1.7.1 Facilitating the link between evidence and practice: The process of evidence-brokering undertaken by advanced practice nurses (47)

Kate Gerrish, Professor of Nursing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, United Kingdom Co authors: Ann McDonnell, Marilyn Kirchbaum, Louise Guillaume, Angela Todd & Mike Nolan, Susan Read k.gerrish@shu.ac.uk

Abstract:

Background:

Research examining evidence-based practice identifies the role that ‘opinion leaders’ such as advanced practice nurses (APNs) play in influencing the practice of front-line nurses (Fitzgerald et al 2003). Milner et al (2005) propose that APNs act as ‘knowledge brokers’ by creating links between different practice communities, in particular acting as intermediaries between the clinical and research communities. However little is known about the process whereby APNs broker knowledge.

Aim:

This paper will present findings from one aspect of a study examining the contribution of APNs to promoting evidence-based practice among front-line staff.

Methods:

A collective instrumental case study approach (Stake 1995) was used. A total of 23 case studies of APNs were completed in 2006. Interviews and observation were used to elicit the opinions of stakeholders within the practice environment of APNs, including front-line nurses, patients/carers, managers, and the multi-disciplinary team. Data analysis drew upon the principles of Framework analysis.

Results:

Evidence-brokering was an overarching concept comprising five processes: Generating evidence: APNs generated different types of evidence including empirical evidence from research, audit and service evaluation, professional expertise, personal knowledge about patients and relational knowledge. New knowledge was generated through blending different types of evidence. Accumulating evidence: APNs accumulated evidence through actively searching, networking and acting as a conduit for organisational evidence.

Translating evidence:

APNs evaluated, interpreted and distilled evidence to make it accessible to different audiences.

Disseminating evidence:

APNs used formal and informal approaches to disseminating evidence to front-line staff and patients.

Applying evidence:

APNs utilised evidence directly, persuasively or conceptually in their own practice and in promoting evidence-based practice with front-line staff.

Conclusion:

The evidence-brokering undertaken by APNs is a complex, iterative process in which they draw upon different types of evidence in order to influence the practice of front-line staff. Implications for practice will be considered.

Biography:

Kate Gerrish holds a joint post between Centre for Health and Social Care Research, Sheffield Hallam University and Sheffield Teaching Hospitals NHS Foundation Trust as Professor of Nursing. Kate’s role in both organisations is to support nursing research and practice development. Kate has held a variety of clinical posts in acute and community nursing in both the UK and Zambia. She also has extensive experience of nurse education having worked in both pre and post registration and nurse teacher preparation. Her main research interests are in the areas of nursing development, transcultural nursing and nurse education and she has published widely in each of these areas. Kate has a long standing interest in promoting evidence-based practice which will form the focus of her conference presentation.