organizational well-defined methods using a rigorous approach; consistent results with sufficient sample size; use of reliable and valid measures
Expert Opinion expertise is clearly evident B Good Research reasonably consistent results, sufficient sample size, some control, with fairly definitive conclusions;
reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence
Summative reviews
reasonably thorough and appropriate search; reasonably consistent results with sufficient numbers of well defined studies; evaluation of strengths and limitations of included studies; fairly definitive conclusions.
Organizational Well-defined methods; reasonably consistent results with sufficient numbers; use of reliable and valid measures; reasonably consistent recommendations
Expert Opinion expertise appears to be credible. C Low quality
or major flaws
Research little evidence with inconsistent results, insufficient sample size, conclusions cannot be drawn Summative reviews
undefined, poorly defined, or limited search strategies; insufficient evidence with inconsistent results; conclusions cannot be drawn
Organizational Undefined, or poorly defined methods; insufficient sample size; inconsistent results; undefined, poorly defined or measures that lack adequate reliability or validity
Expert Opinion expertise is not discernable or is dubious. *A study rated an A would be of high quality, whereas, a study rated a C would have major flaws that raise serious questions about the believability of the findings and should be automatically eliminated from consideration.
Newhouse R, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-based Practice Rating Scale. 2005. Baltimore, MD,
The Johns Hopkins Hospital; Johns Hopkins University School of Nursing.