Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

11 Lessons from Practice: Using the JHNEBP Tools 255

Level IV

■■Opinions of respected authorities and/

or reports of nationally recognized

expert committees or consensus

panels based on scientific evidence

Level V

■■Evidence obtained from literature

or integrative reviews, quality

improvement, program evaluation,

financial evaluation, or case reports

■■Opinion of nationally recognized

expert(s) based on experiential

evidence

A-B

Several hospitals have moved to only

wipe care, while others determine

care requirements on a case-by-case

basis (6, 12, 14)

Cleansing wipes provide comfort

and decrease rates of CAUTI for

hospitalized individuals (4)

Decrease in the incidence of CAUTI

(4)

Do you recall the numbers assigned to

each source of evidence? They were

entered on the evidence appraisal

tools, were carried over to the Individual

Evidence Summary, and are entered at

the end of each finding. This allows the

team to easily refer to the original source

should they need to, without crowding

the table with citations.

EBP Question: Could the use of plain, disposable bathing wipes, instead of traditional basin bathing, reduce
the incidence of CAUTIs for adult patients on a medical/surgical unit?

Based on your synthesis, which of the following four pathways to translation represents the overall

strength of the evidence?

❑ Strong, compelling evidence, consistent results: Solid indication for a practice change is indicated.

✘ Good and consistent evidence: Consider pilot of change or further investigation.

❑ Good but conflicting evidence: No indication for practice change; consider further investigation for new

evidence or develop a research study.

❑ Little or no evidence: No indication for practice change; consider further investigation for new evidence or

develop a research study or discontinue project.

If you selected either the first option or the second option, continue. If not, STOP—translation is not indicated

Recommendations based on evidence synthesis and selected translation pathway

Pilot the use of plain cleansing wipes on one med/surg unit

Remove basins from storage on pilot unit

Initiate daily plain wipe cleansing

Monitor for effectiveness

After determining they had good and

consistent evidence, the team developed

recommendations. These flowed directly

from the synthesis of evidence above.