Nursing-Johns Hopkins Evidence-Based Practice Model

Evidence-Based Practice (EBP) uses a rating system to appraise evidence (usually a research study published as a journal article). The level of evidence corresponds to the research study design. Scientific research is considered to be the strongest form of evidence and recommendations from the strongest form of evidence will most likely lead to the best practices. The strength of evidence can vary from study to study based on the methods used and the quality of reporting by the researchers. You will want to seek the highest level of evidence available on your topic (Dang et al., 2022, p. 130).

The Johns Hopkins EBP model uses 3 ratings for the level of scientific research evidence

• true experimental (level I)
• quasi-experimental (level II)
• nonexperimental (level III)

The level determination is based on the research meeting the study design requirements (Dang et al., 2022, p. 146-7).

You will use the Research Appraisal Tool (Appendix E) along with the Evidence Level and Quality Guide (Appendix D) to analyze and appraise research studies . (Tools linked below.)

N onresearch evidence is covered in Levels IV and V.

JHEBP Levels of Evidence Overview

Level I
Experimental study

• randomized controlled trial (RCT)
• Systematic review of RCTs, with or without meta-analysis

Level II
Quasi-experimental Study

• Systematic review of a combination of RCTs and quasi-experimental, or quasi-experimental studies only, with or without meta-analysis.

Level III
Non-experimental study

• Systematic review of a combination of RCTs, quasi-experimental and non-experimental, or non-experimental studies only, with or without meta-analysis.
• Qualitative study or systematic review, with or without meta-analysis

Level IV
Opinion of respected authorities and/or nationally recognized expert committees/consensus panels based on scientific evidence.

• Clinical practice guidelines
• Consensus panels

Level V
Based on experiential and non-research evidence.

• Literature reviews
• Quality improvement, program, or financial evaluation
• Case reports
• Opinion of nationally recognized expert(s) based on experiential evidence

These flow charts can also help you detemine the level of evidence throigh a series of questions.

Single Quantitative Research Study

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These charts are a part of the Research Evidence Appraisal Tool (Appendix E) document.

Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. 4th ed. Sigma Theta Tau International