Clinical nurse specialists' use of evidence in practice: a pilot study.
BACKGROUND
The interest in finding ways to bridge the gap between nursing research and implementation of findings into practice has been increasing. Clinical nurse specialists (CNSs) may be a bridge between frontline nurses and current developments in practice. While several researchers have studied the use of evidence by nurses in general, no known studies have been focused specifically on the use of evidence by CNSs.


OBJECTIVE
The purpose of this pilot study was to develop an understanding of the sources, nature, and application of evidence used by CNSs in practice and to investigate the feasibility of conducting a qualitative study focused on the CNS role in relation to evidence use in practice.


METHODS
This pilot study is a descriptive exploratory design in the qualitative paradigm. Seven CNSs from a large Western Canadian health region were interviewed. Interview transcripts were reviewed for recurrent themes about sources of evidence, evidence use, and barriers and facilitators to evidence use.


RESULTS
CNSs access and use evidence from a variety of sources. All CNSs indicated that research literature was a primary source of evidence and research was used in decision-making. Peers and experience were also important sources of evidence. CNSs used the Internet extensively to consult research databases, online sources of evidence, and to contact peers about current practice. CNSs also gathered evidence from frontline nurses, healthcare team members, and families before decision-making. The choice of evidence often depended upon the type of question they were attempting to answer. Barriers cited by CNSs support previous research and included lack of time, resources, and receptivity at clinical and organizational levels. Facilitators included peers, organizational support, and advanced education.


CONCLUSIONS
CNSs in Canada have advanced education and clinical expertise and many are employed in roles that permeate organizational management and clinical nursing care. It is suggested that qualitative research in naturalized settings that investigates the role of CNSs in relation to the dissemination of evidence in nursing practice needs attention.
Profetto-McGrath
Joanne
J
Faculty of Nursing, Knowledge Utilization Studies Program (KUSP), and Centre for Knowledge Transfer, University of Alberta, Edmonton, Alberta, Canada. joanne.profetto-mcgrath@ualberta.ca
Smith
Karen Bulmer
KB
Hugo
Kylie
K
Taylor
Michael
M
El-Hajj
Hannan
H
D000416:Alberta; D001291:Attitude of Health Personnel; D003142:Communication; D003657:Decision Making; D004059:Diffusion of Innovation; D034742:Electronic Mail; D019317:Evidence-Based Medicine / Q000193:education / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D007400:Interprofessional Relations; D007587:Job Description; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D015399:Nursing Research / Q000193:education / Q000458:organization & administration; D015279:Organizational Culture; D010865:Pilot Projects; D011361:Professional Competence; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D018581:Technology Transfer; D013997:Time Factors