Guide Fostering Nurse-Led Care: Professional Practice for the Bedside Leader

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One morning recently, I attended my biennial mentorship update, led by a representative of the local university. A hospital trust in Cambridgeshire is seeking to recruit nearly extra nurses in order to reduce its reliance on agency staff. Peterborough and Stamford Hospitals NHS Foundation Trust has announced it will be holding six recruitment days through the year in order to try and attract nurses. Like many….

Fostering Nurse-Led Care

A new drug has been launched for women with advanced HER2-positive breast cancer who have stopped responding to trastuzumab Herceptin. Trastuzumab emtansine Kadcyla has been licensed by the European Medicines Agency for patients who have failed on conventional treatment with trastuzumab and chemotherapy. It encourages you to seek answers regarding how things can improve or the effectiveness of certain methods and to search out and emphasize an evidence-based practice.

Nurse Innovation: Saving the Future of Healthcare - Rebecca Love - TEDxBeaconStreet

This has been wonderful to open your eyes to all the different things you can do for your patients. Administrators perceived the training program to raise awareness of the links between good clinical practice and research evidence:. There is more of an understanding or realization that whatever we implement or whatever practice we are carrying out, we do need to be more conscious of whether there is any evidence for it.

There is more intentional scrutiny of what we are doing now, and the training program certainly reinforced that. Not only did they gain the language, resources, and evidence needed to be taken seriously by other members of the healthcare team, but also their motivation and commitment to promote practice change were enhanced by their engagement in the research process:. It makes the frontline workers really push to get the best possible evidence-based guidelines and practice because they want it. Some participants and their teams did report practice change to result from their research, including shifts in practice guidelines and care standards.

Three examples of practice and policy changes as a result of the training program and subsequent research included 1 a qualitative project that examined the experience of newly admitted residents to a long-term-care facility altered their admission process as a result of their findings; 2 a team in acute care developed a new order set that has significantly reduced emergency room wait times for myocardial infarction patients prescribed the hypothermia protocol; and 3 findings from a hemophilia study have led to implementation of individualized hemophilia treatment plans at the provincial hemophilia clinic and funding of an expanded study.

Despite the benefits noted by administrators and participants, the training program and the completion of the research project were challenging for most point-of-care clinicians. Research mentors and the program organizers were perceived by participants to be invaluable in assisting them in navigating the complex research process. Further training in conducting data collection and analysis, as well as developing dissemination products, was suggested by several participants.

This study is 1 of the 1st to implement and evaluate an EBP intervention that aimed to increase awareness and the practice of EBP through the inclusion of point-of-care clinicians in the creation of research evidence. This innovative approach bridged the traditional gap between clinical practice and research by empowering clinicians to identify challenging clinical issues and providing them with the knowledge, skills, and resources needed to look for solutions in an evidence-based manner.

By involving point-of-care clinicians in research, we hoped to build excitement about research and EBP in the workplace. Willingness to engage in research, however, did not significantly change. A variety of other strategies have been proposed to promote EBP among clinicians, including journal clubs, EBP education programs, 28,29 knowledge brokers, 30 and mentorship programs.

Most striking was the number of participants who reported an increased commitment to practice improvement as well as shifts in clinical practice through revisions to practice guidelines and the development of patient and professional resources. The research training program successfully addressed many of the barriers to EBP that have been previously identified.

Although many participants still struggled to balance competing priorities, their willingness to engage in research was maintained over the course of the training program.


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Training programs, such as the 1 tested in this study, create a culture of learning and respect in a healthcare organization for the pivotal role played by clinicians in not only utilizing research but also generating evidence and becoming change agents. The importance of knowledge translation in healthcare has received much attention and scholarship in recent years, with efforts focused on increasing uptake of new research evidence by point-of-care clinicians.

Nurse Leadership from Bedside to Boardroom

In addition, 2 research teams have been successful in securing national funding to expand their original studies. There were several limitations to the study. The sample was restricted to clinicians working at a Canadian healthcare organization. Although the sample was diverse with regard to age, health disciplines, and years in practice, the majority of participants were females practicing in acute care.

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Caution is thus needed in generalizing the findings to other clinical settings and populations. Lastly, the potential clustering effect among research team members, which could not be controlled in the data analysis due to the survey not collecting data on team membership, may have influenced the linear regression modeling results.

see For administrators, the research training program illustrates a successful model for enhancing EBP while strengthening academic-practice partnerships and creating professional development opportunities for point-of-care clinicians. Support for such programs highlights the importance and value attributed to research and EBP, which may help brand a healthcare organization as one with a strong research culture that attracts and keeps the best and brightest clinicians. Healthcare organizations can no longer afford for EBP to remain an abstract concept or an idealized competency.

The research training program evaluated in this article is a promising initiative that brings EBP to life for point-of-care clinicians by not only highlighting the importance of research in clinical practice, but empowering them to take a leading role. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent.

For more information, please refer to our Privacy Policy. Subscribe to eTOC. Advanced Search. Toggle navigation. Subscribe Register Login. Your Name: optional. Your Email:. Colleague's Email:. Separate multiple e-mails with a ;. Send a copy to your email. Some error has occurred while processing your request. Please try after some time. The authors declare no conflicts of interest. Back to Top Article Outline. Figure 1. Table 1. Transforming health care from the inside out: advancing evidence-based practice in the 21st century. J Prof Nurs. Cited Here PubMed CrossRef.

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Association of evidence-based care processes and outcomes among patients with acute coronary syndromes: performance matters. J Cardiovasc Nurs. An evidence-based practice approach to improving nursing care of acute stroke in an Australian emergency department. J Clin Nurs. J Adv Nurs. Publisher: Indianapolis, Ind.


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  • It will provide key background and how-to information about the important leadership roles that nurses can assume at the bedside while caring or patients and families and perhaps most importantly, how to create an environment in which these initiatives can flourish and advance quality health care. Read more Show all links. Allow this favorite library to be seen by others Keep this favorite library private.

    Find a copy in the library Finding libraries that hold this item This book discusses the importance of nurse-led care at the bedside and how to achieve a professional practice model that allows for such leadership growth, in connection with the recommendations from the Future of Nursing Report.

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