Johns Hopkins Evidence Level And Quality Guide

Johns Hopkins Evidence Level and Quality Guide: A Comprehensive Overview

Introduction:

Are you overwhelmed by the sheer volume of medical research available? Do you struggle to differentiate between robust, evidence-based findings and less reliable studies? Navigating the complexities of medical literature is a challenge, even for seasoned healthcare professionals. This comprehensive guide delves into the renowned Johns Hopkins Evidence Level and Quality Guide, providing a clear, concise understanding of its system for evaluating research and its implications for clinical decision-making. We'll break down the levels of evidence, explore the assessment of study quality, and offer practical applications to help you critically appraise medical research. This guide is essential for anyone involved in healthcare, research, or simply seeking to make informed decisions based on reliable evidence.


Understanding the Johns Hopkins Evidence Level and Quality System

The Johns Hopkins Evidence Level and Quality Guide provides a structured framework for classifying the strength of evidence supporting various medical interventions and treatments. This system isn't a standalone creation but is broadly aligned with established hierarchies of evidence, such as those utilized by the Centre for Evidence-Based Medicine (CEBM). However, the Johns Hopkins system offers a unique lens, emphasizing both the level of evidence and the quality of the supporting research. This dual assessment ensures a more nuanced understanding of the reliability and applicability of the findings.

Levels of Evidence:

The core of the Johns Hopkins system is its hierarchical classification of evidence levels. These levels reflect the design and methodological rigor of the study, with higher levels generally indicating stronger evidence. While the exact nomenclature might vary slightly depending on the specific application within Johns Hopkins, the underlying principles remain consistent. Generally, the levels progress from less rigorous designs (e.g., expert opinion) to more rigorous designs (e.g., randomized controlled trials). Here's a generalized representation:

Level I: Evidence from systematic reviews or meta-analyses of randomized controlled trials (RCTs). This represents the strongest level of evidence, synthesizing results from multiple high-quality RCTs.
Level II: Evidence from at least one well-designed RCT. A single, well-conducted RCT provides strong evidence, although it might be subject to limitations compared to a meta-analysis.
Level III: Evidence from well-designed controlled trials without randomization. These studies lack the randomization inherent in RCTs, potentially introducing bias, but still offer valuable information.
Level IV: Evidence from well-designed case-control and cohort studies. These observational studies can provide valuable insights, particularly when RCTs are unethical or impractical, but are susceptible to confounding factors.
Level V: Evidence from systematic reviews of descriptive and qualitative studies. This level focuses on summarizing descriptive or qualitative research, providing valuable context and insights but not direct evidence of cause-and-effect relationships.
Level VI: Evidence from single descriptive or qualitative studies. These studies offer valuable exploratory information but lack the rigor of higher levels.
Level VII: Evidence from the opinion of authorities and/or reports of expert committees. This represents the weakest level of evidence and should be interpreted cautiously.


Assessing Study Quality:

Beyond the level of evidence, the Johns Hopkins system emphasizes the critical assessment of study quality. This involves evaluating various methodological aspects of the study to determine its trustworthiness and the likelihood of bias. Key aspects considered include:

Study design: The appropriateness of the study design for the research question.
Sample size and selection: Adequate sample size and appropriate participant selection to minimize bias.
Blinding: The extent to which participants and researchers were blinded to treatment assignments (crucial in RCTs).
Randomization: The method of randomization used in RCTs to ensure comparability between groups.
Data collection methods: The reliability and validity of the methods used to collect and measure data.
Statistical analysis: The appropriateness of the statistical methods used to analyze the data.
Risk of bias: An overall assessment of the potential for bias to influence the study results.


Practical Applications of the Johns Hopkins Guide:

The Johns Hopkins Evidence Level and Quality Guide is not just a theoretical framework; it's a practical tool for clinicians, researchers, and healthcare decision-makers. Understanding this system allows for:

Improved critical appraisal of medical literature: The ability to systematically evaluate the strength and reliability of research findings.
Informed clinical decision-making: Making evidence-based choices based on the most robust available evidence.
Development of effective clinical guidelines: Creating guidelines that reflect the highest level of evidence.
Enhanced research design: Designing studies that adhere to rigorous methodological standards.
Effective communication of research findings: Clearly communicating the strength and limitations of research findings to different audiences.


Example: A Hypothetical Study Evaluation

Imagine a study investigating the effectiveness of a new drug for treating hypertension. Using the Johns Hopkins system, we might classify it as follows:

Level of Evidence: If the study is a well-conducted RCT, it would be Level II evidence.
Quality Assessment: We would then assess aspects like randomization, blinding, sample size, and potential biases. A high-quality study would demonstrate minimal bias and strong methodological rigor. A lower-quality study might have flaws that weaken the interpretation of its results, even if it's an RCT.


A Sample Johns Hopkins Evidence Level and Quality Guide Outline:

Title: A Practical Guide to Understanding and Applying the Johns Hopkins Evidence Level and Quality System

Introduction: Defining evidence-based medicine and the importance of critical appraisal.
Chapter 1: Levels of Evidence: Detailed explanation of each level, with examples.
Chapter 2: Assessing Study Quality: A comprehensive review of the key quality indicators and how to assess them.
Chapter 3: Integrating Levels of Evidence and Quality: How to combine both assessments for a holistic evaluation.
Chapter 4: Practical Applications in Clinical Practice: Case studies and examples demonstrating the application of the system in real-world scenarios.
Chapter 5: Limitations and Future Directions: Acknowledging the limitations of any evidence-based system and discussing future developments.
Conclusion: Recap of key concepts and encouragement for continued learning and critical appraisal.


(Detailed explanation of each chapter would follow here, expanding on the points in the outline. This section would comprise several hundred words further elaborating each chapter's content with examples and detailed explanations. Due to space constraints, this detailed expansion is omitted here.)


FAQs:

1. What is the difference between evidence level and quality assessment? Evidence level refers to the study design; quality assessment focuses on methodological rigor.
2. Can a Level I study be of poor quality? Yes, even systematic reviews can have methodological flaws affecting the reliability of their conclusions.
3. How does this system differ from other evidence-based frameworks? While similar in principle, the Johns Hopkins guide emphasizes a combined evaluation of both evidence level and quality.
4. Is this system only for medical research? While frequently used in medicine, the principles are adaptable to other fields requiring evidence-based decision-making.
5. Where can I find the official Johns Hopkins guide? The specific guide may vary depending on the department or program within Johns Hopkins; searching their website for relevant publications is recommended.
6. What if there are conflicting studies at different evidence levels? Prioritize higher-level evidence and critically appraise the quality of all studies involved.
7. How can I learn more about critical appraisal skills? Numerous resources are available online and through professional organizations.
8. Is this system suitable for non-professionals? While the concepts are accessible, a basic understanding of research methodology is helpful.
9. What are the limitations of this system? It's a framework, not a definitive answer; clinical judgment is still crucial in making decisions.


Related Articles:

1. Critical Appraisal of Research Papers: A Step-by-Step Guide: Provides practical guidance on evaluating research papers.
2. Understanding Bias in Research Studies: Explains different types of bias and their impact on research findings.
3. Systematic Reviews and Meta-Analyses: A Beginner's Guide: Introduces these powerful research synthesis methods.
4. Randomized Controlled Trials: Design and Interpretation: Focuses on the gold standard of research design.
5. Cohort Studies and Case-Control Studies: Strengths and Limitations: Compares these important observational study designs.
6. Evidence-Based Practice in Healthcare: Explains the broader context of evidence-based medicine.
7. The Role of Qualitative Research in Healthcare: Discusses the value of qualitative research alongside quantitative methods.
8. How to Read a Medical Journal Article: Practical steps for understanding complex medical research.
9. Developing Clinical Practice Guidelines: A Comprehensive Approach: Details the process of developing evidence-based guidelines.


This comprehensive guide aims to provide a thorough understanding of the Johns Hopkins Evidence Level and Quality Guide. Remember that critical appraisal is an ongoing process requiring continuous learning and refinement of skills. By mastering this system, you can significantly improve your ability to make informed decisions based on the best available evidence.


  johns hopkins evidence level and quality guide: Johns Hopkins Nursing Evidence-based Practice Deborah Dang, Sandra Dearholt, 2018 Appendix F_Nonresearch Evidence Appraisal Tool--Appendix G_Individual Evidence Summary Tool--Appendix H_Synthesis Process and Recommendations Tool -- Appendix I_Action Planning Tool -- Appendix J_Dissemination Tool
  johns hopkins evidence level and quality guide: Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals, Fourth Edition: Model and Guidelines Deborah Dang, Sandra L. Dearholt, Kim Bissett, 2021-06-15 Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals has proven to be one of the most foundational books on EBP in nursing and healthcare.
  johns hopkins evidence level and quality guide: Fast Facts for Evidence-Based Practice Maryann Godshall, PhD, CNE, CCRN, CPN, 2009-12-07 Designated a 2014 Doodyís Core Title by Doodyís Medical Reviews Concise and comprehensive, this book covers the basics of nursing research and the essentials of how to implement Evidence Based Practice (EBP). Using the short, reader-friendly, Fast Facts Series 'style,' the book is designed for those RNs studying Evidence Based Practice (EBP) who want quick access core content. Undergraduate nursing students who want a solid review of evidence based practice (& nursing research) will also find this book useful, as well as RN to BSNs student who need to assimilate content on basic nursing research. It is vital for both the practicing RNs and students to know the basics of EBP and understand how EBP can be implemented. Key features covered include: Delivery of a wide scope of EBP content in the abbreviated style of the Fast Facts series Includes coverage of quantitative and qualitative research approaches, defining the 'compelling question', finding and critiquing the evidence, and disseminating the research Unlocks the mystery surrounding systematic reviews and searching a database Class-tested content, used in seated and online course environments
  johns hopkins evidence level and quality guide: Finding What Works in Health Care Institute of Medicine, Board on Health Care Services, Committee on Standards for Systematic Reviews of Comparative Effectiveness Research, 2011-07-20 Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
  johns hopkins evidence level and quality guide: Evidence-Based Practice in Nursing & Healthcare Bernadette Mazurek Melnyk, Ellen Fineout-Overholt, 2018-10-17 Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, 4th Edition Bernadette Mazurek Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN and Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN Enhance your clinical decision-making capabilities and improve patient outcomes through evidence-based practice. Develop the skills and knowledge you need to make evidence-based practice (EBP) an integral part of your clinical decision-making and everyday nursing practice with this proven, approachable text. Written in a straightforward, conversational style, Evidence-Based Practice in Nursing & Healthcare delivers real-world examples and meaningful strategies in every chapter to help you confidently meet today’s clinical challenges and ensure positive patient outcomes. NEW! Making Connections: An EBP Exemplar opens each unit, immersing you in an unfolding case study of EBP in real-life practice. NEW! Chapters reflect the most current implications of EBP on health policy and the context, content, and outcomes of implementing EBP competencies in clinical and academic settings. NEW! Learning objectives and EBP Terms to Learn at both the unit and chapter levels help you study efficiently and stay focused on essential concepts and vocabulary. Making EBP Real features continue to end each unit with real-world examples that demonstrate the principles of EBP applied. EBP Fast Facts reinforce key points at a glance. Clinical Scenarios clarify the EBP process and enhance your rapid appraisal capabilities.
  johns hopkins evidence level and quality guide: Translation of Evidence Into Nursing and Healthcare Kathleen M. White, PhD, RN, NEA-BC, FAAN, Sharon Dudley-Brown, PhD, RN, FNP-BC, FAAN, Mary F. Terhaar, PhD, RN, ANEF, FAAN, 2019-12-19 NAMED A DOODY’S CORE TITLE! Designed as both a text for the DNP curriculum and a practical resource for seasoned health professionals, this acclaimed book demonstrates the importance of using an interprofessional approach to translating evidence into nursing and healthcare practice in both clinical and nonclinical environments. This third edition reflects the continuing evolution of translation frameworks by expanding the Methods and Process for Translation section and providing updated exemplars illustrating actual translation work in population health, specialty practice, and the healthcare delivery system. It incorporates important new information about legal and ethical issues, the institutional review process for quality improvement and research, and teamwork and building teams for translation. In addition, an unfolding case study on translation is threaded throughout the text. Reorganized for greater ease of use, the third edition continues to deliver applicable theory and practical strategies to lead translation efforts and meet DNP core competency requirements. It features a variety of relevant change-management theories and presents strategies for improving healthcare outcomes and quality and safety. It also addresses the use of evidence to improve nursing education, discusses how to reduce the divide between researchers and policy makers, and describes the interprofessional collaboration imperative for our complex healthcare environment. Consistently woven throughout are themes of integration and application of knowledge into practice. NEW TO THE THIRD EDITION: Expands the Methods and Process for Translation section Provides updated exemplars illustrating translation work in population health, specialty practice, and the healthcare delivery system Offers a new, more user-friendly format Includes an entire new section, Enablers of Translation Delivers expanded information on legal and ethical issues Presents new chapter, Ethical Responsibilities of Translation of Evidence and Evaluation of Outcomes Weaves an unfolding case study on translation throughout the text KEY FEATURES: Delivers applicable theories and strategies that meet DNP core requirements Presents a variety of relevant change-management theories Offers strategies for improving outcomes and quality and safety Addresses the use of evidence to improve nursing education Discusses how to reduce the divide between researchers and policy makers Supplies extensive lists of references, web links, and other resources to enhance learning Purchase includes digital access for use on most mobile devices or computers
  johns hopkins evidence level and quality guide: Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines, Fourth Edition Deborah Dang, Sandra L. Dearholt, Kim Bissett, Judith Ascenzi, Madeleine Whalen, 2021-06-30 Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals has proven to be one of the most foundational books on EBP in nursing and healthcare. Building on the strength of previous versions, the fourth edition is fully revised to include updated content based on more than a decade of the model’s use, refinement in real-life settings, and feedback from nurses and other healthcare professionals around the world. Key features of the book include: · NEW strategies for dissemination, including guidance on submitting manuscripts for publication · EXPANDED focus on the importance of interprofessional collaboration and teamwork, particularly when addressing the complex care issues often tackled by EBP teams · EXPANDED synthesis and translation steps, including an expanded list of outcome measures to determine the success of an EBP project · Tools to guide the EBP process, such as stakeholder analysis, action planning, and dissemination · Explanation of the practice question, evidence, and translation (PET) approach to EBP projects · Overview of the patient, intervention, comparison, and outcome (PICO) approach to EBP question development · Creation of a supportive infrastructure for building an EBP nursing environment · Exemplars detailing real-world EBP experiences
  johns hopkins evidence level and quality guide: Framework for Determining Research Gaps During Systematic Review U. S. Department of Health and Human Services, Agency for Healthcare Research and Quality, 2013-03-23 The identification of gaps from systematic reviews is essential to the practice of ''evidence-based research.'' Health care research should begin and end with a systematic review. A comprehensive and explicit consideration of the existing evidence is necessary for the identification and development of an unanswered and answerable question, for the design of a study most likely to answer that question, and for the interpretation of the results of the study. In a systematic review, the consideration of existing evidence often highlights important areas where deficiencies in information limit our ability to make decisions. We define a research gap as a topic or area for which missing or inadequate information limits the ability of reviewers to reach a conclusion for a given question. A research gap may be further developed, such as through stakeholder engagement in prioritization, into research needs. Research needs are those areas where the gaps in the evidence limit decision making by patients, clinicians, and policy makers. A research gap may not be a research need if filling the gap would not be of use to stakeholders that make decisions in health care. The clear and explicit identification of research gaps is a necessary step in developing a research agenda. Evidence reports produced by Evidence-based Practice Centers (EPCs) have always included a future research section. However, in contrast to the explicit and transparent steps taken in the completion of a systematic review, there has not been a systematic process for the identification of research gaps. We developed a framework to systematically identify research gaps from systematic reviews. This framework facilitates the classification of where the current evidence falls short and why the evidence falls short. The framework included two elements: (1) the characterization the gaps and (2) the identification and classification of the reason(s) for the research gap. The PICOS structure (Population, Intervention, Comparison, Outcome and Setting) was used in this framework to describe questions or parts of questions inadequately addressed by the evidence synthesized in the systematic review. The issue of timing, sometimes included as PICOTS, was considered separately for Intervention, Comparison, and Outcome. The PICOS elements were the only sort of framework we had identified in an audit of existing methods for the identification of gaps used by EPCs and other related organizations (i.e., health technology assessment organizations). We chose to use this structure as it is one familiar to EPCs, and others, in developing questions. It is not only important to identify research gaps but also to determine how the evidence falls short, in order to maximally inform researchers, policy makers, and funders on the types of questions that need to be addressed and the types of studies needed to address these questions. Thus, the second element of the framework was the classification of the reasons for the existence of a research gap. For each research gap, the reason(s) that most preclude conclusions from being made in the systematic review is chosen by the review team completing the framework. To leverage work already being completed by review teams, we mapped the reasons for research gaps to concepts from commonly used evidence grading systems. Our objective in this project was to complete two types of further evaluation: (1) application of the framework across a larger sample of existing systematic reviews in different topic areas, and (2) implementation of the framework by EPCs. These two objectives were used to evaluate the framework and instructions for usability and to evaluate the application of the framework by others, outside of our EPC, including as part of the process of completing an EPC report. Our overall goal was to produce a revised framework with guidance that could be used by EPCs to explicitly identify research gaps from systematic reviews.
  johns hopkins evidence level and quality guide: Evidence-based Practice in Nursing & Healthcare Bernadette Mazurek Melnyk, Ellen Fineout-Overholt, 2015 This user-friendly guide to evidence-based practice will serve as a guide to implementing evidence-based practice in nursing and healthcare.
  johns hopkins evidence level and quality guide: How to Read a Paper Trisha Greenhalgh, 2019-05-06 Required reading in many medical and healthcare institutions, How to Read a Paper is a clear and wide-ranging introduction to evidence-based medicine and healthcare, helping readers to understand its central principles, critically evaluate published data, and implement the results in practical settings. Author Trisha Greenhalgh guides readers through each fundamental step of inquiry, from searching the literature to assessing methodological quality and appraising statistics. How to Read a Paper addresses the common criticisms of evidence-based healthcare, dispelling many of its myths and misconceptions, while providing a pragmatic framework for testing the validity of healthcare literature. Now in its sixth edition, this informative text includes new and expanded discussions of study bias, political interference in published reports, medical statistics, big data and more. Offers user-friendly guidance on evidence-based healthcare that is applicable to both experienced and novice readers Authored by an internationally recognised practitioner and researcher in evidence-based healthcare and primary care Includes updated references, additional figures, improved checklists and more How to Read a Paper is an ideal resource for healthcare students, practitioners and anyone seeking an accessible introduction to evidence-based healthcare.
  johns hopkins evidence level and quality guide: How to Read a Paper Trisha Greenhalgh, 2014-02-26 The best-selling introduction to evidence-based medicine In a clear and engaging style, How to Read a Paper demystifies evidence-based medicine and explains how to critically appraise published research and also put the findings into practice. An ideal introduction to evidence-based medicine, How to Read a Paper explains what to look for in different types of papers and how best to evaluate the literature and then implement the findings in an evidence-based, patient-centred way. Helpful checklist summaries of the key points in each chapter provide a useful framework for applying the principles of evidence-based medicine in everyday practice. This fifth edition has been fully updated with new examples and references to reflect recent developments and current practice. It also includes two new chapters on applying evidence-based medicine with patients and on the common criticisms of evidence-based medicine and responses. How to Read a Paper is a standard text for medical and nursing schools as well as a friendly guide for everyone wanting to teach or learn the basics of evidence-based medicine.
  johns hopkins evidence level and quality guide: Evidence-based Medicine Sharon E. Straus, 2005 The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.
  johns hopkins evidence level and quality guide: Health Promotion Marilyn Frenn, Diane K. Whitehead, 2021-01-05 Take an evidence-based approach to health promotion across the lifespan and clinical specialties. Written for NPs and advanced practitioners, this text provides coaching in how to read, evaluate, and apply the best evidence to health promotion plans for individuals and their families to help them prevent or manage chronic and acute diseases and disorders. Step-by-step, a who’s who of educators, researchers, and practitioners explore the models and skills you need to help your patients, including those with multiple co-morbidities, while evaluating medical evidence that changes rapidly, or may be unclear. You’ll also be prepared for the health promotion questions on certification exams.
  johns hopkins evidence level and quality guide: Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide Agency for Health Care Research and Quality (U.S.), 2013-02-21 This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)
  johns hopkins evidence level and quality guide: The Improvement Guide Gerald J. Langley, Ronald D. Moen, Kevin M. Nolan, Thomas W. Nolan, Clifford L. Norman, Lloyd P. Provost, 2009-06-03 This new edition of this bestselling guide offers an integrated approach to process improvement that delivers quick and substantial results in quality and productivity in diverse settings. The authors explore their Model for Improvement that worked with international improvement efforts at multinational companies as well as in different industries such as healthcare and public agencies. This edition includes new information that shows how to accelerate improvement by spreading changes across multiple sites. The book presents a practical tool kit of ideas, examples, and applications.
  johns hopkins evidence level and quality guide: Cochrane Handbook for Systematic Reviews of Interventions Julian P. T. Higgins, Sally Green, 2008-11-24 Healthcare providers, consumers, researchers and policy makers are inundated with unmanageable amounts of information, including evidence from healthcare research. It has become impossible for all to have the time and resources to find, appraise and interpret this evidence and incorporate it into healthcare decisions. Cochrane Reviews respond to this challenge by identifying, appraising and synthesizing research-based evidence and presenting it in a standardized format, published in The Cochrane Library (www.thecochranelibrary.com). The Cochrane Handbook for Systematic Reviews of Interventions contains methodological guidance for the preparation and maintenance of Cochrane intervention reviews. Written in a clear and accessible format, it is the essential manual for all those preparing, maintaining and reading Cochrane reviews. Many of the principles and methods described here are appropriate for systematic reviews applied to other types of research and to systematic reviews of interventions undertaken by others. It is hoped therefore that this book will be invaluable to all those who want to understand the role of systematic reviews, critically appraise published reviews or perform reviews themselves.
  johns hopkins evidence level and quality guide: Patient Safety and Quality Ronda Hughes, 2008 Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043). - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
  johns hopkins evidence level and quality guide: Population Health for Nurses Jessica Ochs, Sherry L. Roper, Susan M. Schwartz, 2024-05-15 Population Health for Nurses prepares nurses to develop interventions, policies, and practices that promote health equity and improved health outcomes across the health care delivery continuum. The text emphasizes the social determinants of health and how nurses can plan and implement health promotion and disease prevention interventions. It takes a holistic perspective, connecting human health behavior to the dynamic, ongoing interactions of the person, social factors, and the physical environment in which people are born, live, learn, play, work, and age. Population Health for Nurses uses a logical, thematic organization that breaks down content into manageable chunks. It presents the material in 35 chapters, organized into 7 thematic units. The text defines and distinguishes among the interrelated nursing areas of population health, public health, and community health nursing, providing both historical context and up-to-date research to help students make connections across content that can inform practice. The result is a holistic approach that applies theoretical concepts to the practical assessment, diagnosis, planning, implementation, and evaluation steps of client care and community-tailored interventions. This is an adaptation of Population Health for Nurses by OpenStax. You can access the textbook as pdf for free at openstax.org. Minor editorial changes were made to ensure a better ebook reading experience. Textbook content produced by OpenStax is licensed under a Creative Commons Attribution 4.0 International License.
  johns hopkins evidence level and quality guide: Improving the Quality of Health Care for Mental and Substance-Use Conditions Institute of Medicine, Board on Health Care Services, Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders, 2006-03-29 Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€use conditions will benefit from this guide to achieving better care.
  johns hopkins evidence level and quality guide: Evidence-Based Practice for Public Health Emergency Preparedness and Response National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Board on Health Sciences Policy, Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response, 2020-11-28 When communities face complex public health emergencies, state local, tribal, and territorial public health agencies must make difficult decisions regarding how to effectively respond. The public health emergency preparedness and response (PHEPR) system, with its multifaceted mission to prevent, protect against, quickly respond to, and recover from public health emergencies, is inherently complex and encompasses policies, organizations, and programs. Since the events of September 11, 2001, the United States has invested billions of dollars and immeasurable amounts of human capital to develop and enhance public health emergency preparedness and infrastructure to respond to a wide range of public health threats, including infectious diseases, natural disasters, and chemical, biological, radiological, and nuclear events. Despite the investments in research and the growing body of empirical literature on a range of preparedness and response capabilities and functions, there has been no national-level, comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those utilized in medicine and other public health fields. Evidence-Based Practice for Public Health Emergency Preparedness and Response reviews the state of the evidence on PHEPR practices and the improvements necessary to move the field forward and to strengthen the PHEPR system. This publication evaluates PHEPR evidence to understand the balance of benefits and harms of PHEPR practices, with a focus on four main areas of PHEPR: engagement with and training of community-based partners to improve the outcomes of at-risk populations after public health emergencies; activation of a public health emergency operations center; communication of public health alerts and guidance to technical audiences during a public health emergency; and implementation of quarantine to reduce the spread of contagious illness.
  johns hopkins evidence level and quality guide: School, Family, and Community Partnerships Joyce L. Epstein, Mavis G. Sanders, Steven B. Sheldon, Beth S. Simon, Karen Clark Salinas, Natalie Rodriguez Jansorn, Frances L. Van Voorhis, Cecelia S. Martin, Brenda G. Thomas, Marsha D. Greenfeld, Darcy J. Hutchins, Kenyatta J. Williams, 2018-07-19 Strengthen programs of family and community engagement to promote equity and increase student success! When schools, families, and communities collaborate and share responsibility for students′ education, more students succeed in school. Based on 30 years of research and fieldwork, the fourth edition of the bestseller School, Family, and Community Partnerships: Your Handbook for Action, presents tools and guidelines to help develop more effective and more equitable programs of family and community engagement. Written by a team of well-known experts, it provides a theory and framework of six types of involvement for action; up-to-date research on school, family, and community collaboration; and new materials for professional development and on-going technical assistance. Readers also will find: Examples of best practices on the six types of involvement from preschools, and elementary, middle, and high schools Checklists, templates, and evaluations to plan goal-linked partnership programs and assess progress CD-ROM with slides and notes for two presentations: A new awareness session to orient colleagues on the major components of a research-based partnership program, and a full One-Day Team Training Workshop to prepare school teams to develop their partnership programs. As a foundational text, this handbook demonstrates a proven approach to implement and sustain inclusive, goal-linked programs of partnership. It shows how a good partnership program is an essential component of good school organization and school improvement for student success. This book will help every district and all schools strengthen and continually improve their programs of family and community engagement.
  johns hopkins evidence level and quality guide: Strengthening Forensic Science in the United States National Research Council, Division on Engineering and Physical Sciences, Committee on Applied and Theoretical Statistics, Policy and Global Affairs, Committee on Science, Technology, and Law, Committee on Identifying the Needs of the Forensic Sciences Community, 2009-07-29 Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.
  johns hopkins evidence level and quality guide: Systematic Reviews in the Social Sciences Mark Petticrew, Helen Roberts, 2008-04-15 Such diverse thinkers as Lao-Tze, Confucius, and U.S. Defense Secretary Donald Rumsfeld have all pointed out that we need to be able to tell the difference between real and assumed knowledge. The systematic review is a scientific tool that can help with this difficult task. It can help, for example, with appraising, summarising, and communicating the results and implications of otherwise unmanageable quantities of data. This book, written by two highly-respected social scientists, provides an overview of systematic literature review methods: Outlining the rationale and methods of systematic reviews; Giving worked examples from social science and other fields; Applying the practice to all social science disciplines; It requires no previous knowledge, but takes the reader through the process stage by stage; Drawing on examples from such diverse fields as psychology, criminology, education, transport, social welfare, public health, and housing and urban policy, among others. Including detailed sections on assessing the quality of both quantitative, and qualitative research; searching for evidence in the social sciences; meta-analytic and other methods of evidence synthesis; publication bias; heterogeneity; and approaches to dissemination.
  johns hopkins evidence level and quality guide: The Intersection Sue Phelps, Loree Hyde, Julie Planchon Wolf, 2018-01-04 The Intersection: Where Evidence Based Nursing and Information Literacy Meet describes how the Association of College and Research Libraries (ACRL) Framework and Information literacy Competency Standards for Nursing mesh with nursing essentials, thus speaking to the information needs of nurses, nurse educators, and librarians who support worldwide nursing programs. In order to find the best evidence from studies, students and practicing nurses must be proficient in the entire range of information literacy skills. Though the references for this document are from U.S. organizations, they are applicable to nursing audiences across the globe. - Describes how the ACRL Framework and Information Literacy Competency Standards for Nursing mesh with the essentials of nursing education and practice in evidence based nursing - Speaks to the information needs of nurses, nurse educators and librarians who support nursing programs in the language of nursing - Written by the authors for the ACRL Framework and Information Literacy Competency Standards for Nursing
  johns hopkins evidence level and quality guide: Knowledge Translation in Health Care Sharon E. Straus, Jacqueline Tetroe, Ian D. Graham, 2011-08-24 Health care systems worldwide are faced with the challenge of improving the quality of care. Providing evidence from health research is necessary but not sufficient for the provision of optimal care and so knowledge translation (KT), the scientific study of methods for closing the knowledge-to-action gap and of the barriers and facilitators inherent in the process, is gaining significance. Knowledge Translation in Health Care explains how to use research findings to improve health care in real life, everyday situations. The authors define and describe knowledge translation, and outline strategies for successful knowledge translation in practice and policy making. The book is full of examples of how knowledge translation models work in closing the gap between evidence and action. Written by a team of authors closely involved in the development of knowledge translation this unique book aims to extend understanding and implementation worldwide. It is an introductory guide to an emerging hot topic in evidence-based care and essential for health policy makers, researchers, managers, clinicians and trainees.
  johns hopkins evidence level and quality guide: Therapeutic Agents for the Physical Therapist Assistant Jennifer Memolo, 2024-06-01 The first textbook specifically for physical therapist assistant (PTA) students on physical agent modalities, Therapeutic Agents for the Physical Therapist Assistant is a standout resource that will greatly enhance a PTA curriculum. Therapeutic Agents for the Physical Therapist Assistant focuses on the use and execution of each physical agent, covering thermal, sound-energy, mechanical, electrical, and electromagnetic agents. Tables, graphs, review questions, and photos are included for visual reference and lab practice. Clinical tips and case studies are sprinkled throughout each chapter, along with sample documentation and checklists to follow when documenting a therapeutic modality. Topics include: Thermal agents, including thermotherapy and cryotherapy Sound-energy modalities, including therapeutic ultrasound and phonophoresis Mechanical agents, including hydrotherapy, traction, compression, manual therapy, and soft-tissue mobilization Electrical agents, including electrotherapy Electromagnetic agents, including shortwave diathermy, low-level laser therapy, infrared light therapy, and ultraviolet light Included with the text are online supplemental materials for faculty use in the classroom, consisting of an Instructor’s Manual and PowerPoint slides. This textbook is perfect for instructors in PTA programs looking for a text on physical modalities and agents that is geared specifically toward their students. This text will equally hold a valuable place on the shelf as an important reference text for PTA students after they enter the field.
  johns hopkins evidence level and quality guide: Burns and Grove's The Practice of Nursing Research - E-Book Jennifer R. Gray, Susan K. Grove, Suzanne Sutherland, 2016-08-10 - NEW Mixed Methods Research chapter and emphasis covers this increasingly popular approach to research. - NEW! Expanded emphasis on qualitative research provides more balanced coverage of qualitative and quantitative methods, addressing the qualitative research methodologies that are often the starting point of research projects, particularly in magnet hospitals and DNP programs. - ENHANCED emphasis on evidence-based practice addresses this key graduate-level QSEN competency. - UPDATED emphasis on the most currently used research methodologies focuses on the methods used in both quantitative research and qualitative research, as well as outcomes research and mixed methods research. - NEW! Quick-reference summaries are located inside the book's covers, including a table of research methods on the inside front cover and a list of types of research syntheses (with definitions) inside the back cover. - NEW student resources on the Evolve companion website include 400 interactive review questions along with a library of 10 Elsevier research articles. - NEW! Colorful design highlights key information such as tables and research examples
  johns hopkins evidence level and quality guide: The Understanding by Design Guide to Creating High-Quality Units Grant Wiggins, Jay McTighe, 2011-03-11 The Understanding by Design Guide to Creating High-Quality Units offers instructional modules on the basic concepts and elements of Understanding by Design (UbD), the backward design approach used by thousands of educators to create curriculum units and assessments that focus on developing students' understanding of important ideas. The eight modules are organized around the UbD Template Version 2.0 and feature components similar to what is typically provided in a UbD design workshop, including— * Discussion and explanation of key ideas in the module; * Guiding exercises, worksheets, and design tips; * Examples of unit designs; * Review criteria with prompts for self-assessment; and * A list of resources for further information. This guide is intended for K-16 educators—either individuals or groups—who may have received some training in UbD and want to continue their work independently; those who've read Understanding by Design and want to design curriculum units but have no access to formal training; graduate and undergraduate students in university curriculum courses; and school and district administrators, curriculum directors, and others who facilitate UbD work with staff. Users can go through the modules in sequence or skip around, depending on their previous experience with UbD and their preferred curriculum design style or approach. Unit creation, planning, and adaptation are easier than ever with the accompanying downloadable resources, including the UbD template set up as a fillable PDF form, additional worksheets, examples, and FAQs about the module topics that speak to UbD novices and veterans alike.
  johns hopkins evidence level and quality guide: Searching for Health Kapil Parakh, Anna Dirksen, 2021-04-20 An insider's guide to searching online, communicating with your physician, and maximizing your health from a doctor who works at Google. We've all been there. Late at night, staring into the glow of a phone trying to make sense of some health-related issue that we know nothing about. In Searching for Health, Dr. Kapil Parakh, with Anna Dirksen, brings to life knowledge he gained from working at Google and practicing medicine. Helping readers avoid common pitfalls, get the information they need, and partner effectively with their health team to figure out a path to good health together, the book distills decades of scientific research into a set of easy-to-follow tips. It also incorporates • firsthand accounts of common challenges on the path to good health; • an inside look at how doctors approach and assess health-related information; • techniques that consumers can use to locate evidence-based information online, whether in blogs, social media postings, forums, or news stories; • guidance on how individuals can make the best use of new technologies, such as health trackers and other applications; • recommendations to help patients assess health information for themselves and make decisions based on what they find; • brief summaries of the scientific studies underpinning the recommendations; and • online and offline resources—including handy checklists and worksheets—to help readers prepare for appointments, discuss tough topics with their doctors, and take control of their health. In addition to helping readers find evidence-based information online, the book provides insights into what you can expect from a visit to a doctor or hospital, how to make a decision about surgery or other treatment, what tests doctors will order, which symptom trackers are really effective, and what questions to ask about medications, supplements, and more. Searching for Health is a valuable resource for charting a healthier path through life.
  johns hopkins evidence level and quality guide: Families Caring for an Aging America National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Committee on Family Caregiving for Older Adults, 2016-12-08 Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
  johns hopkins evidence level and quality guide: Communicating Risks and Benefits Baruch Fischhoff, 2012-03-08 Effective risk communication is essential to the well-being of any organization and those people who depend on it. Ineffective communication can cost lives, money and reputations. Communicating Risks and Benefits: An Evidence-Based User’s Guide provides the scientific foundations for effective communications. The book authoritatively summarizes the relevant research, draws out its implications for communication design, and provides practical ways to evaluate and improve communications for any decision involving risks and benefits. Topics include the communication of quantitative information and warnings, the roles of emotion and the news media, the effects of age and literacy, and tests of how well communications meet the organization’s goals. The guide will help users in any organization, with any budget, to make the science of their communications as sound as the science that they are communicating.
  johns hopkins evidence level and quality guide: Beyond the HIPAA Privacy Rule Institute of Medicine, Board on Health Care Services, Board on Health Sciences Policy, Committee on Health Research and the Privacy of Health Information: The HIPAA Privacy Rule, 2009-03-24 In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.
  johns hopkins evidence level and quality guide: Critiquing Nursing Research 2nd Edition John Cutcliffe, Martin Ward, 2014-10-13 This second edition of Quay Books' bestselling title retains all of the successful features of the first, plus additional material including a chapter on European psychiatric research. Foreword by Kevin Gournay.
  johns hopkins evidence level and quality guide: Evidence-Based Practice Workbook Paul P. Glasziou, Chris Del Mar, Janet Salisbury, 2009-02-04 The Evidence-based Practice Workbook is an ideal tool for use by GPs, medical specialists and other healthcare professionals to learn the concepts of evidence-based practice (EBP). Practical and interactive, this workbook provides simple methods to help health professionals find and use the best evidence to answer clinical questions, developing their skills in: asking clinical questions searching for answers discriminating good from poor information and research using the answers to make clinical decisions. This attractive, colour workbook provides a clear explanation of EBP skills and concepts. Written by internationally respected authors, this expanded and updated edition has been developed from evidence-based practice workshops run by the Centre for Evidence-Based Medicine at the University of Queensland and Oxford, and contains information and exercises to help health professionals learn how to use EBP in their clinical practice.
  johns hopkins evidence level and quality guide: Priority Areas for National Action Institute of Medicine, Board on Health Care Services, Committee on Identifying Priority Areas for Quality Improvement, 2003-04-10 A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas.
  johns hopkins evidence level and quality guide: The Greenhouse Gas Protocol , 2004 The GHG Protocol Corporate Accounting and Reporting Standard helps companies and other organizations to identify, calculate, and report GHG emissions. It is designed to set the standard for accurate, complete, consistent, relevant and transparent accounting and reporting of GHG emissions.
  johns hopkins evidence level and quality guide: The Future of Nursing Institute of Medicine, Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011-02-08 The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
  johns hopkins evidence level and quality guide: BOOK ALONE - Evidence-Based Practice for Nurses Nola Schmidt, Janet Brown, 2011-02-05 Doody's Review Service - 5 Stars! Evidence-Based Practice for Nurses: Appraisal and Applications of Research, Second Edition serves as the definitive reference for transitioning research into nursing practice. Ideal for undergraduate research courses or courses on role development, this text provides a fresh approach for teaching nursing research using evidence-based practice. Updated and revised, the Second Edition of Evidence-Based Practice for Nurses includes new articles and a companion website.
  johns hopkins evidence level and quality guide: Just and Lasting Change Daniel C. Taylor, Carl E. Taylor, 2016-06-15 With contributions from leading international experts in community-based development and public health, Just and Lasting Change offers a hopeful description of how people have made a difference in diverse communities around the world and a practical, accessible handbook for those trying to improve the quality of life in underdeveloped communities everywhere.
  johns hopkins evidence level and quality guide: The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder American Psychiatric Association, 2018-01-11 Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.