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Advanced practice nurses are well placed as clinical leaders to promote evidence-based practice by frontline nurses but require further development of their skills in evidence-based practice. In order to maximize their potential, advanced practice nurses require Master's preparation.

Aim: 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

It is important for all healthcare professionals involved in the care of individuals affected by breast cancer to be aware of the evidence surrounding the benefits of exercise and to encourage patients to increase physical activity and improve their overall health and well-being.

BackgroundAdvanced practice nurses have an important role in promoting evidence-based practice among frontline nurses. Factors influencing frontline nurses' engagement with evidencebased practice are well documented but little is known about factors which affect advanced practice nurses' ability to facilitate evidence in practice. AimsTo identify factors that influence advanced practice nurses' ability to promote evidence-based practice among frontline nurses. MethodsA collective instrumental case study of 23 advanced practice nurses from hospital and primary care settings across seven English health authorities was undertaken. Data collection comprised interviews and observation of advanced practice nurses and interviews with frontline nurses and other healthcare professionals. Data were analysed using the Framework approach. ConclusionsAdvanced practice nurses need to be supported to address the individual, interpersonal and organisational factors which influence their ability to promote evidence-based practice. Organisational commitment at the highest level is key to APNs' ability to fulfil this aspect of their role.

Background:There were 509,090 deaths recorded in England and Wales for 2008 (ONS, 2010).Of these numbers over 56% (260,000) occurred in National Health Service Hospitals, This shows the large numbers of people dying each year in hospitals. The death of a patient is an event which most if not all nursing staff will encounter during their work.This experience can elicit physical, cognitive, behavioural, spiritual and emotional responses (Parkes, 1998). Aim:The aim of this literature review is to explore how the death of patients in a hospital setting impact on nursing staff. Methodology:A review of the literature was undertaken using the online databases CINAHL, Medline and PsychInfo. The search was limited to articles in the English language and those from peer reviewed journals. Results:Themes arising from the literature review were: the theoretical context, the emotional impact, the culture of the healthcare setting, staff's previous life experiences and support available for healthcare staff. Conclusions:The death of patients does have an impact on nurses. This can affect them both in their work environment and outside of work. Education around grief theory and support from others are helpful for staff in developing strategies for coping with patient deaths.

This study evaluated the acceptability of a supportive model of follow‐up. One hundred and twelve women recovering from breast cancer were randomised to receive standard breast clinic aftercare (Control n = 56) or on demand by open access aftercare by breast care nurses (Intervention n = 56). Participants attended a support‐based psycho‐educational programme delivered in four half‐day group sessions. Three quality of life questionnaires (EORTC QLQ‐C30, QLQ‐BR23, HADS) were administered at baseline and 6‐monthly intervals for 2 years. Multilevel linear regression modelling methods were used for evaluation. Age was found to be a statistically significant predictor of quality of life in several sub‐scales. Increasing age was negatively associated with sexual functioning, systematic therapy side effects and physical functioning, and positively associated with future perspective. Aftercare assignment was not found to be a statistically significant predictor. Women treated for early breast cancer were not disadvantaged by allocation to the open access supportive care model in terms of quality of life experienced. The model for follow‐up was demonstrated to be a feasible alternative to routinised hospital‐based follow‐up and adds to the evidence for stratified follow‐up for low‐risk cancer patients, incorporating self‐management education. Stratified follow‐up pathways are viewed as a preferable approach.

Aims and objectives To explore parental involvement in the child's acute pain care and establish ways in which parental preferences for involvement in their child's care can be identified, facilitated and enhanced by nurses. Background Despite growing evidence supporting effective acute pain management in children and the availability of national and international practice guidelines, children still experience acute pain. Involving parents in their child's pain care has been identified as being a central tenet of pain management in children. Design and methods A qualitative study using an ethnographical approach with nonparticipant observation and follow‐up semi‐structured interviews was undertaken. Nurses (n = 14), parents (n = 41), grandparents (n = 2), other relative (n = 1) and children (n = 30) participated. The framework approach underpinned data analysis. Consolidated criteria for reporting qualitative research (COREQ) enabled comprehensive reporting of the study. Results Three concepts emerged from the data: “parents as advocates for their child,” “nurses promoting involvement and partnership” and “nurses unintentionally preventing involvement and partnership.” Variations in the way parents were involved in their child's pain care were identified. Despite family‐centred care being the dominant model of involving families in their child's care, evidence of this being implemented was limited. Parents attempted to advocate effective pain care for their child, whether or not they were supported by nurses. Conclusions Parental involvement in their child's acute pain care can improve the child's pain experience, reduce parental anxiety and increase parents’ satisfaction in care. Nurses aspired to involve parents in pain care, but did not always enact this in practice. Relevance for practice Children deserve optimum pain care, which includes parental involvement. Parental involvement underpinned by the principles of family‐centred care was poorly implemented. Parents attempted to be involved and advocate for their child's pain care whether or not they were supported by nurses. An alternative approach for supporting parents to advocate in their child's acute pain care is offered, the “Partnership in Pain Care Model.”