Tag Archives: Evidence based nursing

“How many articles are enough?” Is that even the right question?

How do you know when you have found enough research evidence on a topic to be able to use the findings in clinical practice? How many articles are enough? 5? 50? 100? 1000? Good question!

You have probably heard general rules like these for finding enough applicable evidence: Stick close to your key search terms derived from PICOT statement of problem; Use only research published in the last 5-7 years unless it is a “classic; & Find randomized controlled trials (RCTs), meta-analyses, & systematic reviews of RCTs that document cause-and-effect relationships. These are good strategies. The only problem is that sometimes they don’t work!

Unfortunately, some clinical issues are “orphan topics.” No one has adequately researched them. And while there may be a few, well-done, valuable published studies on the topic, those studies may simply describe bits of the phenomena or focus on how to measure the phenomena (i.e., instrument development). They may give us little to no information on correlation and causation. There may be no RCTs. This situation may tempt us just to discard our clinical issue and to wait for more research (or of course to do research, but that could take years).

In her classic 1998 1-page article, “When is enough, enough?” Dr. Carol Deets, argues that asking how many research reports we need may be the wrong question! Instead, she proposes, we should ask, “What should be done to evaluate the implementation of research findings in the clinical setting?”

When research evidence is minimal, then careful process and outcome evaluation of its use in clinical practice can: 1) Keep patient safety as the top priority, 2) Document cost-effectiveness and efficacy of new interventions, and 3) Facilitate swift, ethical use of findings that contributes to nursing knowledge. At the same time, Deets recognizes that for many this idea may be revolutionary, requiring us to change the way we think.

So back to the original question…How many articles are enough? Deets’ answer? “One study is enough” if we build in strong evaluation as we translate it into practice.

Reference: Deets, C. (1998). When is enough, enough? Journal of Professional Nursing, 14(4), 196. doi.org/10.1016/S8755-7223(98)80058-6

Evidence-based Practice Institute

I recommend this event. I have no conflict of interest.

New virtual EBP Institute – Advanced Practice Institute: Promoting Adoption of Evidence-Based Practice is going virtual this October.

This Institute is a unique advanced program designed to build skills in the most challenging steps of the evidence-based practice process and in creating an organizational infrastructure to support evidence-based health care. Participants will learn how to implement, evaluate, and sustain EBP changes in complex health care systems. 

Each participant also receives Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From the University of Iowa Hospitals and Clinics. This book is an application-oriented EBP resource organized based on the latest Iowa Model and can be used with any practice change. The Institute will include tools and strategies directly from the book.

3-Day Virtual Institute

Wednesday, October 7

Wednesday, October 14

Wednesday, October 21

(participation is required for all 3 days)

Special pricing for this virtual institute: 5 participants from the same institution for the price of 4

Learn more and register for the October 2020 Advanced Practice Institute: Promoting Adoption of Evidence-Based Practice. 

Kristen Rempel

Administrative Services Specialist Nursing Research & Evidence-Based Practice

University of Iowa Health Care | Department of Nursing Services and Patient Care

200 Hawkins Dr, T155 GH, Iowa City, IA 52242 | 319-384-6737

uihc.org/nursing-research-and-evidence-based-practice-and quality

A practical place to start

Enrolled in an MSN….and wondering what to do for an evidence-based clinical project?

Recently a former student contacted me about that very question. Part of my response to her is below:

“One good place to start if you are flexible on your topic is to look through Cochrane Reviews, Joanna Briggs Institute, AHRQ Clinical Practice Guidelines, or similar for very strong evidence on a particular topic and then work to move that into practice in some way.  (e.g., right now I’m involved in a project on using evidence of a Cochrane review on the benefits of music listening–not therapy–in improving patient outcomes like pain, mood, & opioid use).

Once you narrow the topic it will get easier.  Also, you can apply only the best evidence you have, so if there isn’t much research or other evidence about the topic you might have to tackle the problem from a different angle” or pick an area where there IS enough evidence to apply.

Blessings! -Dr.H