(^158) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Community Standard (Level V Evidence)
When an EPB team is searching for evidence, one consideration is the current
practice standard in the community. To learn the community standard, the EBP
team identifies healthcare providers, agencies, or organizations from which they
can gain evidence. The team devises a standard list of questions and a systematic
approach to data collection. For example, Johns Hopkins University School of
Nursing students were assisting with an EBP project with this question: “Does
charge nurse availability during the shift affect staff nurse satisfaction with work
flow?” An EBP team member contacted local hospitals to determine whether
charge nurses had patient assignments. Students developed a data sheet with
questions about the healthcare facility, the unit, the staffing pattern, and staff
comments about satisfaction. The students reported the number of units
contacted and responses, information source, and number of sources using the
Nonresearch Evidence Appraisal Tool. Additionally, this approach provides an
opportunity to network with other clinicians about a clinical issue.
Social networking, blogs from a professional organization’s websites, and special
interest groups are other sources of information about community standards. The
online Pediatric Emergency Medicine Database (http://www.pemdatabase.org)
provides articles and a discussion list for clinical questions. These types of data-
bases can provide helpful information about community standards.Clinician Experience (Level V Evidence)
Though this section focuses on nurse experience, the best application of EBP oc-
curs within the interdisciplinary care team because no single discipline provides
healthcare in isolation.
The concept of holistic care as the hallmark of nursing expertise, advocated by
Benner (2001), supports the notion that evidence of all types (both research and
nonresearch) must inform nursing practice. Novice nurses rely heavily on guide-
lines and care protocols to enhance skill development, looking at the patient as
the sum of composite parts. The more experienced expert nurse skillfully syn-
thesizes and applies information from research findings and experience (Garland
Baird & Miller, 2015).