Individualized care and support for these ICD patients appeared lacking according to respondents. Opportunities to discuss concerns appeared non-existent, which may indicate that UK patients are disadvantaged in the domain of psychological support compared with their European and North American counterparts. Findings remain tentative until explored with a larger, more representative and international sample.

This qualitative study suggests that partners of ICD recipients progress through various difficult and adaptive stages when learning how best to support the patient. A point is reached when most are able to assume control and normalise their lives. This transformation is slow; however, to improve this process and empower partners, nurses should provide relevant information and include them in decisions affecting the patient. Further research into the unique needs of partners, which includes international perspectives, would be significant in developing practice and theory in this area.

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Implementing evidence based-practice and research findings into nursing care has been identified as a challenge to nursing staff. This article identifies key barriers to the use of research in the international literature, however, there are limited suggestions as to how to improve this in the clinical arena. This article aims to identify how nurses could optimize the implementation of evidence and research into their clinical care and reviews barriers to implementing and undertaking nursing research, suggesting a framework for improvement. It considers the widely varied levels of knowledge of research and equally varied critical appraisal skills present both at a pre and post-registration nursing level. The authors discuss an innovative, collaborative approach that considers the role of the nurse consultant, clinical academic and research facilitator posts. To ensure quality evidence-based practice is implemented into clinical nursing care a realistic and practical structure must be applied. With the appropriate framework, clinical structure and organizational support, promotion of evidence-based practice and research for patient benefit can be optimized. The implications for practice are also discussed. The implementation of a realistic research framework into clinical nursing practice has the potential to influence and develop a more active nursing research culture and promote evidence-based care within the workplace.

This study explored nurses' confidence and competence in preparing patients for having an implantable cardioverter defibrillator implanted and for life at home after discharge. Whilst research has identified various physical and psychosocial effects to patients and their partners associated with device implant and subsequent lifestyle adjustments, no research has explored nurses' knowledge of the device or these effects. A survey was designed using a purposive sample of 152 nurses from cardiology areas in four large teaching hospitals and a 28-point postal questionnaire to explore knowledge of the device and its impact. Most subjects were not confident in their abilities to prepare patients for implant or life at home after implant. Knowledge of the device and its effects appeared poorly understood by all nurses, irrespective of additional qualifications, length of time since qualifying or area of work. Many participants were aware of the poor knowledge level of nurses and identified it as a weakness in current care practices. Lack of understanding may impair preparation of patients for implantation of or for living with an implantable cardioverter defibrillator, and feasible strategies to change this situation will require careful consideration and further investment.