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transfer time by 48% by improving coordination in multiple stages. This Level V
evidence is from one institution that implemented a quality improvement project.
Financial Evaluation (Level V Evidence)
Financial and quality measures in healthcare facilities provide data to assess the
cost associated with practice changes. Cost savings can be powerful information
as the best practice is examined. An EBP team can find reports of cost effective-
ness and economic evaluations (Level V) in published data or internal organi-
zational reports. One example is “The Value of Reducing Hospital-Acquired
Pressure Ulcer Prevalence.” This study assessed the cost savings associated with
implementing nursing approaches to prevent hospital-acquired pressure ulcers
(HAPU) (Spetz, Brown, Aydin, Donaldson, 2013).
Terms used in the literature for projects dealing with finances include an econom-
ic evaluation that applies analytic techniques to identify, measure, and compare
the costs and outcomes of two or more alternative programs or interventions
(Centers for Disease Control and Prevention [CDC], 2007). A common economic
evaluation of healthcare decision-making is a cost-effectiveness analysis, which
compares costs of alternative interventions that produce a common health out-
come. Although the results of such an analysis can provide justification for a pro-
gram, empirical evidence can provide support for an increase in program funding
or a switch from one program to another (CDC, 2007).
Financial data can be evaluated as listed on the JHNEBP Nonresearch Evidence
Appraisal Tool. In reviewing a report, examine the aim, method, measures, re-
sults, and discussion for clarity. Carande-Kulis et al. (2000) recommend that
standard inclusion criteria for economic studies have an analytic method and
provide sufficient detail regarding the method and results. In assessing the quality
of the economic study, the Community Guide “Economic Evaluation Abstraction
Form” (2010) suggests that you ask the following questions:
■■ Was the study population well described?
■■ Was the question being analyzed well defined?
■■ Did the study define the time frame?
