Redeployment during the first wave of the COVID-19 pandemic: implications for a clinical research workforce.

BACKGROUND: Health professionals are considered a group vulnerable to developing mental health symptoms during a pandemic, with redeployment being a risk factor. However, previous literature suggests workplace communication can be a protective element. AIMS: An audit aimed to evaluate NHS research staff's experiences of redeployment in order to provide suggestions for future improvements in the process. METHODS: A questionnaire was disseminated to all staff in the clinical research directorate of an NHS trust. Responses were analysed using thematic analysis. FINDINGS: Over half the redeployed staff experienced perceived negative psychological outcomes. The main reported contributor to this was perceived lack of communication. CONCLUSION: Communication needs to be improved in future redeployments. Future research should consider a larger cohort and more input from team members who remained on the pre-COVID-19 studies in order to improve the transition back from redeployment.

Clinical academic research internships for nurses, midwives and allied health professionals: a qualitative evaluation.

BACKGROUND: Nurses, midwives and allied health professionals are integral to research, yet rarely engage simultaneously in research and clinical practice. Clinical academic internships offer a route for accessing academic research training. AIM: To determine facilitators and barriers to nurses' participation and engagement in research internships, and to suggest improvements for future programmes. DISCUSSION: The experiences of ten health professional research interns were explored, using a method based on a synthesis between grounded theory and content analysis. Four categories emerged: integrating clinical and research aspirations; support - or lack of it; the hidden curriculum; and the legacy effect. Respondents identified facilitators and barriers to engagement in these categories, including unforeseen challenges. CONCLUSION: Formal support is necessary but is insufficient for fostering engagement and maximising benefits. Participation must be supported by colleagues and enabled by institutional structures. The potential effects of internships on engagement with research is considerable but requires collaboration between all stakeholders. IMPLICATIONS FOR PRACTICE: Deeper institutional engagement is needed so that internship opportunities are fully supported by all colleagues and practically enabled by institutional structures. Future schemes should attempt to promote opportunities to collaborate through group projects to reduce researchers' isolation.

A Transformative Impact of Theory in Clinical Practice: A Study in a Cardiogenetics Clinic.

BACKGROUND AND PURPOSE: This qualitative phenomenological study explored the lived experiences of family members who have been referred to a cardiogenetics clinic following the loss of a family member to sudden cardiac death (SCD). These family members were evaluated in a Cardiogenetics Clinic in a Children's Hospital in the New York region, which utilizes an interprofessional approach to care. METHODS: A qualitative phenomenological approach was used to explore the lived experience of family members that were referred following the SCD of a family member. The researcher used hermeneutic dialectics and interviewed family members that attended the Cardiogenetics Clinic. RESULTS: Insights gained through discussion were discussed in the following themes: stories of feelings being heard, stories of meaningfulness, and stories of mutual process. This led to the transformation of the typical linear clinic process to a transformative and dynamic model for integrated delivery of care. IMPLICATIONS FOR PRACTICE: This interprofessional model of care offers information regarding SCD, a genetic profile to determine risk for SCD, an integrative collaborative approach to care as well as nursing, medical interventions, psychological support, and counseling for families.

US Food and Drug Administration Clinical Investigator Inspections.

OBJECTIVE: To review the US Food and Drug Administration (FDA) Bioresearch Monitoring clinical investigator inspection process from start to final classification to support clinical research nurses in practice. DATA SOURCES: Published articles, websites, and author's expertise with FDA inspections. CONCLUSION: Clinical research nurses should conduct and manage every clinical trial as if it were to be inspected by the FDA. This recommendation is considered best practice for clinical research nurses to prevent last-minute preparations to organize and clean up research data and records retrospectively. IMPLICATIONS FOR NURSING PRACTICE: This article will assist the oncology research nurse and interdisciplinary research members at the research site in the preparedness for an FDA inspection.

National Cancer Institute: Restructuring to Support the Clinical Trials of the Future.

OBJECTIVES: To describe the evolution and structure of the National Cancer Institute clinical trials programs, their notable accomplishments, nurses' roles in these accomplishments, and the essential role of nursing today and in the future. DATA SOURCES: Manuscripts, government publications, websites, and professional communications. CONCLUSION: Change is inevitable and a constant factor in the world of advancing science and clinical research. Nurses' contribution to research and evidence-based practice will continue to grow and is vital as the scientific landscape evolves. IMPLICATIONS FOR NURSING PRACTICE: As the understanding of cancer biology increases and clinical trials evolve, nurses will need to remain key team members and leaders in National Cancer Institute Community Oncology Research Program and National Cancer Trials Network trials and their associated infrastructure.

Human Subjects Protection and Federal Regulations of Clinical Trials.

OBJECTIVES: To explore the federal regulations governing clinical trials and human subject protection, the importance of research participant's informed consent, and the role the oncology clinical research nurse has within the clinical trial setting. DATA SOURCES: Peer-reviewed journal articles, internet, book chapters, white papers. CONCLUSION: Federal regulations mandate the conduct of a clinical research trial, human research participant protection, and the informed consent process. IMPLICATIONS FOR NURSING PRACTICE: The oncology nurse supports the autonomy and safe conduct of the human research participant during a clinical research trial and provides education and support through the informed consent process.

Nursing Research Priorities in Critical Care, Pulmonary, and Sleep: International Delphi Survey of Nurses, Patients, and Caregivers.

The objective of this workshop was to determine current nursing research priorities in critical care, adult pulmonary, and sleep conditions through input from consumer (patient, family, and formal and informal caregivers) and nursing experts around the world. Working groups composed of nurses and patients selected potential research priorities based on patient insight and a literature review of patient-reported outcomes, patient-reported experiences, and processes and clinical outcomes in the focal areas. A Delphi consensus approach, using a qualitative survey method to elicit expert opinion from nurses and consumers was conducted. Two rounds of online surveys available in English, Spanish, and Chinese were completed. A 75% or greater threshold for endorsement (combined responses from nursing and consumer participants) was determined a priori to retain survey items. A total of 837 participants (649 nurses and 188 patients, family, and/or caregivers) from 45 countries responded. Survey data were analyzed and nursing research priorities that comprise 23 critical care, 45 adult pulmonary, and 16 sleep items were identified. This project was successful in engaging a wide variety of nursing and consumer experts, applying a patient-reported outcome/patient-reported experience framework for organizing and understanding research priorities. The project outcome was a research agenda to inform, guide, and aid nurse scientists, educators, and providers, and to advise agencies that provide research and program funding in these fields.

Participation in nursing research: We can do better.

This article discusses the potential drivers and barriers to clinical nurse research participation. Here, the author describes a research exemplar that highlights how understanding the link between research and practice can influence participation.

Using a Delphi Survey to Develop Clinical Nursing Research Priorities Among Nursing Management.

OBJECTIVE: The aim of this study was to identify clinical nursing research priorities among nurse managers (NMs). BACKGROUND: Determining research priorities is the 1st step toward building a solid evidence base for clinical practice. NMs are well poised to identify research priorities, and yet, a literature review revealed a dearth of research priorities as determined by clinical NMs. METHODS: Using a Delphi survey, 38 NMs were queried at a large, urban hospital regarding critical priorities for nursing research. RESULTS: Critical priorities for clinical nursing research included nursing workforce/nursing workflow and communication (categorized as critical by 68% and 53% of NMs, respectively). Other important priorities focused on falls/patient safety/hospital-acquired infections, patient/family satisfaction, emergency preparedness, patient outcomes, and collaboration/interdisciplinary research. CONCLUSIONS: Because NMs are positioned to direct clinical research agendas, the results provide a critical guide for policy development surrounding nursing research. Directing research toward these identified topics will help build a solid evidence base for nurses and ultimately improve patient outcomes.

Linking to Improve Nursing Care and Knowledge: Evaluation of an Initiative to Provide Research Support to Clinical Nurses.

OBJECTIVES: The aim of this study is to describe and evaluate the impact of the Linking to Improve Nursing Care and Knowledge (LINK) project on increasing nurse-led clinical research. BACKGROUND: Nurse-generated research is the cornerstone of evidence-based practice and continues to be a marker of nursing excellence. However, the dearth of PhD-prepared nurses creates a challenge for creating an environment to promote clinical nursing research. We evaluated the LINK project, an academic-clinical partnership, to assess its impact and feasibility, for fostering nurse-led clinical research. METHODS: The LINK project created a formal command and control structure bringing together existing academic resources, including a PhD-prepared nurse researcher, a biostatistician, and a development of a formal research consultation request process. Measures tracked over a 12-month period included average response time, request volume, client satisfaction, institutional review board (IRB)-submitted protocols, and work products. RESULTS: All measures exceeded expectations with an average 1-day request response time, 35 requests, 98% client satisfaction, a 367% increase in nurse-led IRB approved protocols from the previous 12-month period, and 2 publications in peer-reviewed journals. CONCLUSIONS: The process and outcome measures indicate that the LINK project is feasible, sustainable, and reproducible. We were able to meet and, in many cases, exceed measurement goals. In addition, implementation science literature indicates that the most valid measure of a successful project rollout is user satisfaction and usefulness. The LINK project received consistently positive feedback.

Barriers for nurses' participation in and utilisation of clinical research in three hospitals within the Kumasi Metropolis, Ghana.

INTRODUCTION: Scientific research results are a necessary base for high quality nursing practice. The level of implementation of research in the clinical setting, including nurses' participation in and knowledge of research results, have gained considerable attention internationally. However, the remarkable international increase of such studies does not apply to the Ghanaian context. We therefore set out to evaluate the degree of involvement of nurses in research, as well as their utilization patterns of research findings in Ghana. Objectives: the study sought to investigate the proportion of nurses involved in clinical research as well as barriers for nurses' participation and utilization of research findings, within the Kumasi Metropolis area, Ghana. METHODS: A descriptive and analytical cross-sectional study design was used in this study. A 47 item questionnaire elicited data on 158 participants' demographics, the proportion and the barriers to participation, which was then analyzed using SSPS version 17 software. Qualitative interviews with key informants complemented quantitative survey data. In-depth interviews with nurse managers at the hospitals in focus was conducted and analyzed thematically. RESULTS: The study shows that 36.1% of the nurses, included in the study, had participated in research and only 25.3% of these had (knowingly) used specific research results in clinical practice. However, the level of research participation differed greatly between nurses working at different hospitals. Nurses' participation in clinical research was shown to be associated with their perception of benefit of research to practice as well as their understanding of time as a factor for them engaging in reading scientific articles. In addition, barriers associated with nurses' integration of research findings into the daily practice was their perceived lack of support from the collegium and their perception of research as not part of the nursing role. CONCLUSION: Findings from the study suggest that there is a need to create institutional support to facilitate and encourage nurses' participation in research, yet also to formalize nurses' continuous professional development. This, could change nurses' attitudes towards research, and contribute to improving health care as it would increase nurses' role as agents for evidence based clinical practice.

Clinical application research through reflection, interpretation and new understanding - a hermeneutic design.

The implementation of theoretical knowledge in clinical practice and the implementation of good clinical practice into theory have been of interest in caring science for the last 30 years. The aim of this article was to elaborate and discuss a methodology named clinical application research. The method is grounded in a hermeneutical design inspired by Gadamer's philosophy. The methodology, clinical application research, has been used in a research project A life in dignity and experiences from the researchers forms the bases for the elaboration and discussion. The project was performed in collaboration with residents, family caregivers and healthcare providers at six nursing homes in Scandinavia. The material for this article is based on the previous research, that is the results from 10 different articles showing the meaning of dignity and indignity in daily life in nursing homes. Data were generated from 56 individual interviews and 18 focus-group interviews with a total of 40 staff members with five to eight participants at every interview session. By reflection, interpretation and new understanding our results provide knowledge about dignity and how to preserve dignity for older people in an appropriate ethical way. The methodology was relevant for the research project A life in dignity and relevant to caring practice in nursing homes as it opens new possibilities and new ways of thinking when performing dignified care to older people.

Professional identity and the Clinical Research Nurse: A qualitative study exploring issues having an impact on participant recruitment in research.

AIMS: The aim of this study was to explore the experiences of Clinical Research Nurses, with an emphasis on factors that may have an impact on successful study delivery. BACKGROUND: The Clinical Research Nurse workforce is pivotal to improving health outcomes through supporting research-active health economies. Investment in research infrastructure has led to nurses and midwives increasingly undertaking extended roles to deliver clinical research. Despite such opportunities, the recruitment of sufficient participants into research studies remains problematic. A growing body of literature is exploring barriers to successful study delivery, indicating the emergence of a caring-recruiting dichotomy in clinical research staff. DESIGN: This qualitative study investigates the experiences of Clinical Research Nurses delivering research in the United Kingdom National Health Service. METHODS: Four Focus groups (total 19 participants) were conducted in a large North East National Health Service Foundation Trust from November 2015 - February 2016. FINDINGS: Thematic analysis identified perceptions of the role in the wider context of professional identity. Role transition, altered relationships and workload complexity, affected participants' practice, leading to inconsistency between core clinical values and perceived identities as research delivery staff. A duty of care as patient advocates contrasted elements of the work reflecting that of salespeople. The emotional labour of approaching patients and unease regarding peer perceptions of the Clinical Research Nurse role, affected the positive aspects of research delivery. CONCLUSION: Professional-identity and self-concept appear to have an impact on practice in a research delivery role. Further research should explore these issues further, to enlighten the basis on which such feelings are positioned and to work towards practical solutions.

Recruiting to cohort studies in specialist healthcare services: Lessons learned from clinical research nurses in UK cleft services.

AIMS AND OBJECTIVES: To explore the experiences of clinical research nurses recruiting patients in a large specialist care-based cohort study. BACKGROUND: Longitudinal studies are vital to better understand the aetiology and moderators of health conditions. This need is especially salient for congenital conditions, such as cleft lip and/or palate, where establishing large, comprehensive data sets from birth is vital to improve understanding and to inform interventions. Various barriers exist in recruiting patients to large cohort studies. The role of clinical research nurses embedded within health settings has grown over past decades to facilitate data collection, yet challenges remain. DESIGN: Qualitative descriptive study. METHODS: Individual semi-structured interviews with 12 clinical research nurses based in 10 National Health Service cleft services across the UK, recruiting to the Cleft Collective Birth Cohort Study. RESULTS: Of seven emergent themes, three highlighted challenges to recruiting patients, another three described facilitative factors, and one theme overlapped challenges and facilitators. Challenges included the life circumstances of potential participants; language barriers; and limited clinical research nurse time for study. Facilitative factors included integrating research into clinical practice; patient information shared with clinical research nurses; and support from the university-based research study team. The theme "Method of data collection" related to both challenges and facilitators. CONCLUSIONS: The qualitative data from clinical research nurses recruiting to a large birth cohort study provide helpful practical detail for specialist healthcare teams, specialist nurses, clinical research nurses and researchers looking to optimise recruitment and data collection in longitudinal studies. RELEVANCE TO CLINICAL PRACTICE: The findings suggest the importance of specialist clinical services and research study teams cooperating to embed research into everyday clinical practice, without compromising care. This should facilitate patients' willingness to participate in important research like the Cleft Collective study and provide them with a positive experience of research.

Factors Facilitating Publication by Clinical Nurses in a Magnet® Hospital.

OBJECTIVE: This study examined the cognitive, behavioral, and environmental factors that facilitate publication by clinical nurses in Magnet® hospitals. BACKGROUND: The culture promoted by the Magnet Recognition Program® promotes nurses practicing in those settings to use, generate, and disseminate best practices. Successful and promising models of care and nursing practice are rarely disseminated beyond the organization where they are practiced. The questions persist: what barriers to writing for publication exist for clinical nurses, and how do we overcome them to advance emergent evidence? METHODS: A focused ethnographic, multiple-case study design examined 5 well-published nurses with high levels of dissemination occurring outside the Magnet organization where they were employed. RESULTS: Nurses in this study most often credited cognitive and behavioral factors for promoting publication. Although the organization encouraged peer-reviewed publication, there were limited environmental efforts to support efforts to publish in peer-reviewed journals by clinical nurses. CONCLUSIONS: The results of this case study call for more research on the multifaceted factors that promote publication by clinical nurses in the practice environment. Publication of research in peer-reviewed journals was supported by environmental influences of time to write, collaborative writing opportunities, and supportive and accurate guidance from editors.