(^302) Johns Hopkins Nursing Evidence-Based Practice Synthesis Process and Recommendations Tool
Level and Quality of
Individual Evidence
Appraisal
Quantity
of
Evidence
Consistency of
Findings Across
Evidence
Applicability
(generalizable to
population/setting
of interest)
Recommendations
Strength of overall
evidence to guide
practice
recommendations
Synthesis Process
Key Points:
■■ Evidence synthesis is best done through group discussion. All team mem-
bers share their perspectives, and the team uses critical thinking to arrive
at a judgment based on consensus during the synthesis process. The syn-
thesis process involves both subjective and objective reasoning by the full
EBP team.
Through reasoning, the team:
■ Reviews the quality appraisal of the individual pieces of evidence
■ Assesses and assimilates consistencies in findings
■ Evaluates the meaning and relevance of the findings
■ Merges findings that may either enhance the team’s knowledge or
generate new insights, perspectives, and understandings
■ Highlights inconsistencies in findings
■ Makes recommendations based on the synthesis process.
■■ When evidence includes multiple studies of Level I and Level II evidence,
there is a similar population or setting of interest, and there is consistency
across findings, EBP teams can have greater confidence in recommend-
ing a practice change. However, with a majority of Level II and Level III
evidence, the team should proceed cautiously in making practice changes.
In this instance, recommendation(s) typically include completing a pilot
before deciding to implement a full-scale change.