Recherche et mobilisation des connaissances en sciences infirmières dans un monde en turbulence : un constat critique, mais des innovations possibles Nursing Research and Knowledge Mobilization in a Turbulent World: A Critical Assessment Showing Room for Innovation

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INVITED EDITORIAL
A French team (Rothan-Tondeur, 2021) has reported that in the first six months of 2020, over 700 articles were published in indexed nursing journals with nurses as first authors and that these articles primarily consisted of advice from experts, reflections and recommendations.The majority of the themes were related to the nursing population (nurses' health, safety, training) although there were a small number of clinical studies concerning patient care.During this period until July 2020, many studies were conducted and published rapidly in all disciplines; however, quantity does not necessarily guarantee quality (Jung et al., 2021).The response at the beginning of the pandemic was to engage in a highspeed shift toward focusing on the operational delivery of care and transitioning to remote learning for students.Thus, managers, clinicians, researchers and teachers focused on their respective emergencies, which limited discussion; thereby resulting in too few collective research projects to respond to the questions and urgent needs of decisionmakers for knowledge-based decisions to provide nursing care in times of COVID-19 pandemic.

CHALLENGES FOR CLINICAL RESEARCH AND NURSING INNOVATION IN A CRISIS CONTEXT
Nearly 10 years ago, the Direction des soins infirmiers (nursing department) of the Centre hospitalier de l'Université de Montréal (CHUM) (academic hospital) in Quebec, Canada, which employs approximately 3,000 nurses, set up a structure to support and guide the development of nursing research.By 2019, approximately 20 nurses trained in advanced practice (nurse practitioners, clinical nurse specialists) already held professional health researcher status at the CHUM Research Centre.These individuals have truly driven the production and dissemination of nursing knowledge, the use of evidence-based results and the supervision of graduate students.Like all health care institutions in Quebec, the CHUM has had to mobilize all of its resources to face major challenges in delivering care to its clienteles, thereby halting the research produced by these nurses.The public health context also made it harder for expertise to be shared between clinicians and graduate students, who are usually present in large numbers in care units.
However, although conducting research has not been easy, the production of knowledge and innovation has not stopped, as nurses are and always have been a powerful force when it comes to resolving problems and situations to respond to the needs of patients and their close relatives.Examples include the infusion pump fleet being updated and equipped with a new intelligent system; nursing care adapted to patients that no longer required acute care (alternative level of care); an electronic logbook being implemented so close relatives and staff could chronicle the "experience" of the person in intensive care; teams being structured as triads to ensure that personal protective equipment was used correctly, and a communication solution being implemented that consisted in sending text messages to a close relative at each key moment of a patient's surgery (Innove-Action, 2021).These solutions demonstrate the talent and creativity of the nursing profession in the midst of a pandemic.All these innovations contributed to knowledge production.Based on the urgency of the situation, the nurses' experience and evidence-based results, they are bringing to light concrete solutions developed by nurses to improve care.

WHAT IF WE COULD DO IT OVER?
Drawing on our experience, isn't it time to reflect on whether we did the right thing in terms of research and knowledge mobilization, whether we missed anything and, more importantly, whether any opportunities were missed by the nursing community?Research to develop knowledge is an integral part of nursing and was highlighted in the Rapport des commissaires sur les états généraux de la profession infirmière au Québec (2021), which the consultation was held in Quebec in spring 2021.The commissioners make the following recommendation in point 13, page 83: "Support and foster the participation of nurses in care innovation projects, including research projects" (free translation).
Yes, the nursing profession responded to the urgency call of the pandemic-its response was remarkable and even put the health of its members on the line.Yes, innovations were implemented; however, it seems that some areas of nursing were less well coordinated, due to a lack of structure for producing knowledge through research and a lack of consensus and coordination among the various parties involved.Would it have been possible to set aside time, space and resources so a team of nurses could remain focused on coordinating knowledge development and application?What would have happened if we had been able to think together and come up with solutions to problems?Would it have been easier to weather the storm?Implementing such an initiative, which aims to generate knowledge and identify the interventions most likely to win this battle, would have been a way to improve practices.Core groups from different clinical settings and universities could have worked together to support nursing initiatives, each contributing their own clinical and research expertise.Of course, nurses were caught up in the urgency of the situation; however, could a more agile knowledge society have been set up?Such a knowledge society could have been called upon in an informal and accelerated mode to answer questions, among other things, by conducting and disseminating the results of literature reviews, benchmarks, process validations, and evaluation or research findings.The knowledge produced and validated in this way could have been shared to the benefit of the nursing community and patients.
In doing so, academic and clinical expertise could have been used in tandem to help Quebec's nursing community weather the crisis with clinicians, researchers, managers and students each contributing their tacit knowledge, thereby forming a pool of shared intellectual capital in addition to making available the explicit knowledge that was lacking during the pandemic.
If the nursing community adopts such a strategy in collaboration with health researchers and stakeholders in a future crisis, chances are that the outcome will be different.