5.1.1 The impact of Advanced Practice Nurses in promoting evidence-based practice among front-line staff (48)

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

Abstract:

Background:

Advanced practice nurses (APNs) influence the practice of front-line staff by acting as conduits for disseminating evidence-based information (McCaughan et al 2002) and being a resource to front-line staff in decision making (Thompson et al 2001). However, little is known about the actual impact of this activity on the practice of front-line staff. This paper will present findings from one aspect of a study examining the APN’s role in promoting evidence-based practice among front-line staff.

Aim:

To examine the impact of APNs in promoting evidence-based practice on the experiences of front-line staff within the context of an enriched care environment.

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:

The impact of APNs could be modelled in three dimensions: direct/indirect, immediate/delayed, intentional/unintentional. APNs exerted a positive impact on front-line staff through developing their competence, empowering them to be more confident in decision making, and enhancing personal development and job fulfilment. APNs impacted on the care provided by front-line staff by remedying shortfalls in standards of care and enhancing the quality of care. By drawing together the different elements of impact, APNs’ influence on the overall care environment could be mapped. The care environment was enhanced in relation to five dimensions: care giving, relationship-orientated, learning, workplace and evidence-based environments.

Conclusion:

APNs have a largely positive effect on the experiences of front-line staff, and on care delivery. Collectively, the multi-faceted impact of APNs served to enrich the overall care environment experienced by front-line staff and patients.

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.