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Factors Influencing Advanced Practice Nurses’ Ability to Promote Evidence-Based Practice among Frontline Nurses

Authors

  • Kate Gerrish RN, PhD, MSc,

    1. Kate Gerrish,Professor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Mike Nolan, Professor of Gerontological Nursing, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK;Ann McDonnell,Reader, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Angela Tod, Principal Research Fellow, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Marilyn Kirshbaum, Reader in Nursing, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;Louise Guillaume, Information Specialist, School of Health and Related Research, University of Sheffield, Sheffield, UK.
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  • Mike Nolan RN, PhD,

    1. Kate Gerrish,Professor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Mike Nolan, Professor of Gerontological Nursing, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK;Ann McDonnell,Reader, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Angela Tod, Principal Research Fellow, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Marilyn Kirshbaum, Reader in Nursing, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;Louise Guillaume, Information Specialist, School of Health and Related Research, University of Sheffield, Sheffield, UK.
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  • Ann McDonnell RN, PhD, MSc,

    1. Kate Gerrish,Professor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Mike Nolan, Professor of Gerontological Nursing, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK;Ann McDonnell,Reader, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Angela Tod, Principal Research Fellow, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Marilyn Kirshbaum, Reader in Nursing, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;Louise Guillaume, Information Specialist, School of Health and Related Research, University of Sheffield, Sheffield, UK.
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  • Angela Tod RN, PhD, MSc,

    1. Kate Gerrish,Professor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Mike Nolan, Professor of Gerontological Nursing, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK;Ann McDonnell,Reader, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Angela Tod, Principal Research Fellow, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Marilyn Kirshbaum, Reader in Nursing, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;Louise Guillaume, Information Specialist, School of Health and Related Research, University of Sheffield, Sheffield, UK.
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  • Marilyn Kirshbaum RN, PhD, MSc, RN,

    1. Kate Gerrish,Professor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Mike Nolan, Professor of Gerontological Nursing, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK;Ann McDonnell,Reader, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Angela Tod, Principal Research Fellow, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Marilyn Kirshbaum, Reader in Nursing, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;Louise Guillaume, Information Specialist, School of Health and Related Research, University of Sheffield, Sheffield, UK.
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  • Louise Guillaume PhD, MSc, BA (Hons)

    1. Kate Gerrish,Professor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Mike Nolan, Professor of Gerontological Nursing, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK;Ann McDonnell,Reader, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Angela Tod, Principal Research Fellow, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK;Marilyn Kirshbaum, Reader in Nursing, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;Louise Guillaume, Information Specialist, School of Health and Related Research, University of Sheffield, Sheffield, UK.
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  • We would wish to thank Dr Susan Read who contributed to the design and conduct of the case studies. This study was commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department. This research was funded by the Policy Research Programme of the Department of Health, England. Grant number 0160072.

Kate Gerrish, School of Nursing and Midwifery, Samuel Fox House, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK; kate.gerrish@sheffield.ac.uk

ABSTRACT

Background: Advanced practice nurses (APNs) have an important role in promoting evidence-based practice (EBP) among frontline nurses (FLNs). Factors influencing FLNs’ engagement with EBP are well documented but little is known about factors that affect APNs’ ability to facilitate evidence in practice.

Aims: To identify factors that influence APNs’ ability to promote EBP among FLNs.

Methods: A multiple case study of 23 APNs from hospital and primary care settings across seven English health authorities was undertaken. Data collection comprised interviews and observation of APNs and interviews with FLNs and other healthcare professionals. Data were analysed using the Framework approach.

Findings: Four groups of influencing factors were identified: (1) Personal attributes of APNs included knowledge and skills in EBP, clinical credibility with frontline staff and leadership style. (2) Relationships with stakeholders included APNs’ interactions with FLNs and the level of support from managers and medical colleagues. (3) Aspects of the APN role included their sphere of responsibility and workload. (4) Organisational context included the organisational culture, FLNs’ workload, professional networks and available resources.

Implications: Educational preparation for APNs should enable them to develop expertise in EBP plus interpersonal and leadership skills to manage relational dynamics in clinical settings. APN role specifications should provide the opportunity to promote EBP. The organisational culture should be conducive to enabling EBP with managers supportive of this aspect of the APNs’ role.

Conclusions: APNs need to be supported to address the individual, interpersonal and organisational factors, which influence their ability to promote EBP. Organisational commitment at the highest level is key to APNs’ ability to fulfil this aspect of their role.

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