Clinical Significance as It Relates to Evidence‐Based Practice

Abstract

PURPOSE. This paper analyzes the concept of clinical significance (CS) in relation to evidence‐based practice (EBP). The purpose is to show that CS terminology is inconsistent in the nursing literature. It is argued that nursing outcomes and interventions that include findings of CS are difficult to interpret due to lack of an operational definition. It is further argued that the absence of a consistent operational definition is incompatible with EBPs which require standardization of terminology. DATA SOURCES. The current literature and research studies, particularly from the electronic databases Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge, PubMed, and Cochrane Database of Systematic Reviews. DATA SYNTHESIS. The disparate uses of CS negatively impact standardizing and quantifying research outcomes to discern EBPs. The authors propose a definition of CS inclusive of the multifarious uses that were revealed in the literature, and conclude that there is a need for professional nursing consensus to define the term. A standard operational definition of CS would enable consistency as clinicians interpret research findings and facilitate translating research to practice. CONCLUSIONS. Given the centrality of CS to interpreting research findings and applying them to practice, there is a need to solidify the terminology of and measurements for CS in nursing. National nursing agencies, including The National Institute for Nursing Research and Sigma Theta Tau International, should make standardizing CS a high priority for targeted funding. One method of doing so would be to support a consensus convergence to review and select the optimal measures of CS for nursing research. Research to increase knowledge about what constitutes measurement and change, or CS from the patient perspective is needed. Editors and peer reviewers should encourage authors to include a discussion of CS. Discussions of CS should receive greater emphasis in research journals. It is hoped that the preliminary findings from the concept analysis presented in this article will facilitate the work of such a consensus forum. IMPLICATIONS FOR NURSING PRACTICE. The most immediate and tangible advantages to a common conceptual definition and meaning of CS terminologies by nursing, regardless of which definition is selected, are less confusion and more clarity. Ultimately, the most enduring benefit of a common conceptual definition and measurement for CS is the bridge it provides between research and practice, and the facility with which it promotes the integration of research into EBP.

Statistical, practical and clinical significance and Doctor of Nursing Practice projects

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Developing and evaluating interventions that are applicable and relevant to inpatients and those who care for them; a multiphase, pragmatic action research approach

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Use of standardized nursing terminologies in electronic health records for oncology care

“…Specifically, well-developed SNTs within EHRs benefit by providing: 1) better communication among nurses and other healthcare providers (Lundberg et al, 2008;Rutherford, 2008), 2) increased visibility of the nursing care process (Muller-Staub et al, 2008;Rutherford, 2008), such as nursing diagnoses, nursing interventions, and nursingsensitive patient outcomes, 3) increased adherence to standards of care, which may promote evidence-based practice care as well (Bruner, Corbett, Gates, & Dupler, 2012;Kautz & van Horn, 2008;Rutherford, 2008), 4) facilitation of evaluation of nursing competencies (Rutherford, 2008), 5) increased quality improvement, patient satisfaction,…”

“…Bruner and colleagues analyzed the concept of clinical significance (CS) in relation to evidence-based practice (EBP) and concluded that a standardization of terminology is essential to disseminating best practices in the nursing profession (Bruner et al, 2012). A study of the NNN linkages to enhance EBP was published (Kautz & van Horn, 2008).…”