The role of clinical nurses in harnessing the lessons about evidence from COVID-19
A blog post written by Aileen Collier
Today is World Evidence-Based Healthcare Day. As a clinical academic nurse my aspiration is that every healthcare day would be evidence based. I am particularly passionate about evidence-based care for older people, and people with palliative care needs.
International evidence tells us that where research is embedded within healthcare services, not only do patients, but also staff caring for them, do better. For this vision to be realised, however, we need to move beyond the traditional and normative ‘top down’ and ‘outside in’ ways of creating and ‘translating’ evidence. For many years I have argued for what the Institute for Health care Improvement in the USA coined the Learning Health Care System. This includes embedding research as core business in health, aged care and social care organisations. Further, I have argued that consumers and communities as well as healthcare staff should have the opportunity not only to participate in research but also to partner in research.
I was recently introduced to someone who described themself as a person with ‘lived experience’ and a member of the research team. They emphasised: “You need to include me as a partner, not simply as a token- just because you need a consumer on your team”.
As we wrote in our 2019 Palliative Medicine editorial: we need to recognise that knowledge and learning are, for the most part, a social and cultural phenomenon and so we need innovative research methods that recognise the complexities of care and health systems and give clinicians authority to act on evidence. 
Hot off the press is The Australian Academy of Health and Medical Sciences report Research and innovation as core functions in transforming the health system. Its 4 pillars include:
- A research-active health workforce – at the heart of which sits a cohort of world-class clinician researchers
- Targeted funding for research and innovation to be embedded into the health system
- The whole community has more equal opportunities to shape, participate in and benefit from research that is relevant to them, as active and valued partners
- An active health– academia–industry interface works dynamically to enable fully integrated research teams, supported by healthcare executives and research institution directors.
Clinical academic nurses are ideally placed to contribute to these objectives. As the largest healthcare workforce, nurses caring for older people and those with palliative care needs can make a significant difference to patient, family and community outcomes – but only if they are provided the opportunities and resources to reflect on practice and engage in research activities and if health care managers recognise the benefits of doing so for their teams, services and most significantly – peoples health and wellbeing.
My own Australasian experience of the palliative care sector response to COVID 19 was that people of diverse disciplines and organisations collaborated on evidence based healthcare at a speed and efficiency I had never before witnessed. We must surely learn from these experiences and harness them so that health and aged care services – under pressure as a result of the pandemic, financial constraints, complex health issues as well as a global workforce shortage, can meet the needs of all Australians now and into the future.
- Collier A, Hodgins M, Johnston B, Tieman J. Evidence-based palliative care: How can we account for the messy world of practice? Palliative Medicine. 2019;33(7):723-725. doi:10.1177/0269216319845977
Dr. Aileen Collier has recently been appointed Associate Professor Aged Care and Palliative care nursing, Northern Adelaide Local Health Network and Research Centre for Palliative Care Death and Dying, Flinders University. She is passionate about access to palliative care for all Australians, building research capacity of nurses and consumer and community leadership.