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Background: Research competencies across nurses' career stages have not been adequately explored. Yet, research skills to appraise, synthesize, and implement research findings are required for evidence-based practice.Purpose: To explore the literature on registered nurse research competencies; to identify core competencies (i.e., knowledge, skills, and attitudes), research capacity-building activities, strategies and recommendations to strengthen nurses' research capacity; and to propose a conceptual developmental framework of nurse research competencies. Methods:As part of a larger project titled "Health Services Researcher Pathway", with the consultation of a health sciences librarian, we conducted an integrative literature review drawing on relevant publications. The PubMed (Medline), CINAHL, Web of Science and ProQuest Dissertations and Theses databases were searched from 2000 to 2012. From the revealed publications (n=1012), only 22 articles were relevant to nurse research competencies. Findings:The key themes cited in the literature reviewed include models and partnerships for building and developing competencies for research production (rather than utilization), and educational strategies and recommendations for interventions to provide confidence in evidence-based practice including research utilization and in clinical decisionmaking. According to the five-step evidence-based practice model (i.e., formation of answerable research questions, literature search and retrieval of the best available evidence, critical appraisal of the evidence, application of research findings into practice, and evaluation of performance based on the outcomes), we propose a framework for a nurse researcher pathway that may contribute to two research competency streams: for research users and research producers. The important area of research users is open for further research, since scarce literature exists. Conclusions:The proposed conceptual developmental framework for a nurse researcher pathway includes essential steps toward evidence-based practice in healthcare that have implications at the micro-level (nurse), mesolevel (organization), and macro-level (society). Our work continues to pilot and refine a nurse researcher pathway and its associated competencies.

There have been significant changes to the NHS during the three terms of this Labour government. These have included The NHS Plan (Department of Health (DH), 2000), which established increased access and choice for patients; the national service frameworks, which have set standards for key areas of care; and the new General Medical Services contract (British Medical Association and NHS Confederation, 2003) which was implemented in April 2004. All of these developments have impacted on the role of clinicians working in general practice.

3921 adults randomly selected from across Great Britain were interviewed. Subjects were asked to assess a selection of 10 out of 200 vignettes. Each vignette contained four elements: a category of individual; access to some or all of the health record; specified purpose; and level of patient identifier. Subjects were asked to say how happy they would be to allow access to their health record in the circumstances described.The public were generally happy to provide access to health information. For almost a third of vignettes, subjects said that they would be very happy to allow access to their health information. 9.1% of subjects said that they would be very happy to allow access within all of the vignettes that they were asked to assess. There was however, a significant minority of responses (11.6%) to vignettes where subjects said that they would be very unhappy to allow access. In addition 2.1% of individuals said that they were very unhappy with all of the vignettes presented to them. Individuals from higher social groups, older people and males were more likely to be happy with access to their health information. The individual requesting information was the most important factor determining permission to access health information. Subjects were happier to release anonymised rather than personally identifiable data. Content of the information to be released did not seem to be that important, even when the health record contained sensitive information. With the exception of teaching students, the use of the information wasn't an important determinant of consent.Despite a level of support for use of health information in most circumstances, this doesn't mean that patients don't want to be asked for consent, nor that the views of the small minority can be ignored. The ethical and policy implications of these findings will be discussed.

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Clinical audit Users' and carers' perceptions Creating a learning culture-Conclusion 3. THE AUDIT AND RECOMMENDED ACTION

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The media has been whipped into a frenzy about the new White Paper (Secretary of State for Health, 2010), which describes the way in which the NHS in England is to be run in the future. A wide range of views has been expressed on the government's decision to give most of the commissioning decisions to general practices in the form of GP consortia, with many experts voicing concerns over such dramatic reform