Staff Nurse Role Questioning Practice Locally and Providing a Guide for Nurses Globally

The Future of Nursing: Leading Change, Advancing Health published in 2011 emphasized the need for nurses practicing to the full extent of their education and training. Bedside nurses are busy providing care in an environment of continuous change and pressing patient needs, but care delivery must be evidence-based. Several strategies promote a culture of inquiry and empower staff nurses (STNs) to participate in evidence-based practice (EBP).  Mentoring to support STN-driven EBP has primarily been the responsibility of the CNS, clinical researcher, or faculty. Yet STNs have a critical role in creating a culture where EBP is the norm. STNs can serve as committee co-chairs and clinical experts applying EBP within the governance structure for nurse sensitive quality indicators (e.g., skin, falls, pain). STNs can function on shared governance committees as change agents by serving as opinion leaders and change champions using academic detailing, audit and feedback, practice prompts, and trouble shooting at the point of care. Committee members make EBP actionable in patient care, bring clinical issues forward, help find resolutions, and actively share information bidirectionally between clinical area colleagues and committee members. Unit-based staff nurse champions on the Skin Advocate and Resource (STAR) committee impacted hospital-acquired pressure ulcers rates (over 10% to as low as 1%). An innovative STN role, mentoring STN colleagues, creates an opportunity to expand the ripple effect from traditional mentoring sources and an effective shared governance infrastructure. STN EBP mentors have positively impacted a formal EBP training program serving as faculty; participating on project leadership teams, synthesizing evidence and designing the practice change to fit the local context, planning implementation, facilitating project work while connecting within the infrastructure, and helping interns navigate challenges throughout the process; and consulting nurse leaders for troubleshooting. The STN EBP mentor brings a different, but critical, skill set to the leadership team. These staff nurses are EBP experts who understand and can articulate how to adapt EBP to meet demands of the complex realities found in patient care today. STNs functioning in this role have been effective in promoting a culture of inquiry, adoption of EBP, and improving patient outcomes (e.g., pain management). Interns reported better assistance developing implementation strategies (mean 4.8 vs. 4.1; 1-5 Likert scale); adequate support from STN mentors (mean 5.0); and professional growth (mean 4.9 vs. 4.6) compared with programs not using this STN role.