title: The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses.
abstract: OBJECTIVE
  To identify approaches used by advanced practice nurses to promote evidence-based practice among clinical nurses.
  
  
  BACKGROUND
  Barriers encountered at individual and organizational levels hinder clinical nurses in their ability to deliver evidence-based practice. Advanced practice nurses are well placed to promote evidence-based practice through interactions with clinical nurses. However, little is understood about how advanced practice nurses might realize this potential.
  
  
  METHODS
  A multiple instrumental case study of 23 advanced practice nurses from hospital and primary care settings across seven Strategic Health Authorities in England was undertaken in 2006. Data collection comprised interviews and observation of advanced practice nurses and interviews with clinical nurses and other healthcare professionals. Data were analysed using the Framework approach.
  
  
  RESULTS
  Advanced practice nurses acted as knowledge brokers in promoting evidence-based practice among clinical nurses. Knowledge management and promoting the uptake of knowledge were key components of knowledge brokering. 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. Advanced practice nurses promoted the uptake of evidence by developing the knowledge and skills of clinical nurses through role modelling, teaching, clinical problem-solving and facilitating change.
  
  
  CONCLUSIONS
  The role of advanced practice nurses in knowledge brokering is complex and multi-faceted. It extends beyond the knowledge management, linkage and capacity building identified in the literature to include active processes of problem-solving and facilitating change.
authors.affiliation: Centre for Health and Social Care Research, 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: Ann
authors.initials: A
authors.lastname: McDonnell
authors.forename: Mike
authors.initials: M
authors.lastname: Nolan
authors.forename: Louise
authors.initials: L
authors.lastname: Guillaume
authors.forename: Marilyn
authors.initials: M
authors.lastname: Kirshbaum
authors.forename: Angela
authors.initials: A
authors.lastname: Tod
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D002983:Clinical Competence / Q000592:standards; D004059:Diffusion of Innovation; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D004739:England; D055318:Evidence-Based Nursing / Q000193:education; D055317:Evidence-Based Practice / Q000193:education*; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D007400:Interprofessional Relations; D019359:Knowledge; D058436:Knowledge Management; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000592:standards; D015279:Organizational Culture; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D036301:Qualitative Research