Aim. The purpose of this project is to evaluate a strategy for increasing the capacity for evidence-based practice (EBP) among all levels of nurses at two large academic medical centers.   Background: For nearly 3 decades, with the body of research knowledge exploding, the nursing profession has advanced its efforts to expedite the translation and use of research-based knowledge in clinical practice, clinical education, performance improvement, and nursing management. With respect to clinical practice, this is usually defined as using research to guide the content and actions of clinical practice, a key component of the larger construct of evidence-based practice (EPB). In clinical EBP, best evidence, clinician expertise and judgment, and patient preferences are aligned in making therapeutic plans and treatment decisions. Similar strategies should be used to plan practice-based education, performance improvement efforts, and strategic management decisions. Barriers to research use in clinical nursing have been well documented and highlight the importance of building organizational capacity to empower and support clinicians in developing their evidence-based practice roles, the focus of this project. Methods: With full administrative support, we adopted a highly self-directed coach-fellow model, building on the knowledge and expertise of advanced practice nurses (clinical specialists and nurse educators) to act as coaches for staff nurses engaging in practice-driven, unit-based performance improvement projects. Coaches are introduced to the principles in an all-day workshop, and then work with selected staff nurses (fellows) to undertake a unit-based project. Armed with a novel EBP “Tool Kit,” the coach and fellow progress through a systematically guided 6-month application experience. Evaluation: Full evaluation is pending completion of the first fellowship group in March, 2006. This will include evaluating the scope and effects of completed projects, coach and staff role development, and reduction in perceived organizational barriers to EBP role performance.  

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