1. Gebhardt, Mary Catherine

Article Content

The environment of evidence-based practice necessitates that nurses review research to guide their practice. In many instances, this review requires the nurse to design an actual study in order to explore and develop a deeper knowledge of the clinical phenomena in question. This process is often the case in brain injury rehabilitation. Collaborating with a nurse academician is a logical way to advance professional nursing practice. Academicians want clinical opportunities to conduct research, while clinicians need the research expertise and collegiate resources that academicians possess. Both groups enhance the opportunities for each other. The melding of these two groups, while unique, is not new. Florence Nightingale, one of the first nurse researchers, was a teacher of nursing and-first and foremost-a clinician. This article describes a unique clinical consultation: the addition of the professional nurse scholar to the rehabilitation team.


Clinical Problem

The nurses at a major rehabilitation center had many best-practice-related questions ranging from bowel management to family caregivers' needs. While the nurses had the skill set to perform a proper literature review, they lacked the expertise to design their own study for questions that remained unanswered in the literature. The brain injury program director suggested collaboration between the rehabilitation facility and a large state university. The program director put the clinical nurse specialist (CNS) for the brain injury program in contact with the members of the university's school of nursing and the first meeting was scheduled.


Initial Consultation

The first meeting took place at the university, and the group began to brainstorm about the potential areas of research based on their experiences and interests. The CNS identified research projects in progress in the nursing unit. The faculty offered to assist with these projects as needed. Then, the group began to think in a broader perspective by discussing possible new research interests between the groups. They identified that the faculty brought research expertise, a broad base of experiences, and a new outlook to the rehabilitation issues. The CNS brought rehabilitation experiences and access to both a population of patients and a group of caregivers and staff that the faculty could not have accessed otherwise. Numerous and varied research ideas were identified at this preliminary meeting. Some of the research ideas considered aspects of the current clinical practices and outcomes in the brain injury unit while other ideas focused on staff competencies and family caregivers' needs. Family caregivers were considered fertile research areas, and issues related to current and former patients were also considered.


It was decided that buy-in from the staff members would be imperative in order to begin some of the clinical research identified. The CNS agreed to call a meeting of interested staff members to meet with the nursing faculty. The group hoped that this meeting would provide some insight into what ideas the staff nurses thought would be interesting and beneficial to research.


More than 20 staff members attended the first meeting in the brain injury unit, including registered nurses, licensed practical nurses, nursing assistants, therapy staff, the chief nurse executive, and the program director. After explanations of the collaboration and the purpose of the meeting, the brainstorming began. All the ideas were written on a flip chart so that all participants could see and remember what had been said. The group was very interested in participating in evidence-based research projects. Their ideas included projects related to patient care; spiritual care; caregiver support; investigating what distinguishes rehabilitation nursing from other types of nursing; the characteristics and qualifications of expert rehabilitation nurses; and the process by which new rehabilitation nurses become experts. All of these ideas support evidence-based research in the nursing unit.


Developing the First Research Project

Following the meeting with the staff, the faculty met to simplify the ideas and develop research questions. This was a difficult process because of the need to meld numerous staff ideas. The faculty members were also aware of the research agendas identified by national nursing organizations and tried to determine if the potential research projects would fit into any of the agenda categories, which could facilitate possible funding when the project became a reality.


When this phase was completed, the faculty sought to determine their priorities. The CNS presented the research questions developed from their ideas to the staff members and asked the staff members to prioritize the ideas. The project with the highest priority would be the first developed. All projects fell into one of the research areas identified by the national nursing organizations.


After prioritizing the ideas, the faculty began developing a research project using the funding guidelines determined by one of the national nursing organizations. This would ensure an easier transition from a project on paper to the actual implementation of the first research project. The CNS and the nursing faculty collaborated on the project development. A literature review was conducted and appropriate questions were identified. The team conducted numerous meetings to solidify ideas and determine resources. The project developed involves a mixed-method approach to compare nurses' and caregivers' hopes for the recovery of brain injury patients.


The project had to be submitted to the institutional review boards (IRB) of both the hospital and the university. The CNS took primary responsibility for the IRB at the hospital, while the faculty ensured that the IRB process at the university was followed. The collaborative team submitted the final project for funding within 9 months of the first meeting of the groups.


The project was funded, and data collection was begun. It is anticipated that any manuscripts and presentations related to the project will be a joint effort of the faculty and staff members.



There are many rehabilitation teams and rehabilitation consultants. The team presented here involved the unique collaboration of university nursing scholars and clinicians from a local rehabilitation hospital. The melding of these two groups is providing new opportunities for staff nurses, administrators, and faculty members to work together and use nursing research to provide the base of evidence necessary to enhance rehabilitation nursing knowledge in the brain injury setting.