Pei-Shan Tsai, PhD, Professor, Graduate Institute of Nursing, College of Nursing, Taipei Medical University and Deputy Director, Department of Nursing, Wan-Fang Hospital
The core competencies of Advanced Practice Nurse (APNs) include consultation, collaboration, coaching, research, leadership, and direct patient care. Despite expectations that APNs should promote evidence-based practice (EBP), the role and contribution of APNs in EBP remains poorly defined and underdeveloped. Because APNs are often experienced nurses with an expert knowledge base, clinical competency, and complex decision-making skills, they are expected to apply principles of EBP to all patient care. In addition, their trainings in the roles as an expert consultant, a collaborator, a coach, and a leader allow them to function as a change agent to facilitate the use of evidence in the clinical practice. Of late, the role of APNs in promoting EBP has gained a lot of attention. In order to call the attention to this emerging area of concern, findings from two recent publications on the role and functions of APNs in promoting EBP are summarized in this paper.
Gerrish and colleagues (2011) undertook a cross-sectional survey of 855 APNs working in 87 hospitals or primary care settings in England to examine factors influencing APNs’ contribution to promoting EBP among clinical nurses. Findings of that study revealed that APNs engaged in various activities to promote EBP and had a positive influence on clinical nurses’ practice. However, few APNs considered themselves as an expert in EBP. APNs with a Master qualification perceived themselves to be more skilled in all aspects of EBP than those with lower qualifications, suggesting that Master’s preparation should be considered as the minimum entry level of APNs in order to allow the APNS to maximize their potentials.
Another interesting study explored the role of APN in “knowledge brokering” as a means to promote EBP (Gerrish et al., 2011). In that study, a case study of 23 APNs from hospitals and primary care settings across seven Strategic Health Authorities in England was conducted through interviews of APNs and other healthcare professionals. They found that APNs acted as “knowledge brokers” in promoting EBP among clinical nurses. Key components of knowledge brokering included knowledge management and promoting the uptake of knowledge. Knowledge management involved generating different types of evidence, accumulating evidence to act as a repository for clinical nurses, synthesizing different forms of evidence, translating evidence by evaluating, interpreting and distilling it for different audiences and disseminating evidence by formal and informal means. APNs fostered the uptake of evidence by developing the knowledge and skills of clinical nurses through role modelling, teaching, clinical problem-solving and facilitating change.
In summary, APNs are well suited for the role as a change agent to facilitate the use of evidence in clinical practice and as a clinical leader to promote EBP. Nursing education should be responsive to this emerging area of concern in the preparation of APNs.
References
1. Gerrish, K., Guillaume, L., Kirshbaum, M., McDonnell, A., Tod, A., Nolan, M., 2011. Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey. Journal of Advanced Nursing 67(5), 1079-1090.
2. Gerrish, K., McDonnell, A., Nolan, M., Guillaume, L., Kirshbaum, M., Tod, A., et al., 2011. The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses. Journal of Advanced Nursing [Epub ahead of print].