The literature concerning continuing professional education (CPE) in nursing will be reviewed, with an emphasis on the experience of CPE in the United Kingdom (UK). The reviewed literature will cover aspects of the implementation of CPE, including motivational factors, needs analysis and outcome evaluations, and in addition CPE in the UK will be set in its socio-political context. The literature shows a fragmented, inequitable and poorly funded provision of CPE to date in the UK. The literature has not shown the cyclical nature of CPE, suggesting that a more holistic approach to educational research is needed. There continues to be a lack of research showing the impact of CPE on patient care. If this is not remedied it may be difficult to justify future expenditure of public funds on CPE for nurses.

There continue to be suggestions within the nursing literature that research findings are not being utilized in clinical practice. The reasons for this are well documented. However, less emphasis is given to ways to facilitate utilization. It seemed possible that non-utilization could be due not only to lack of knowledge, but also to the method of implementing change towards research-based practice. The "top-down', authoritarian, approach to dissemination of information within the NHS may have been a block to research use. Could staff be motivated to consider research-based change through use of a different approach? An "action research' approach seemed a possible way to attempt to facilitate research-based practice. Within this study one ward was used with all staff as the participants. The staff identified the area to be studied (devising a protocol for preoperative information-giving). The instruments used were semi-structured interviews and informal discussions and field notes. Rogers' diffusion of innovation model was used to organize data collection and to analyse results. Although the results may not be generalizable, the use of this model provides a useful framework for others interested in an alternative approach to achieving research-based practice.

Auxiliary nurses may form a necessary part of current nursing teams, but how clear are they about their roles, capabilities and limitations? The project described in this paper was divided into two phases: Phase 1 involved interviews with auxiliary nurses and corresponding G grade nurses; Phase two involved distribution of questionnaires to over 350 auxiliary nurses in nine hospitals across the Yorkshire region. This paper focuses on Phase 2 only. The questionnaire was developed from both the literature and Phase I results. The final section of the questionnaire was an adaptation of a series of questions developed from a tool devised by Rhodes (1985) to identify areas of decision-making in qualified nurses. Through use of an assessment scale for qualified staff, clarification of decision-making, both actual and potential, would be highlighted. The results from the adapted scale seem strongly to suggest that not only are auxiliary nurses making decisions that were previously made by qualified nurses, but that an even larger number feel they ought to be making more. The results further suggest that 50% of auxiliary nurses attaining NVQ Level 2 standard still gained most of their knowledge through observing others.

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