title: Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey.
abstract: OBJECTIVE
  This paper is a report of a study to identify factors influencing advanced practice nurses' contribution to promoting evidence-based practice among front-line nurses.
  
  
  BACKGROUND
  Despite widespread recognition that care should be evidence-based, nurses experience challenges implementing evidence-based practice. As opinion leaders, advanced practice nurses can influence the practice of front-line nurses by promoting research use. Little is known about how advanced practice nurses use evidence and their influence on care given by front-line nurses.
  
  
  METHODS
  A cross-sectional survey of 855 advanced practice nurses working in 87 hospital/primary care settings in England. The questionnaire examined understandings of evidence-based practice, sources of evidence used, ways of working with front-line nurses, perceived impact on front-line nurses, skills in evidence-based practice and barriers to promoting evidence-based practice. Data were collected in 2005 and analysed using descriptive statistics. Comparisons were made between advanced practice nurses with Masters qualifications and those with lower qualifications.
  
  
  RESULTS
  Advanced practice nurses used different sources of evidence. They engaged in various activities to promote evidence-based practice and had a positive influence on front-line nurses' practice. Advanced practice nurses' skills in evidence-based practice varied with few considering themselves expert. Advanced practice nurses with Masters qualifications perceived themselves to be more skilled in all aspects of evidence-based practice than those with lower qualifications.
  
  
  CONCLUSIONS
  Advanced practice nurses are well placed as clinical leaders to promote evidence-based practice by frontline nurses but require further development of their skills in evidence-based practice. In order to maximize their potential, advanced practice nurses require Master's preparation.
authors.affiliation: Sheffield Hallam University and Sheffield Teaching Hospitals NHS Foundation Trust, UK. k.gerrish@shu.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Gerrish
authors.forename: Louise
authors.initials: L
authors.lastname: Guillaume
authors.forename: Marilyn
authors.initials: M
authors.lastname: Kirshbaum
authors.forename: Ann
authors.initials: A
authors.lastname: McDonnell
authors.forename: Angela
authors.initials: A
authors.lastname: Tod
authors.forename: Mike
authors.initials: M
authors.lastname: Nolan
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D015400:Clinical Nursing Research / Q000193:education / Q000379:methods; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D004509:Education, Nursing, Continuing / Q000379:methods; D004511:Education, Nursing, Graduate; D004739:England; D055318:Evidence-Based Nursing / Q000193:education / Q000458:organization & administration* / Q000592:standards; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D024802:Nurse's Role; D015404:Nursing Methodology Research / Q000379:methods; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology / Q000592:standards; D015279:Organizational Culture; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D055815:Young Adult