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Clinical Nurse Specialists’ Role in Promoting Evidence Based Practice in Saskatchewan’s Health Care Settings Open Access


Other title
PARiHS framework
Mixed Methods
Clinical Nurse Specialist
Type of item
Degree grantor
University of Alberta
Author or creator
Campbell, Theresa Diane
Supervisor and department
Dr. Joanne Profetto-McGrath, Faculty of Nursing
Examining committee member and department
Dr. Susan Slaughter, Faculty of Nursing, University of Alberta
Dr. Susan Jack, School of Nursing, McMaster University
Dr. Beverly Williams, Faculty of Nursing, University of Alberta
Dr. Kathleen Hunter, Faculty of Nursing, University of Alberta,
Dr. Don Philippon, Professor Emeritus with the School of Public Health and Adjunct Professor School of Business, University of Alberta
Faculty of Nursing

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Background: Nursing is a practice discipline and patients expect nurses will use the best evidence available to improve outcomes. A major challenge to the implementation of best practice is the complexity of organizational and social environments in which nurses’ work. One method to keep nurses informed of best practice is to employ change agents; nurses with clinical expertise and familiarity with research who can transfer the evidence to those in clinical settings. It has been suggested that the clinical nurse specialist (CNS), as an educator, consultant, clinical expert, researcher, and leader is well situated to promote evidence-based practice in the workplace. Purpose: The purpose of this explanatory mixed methods study is to gain a deeper understanding of the CNS role, as it pertains to promoting evidence-based practice. The research question guiding this research is: What is the role of the CNS in promoting evidence-based practice in acute care and community settings in Saskatchewan? Methods: This study used Creswell and Plano Clark’s sequential explanatory mixed methods design that focused on an initial collection and analysis of quantitative data followed by a collection and analysis of qualitative data. The survey data was analyzed using SPSS 18. The transcribed interviews were reviewed for recurrent themes regarding the CNSs’ role in promoting evidence-based practice. The PARiHS framework provided the broad structure to identify themes. Interpretive description was used to analyze the themes. Findings: To carry out their role as facilitators of EBP, CNSs rely on their: master’s preparation, clinical expertise, and people/communication skills. In order to streamline processes to increase efficiencies, share their expert knowledge with staff and patients, and provide leadership, CNSs need to work in supportive contexts and have access to high quality evidence. The primary source of written evidence used by CNSs was the internet at work and the primary source of “people” evidence was the CNS’s personal experience. Lack of role clarity and leadership were barriers to carrying out their roles in an effective manner. Conclusion: CNSs can improve patient outcomes by using best evidence in the provision of care, but to do so, they need to work in supportive contexts.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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