To explore the experience of research nurses who obtain consent from adults in emergency settings to participate in clinical trials, either prospectively or post enrolment.

AIM: To explore the understanding and experiences of research nurses who obtain informed consent from adult patients participating in emergency care research. DESIGN: Qualitative phenomenographic descriptive study. METHODS: Ten research nurses from six hospitals in England were recruited. Data were collected using semi-structured face-to-face and telephone interviews between January 2019 and March 2019. Interviews were transcribed verbatim and analysed thematically, informed by phenomenography. COREQ was followed. RESULTS: Three main themes were identified: (a) emergency research is different, (b) protecting the patient, and (c) experience and confidence with recruitment. It was found that obtaining patient consent in emergency care research was challenging and timing of the process was crucial. Nurses with more experience of emergency care were more confident in approaching patients and their families. There was variability in out-of-hours recruitment which was a consequence of the range of informed consent processes used and the different levels of engagement of clinical teams. CONCLUSION: There is a variety of organisational cultures, processes and procedures which affect the way consent is obtained in emergency care research. A team approach was evident in the hospitals where consent rates were high and was more successful than those reliant solely on the presence of a research nurse. Organisations were able to recruit successfully to emergency care research studies irrespective of size and configuration. Further investigation of their models of working and strategies for engagement is needed. Experienced research nurses made a positive difference to recruitment and were more likely to approach patients to obtain consent. RELEVANCE TO CLINICAL PRACTICE: The understanding and experiences of recruitment to clinical trials in emergency care research by research nurses can help identify barriers to recruitment. This study provides useful insights for healthcare practitioners, clinical trials coordinators and sponsors about how best to develop protocols and policies to increase recruitment to emergency care research.

What are research nurses' experiences of obtaining consent from or for patients participating in emergency care research? A qualitative review.

INTRODUCTION: If studies are to be valid, recruitment of representative samples is essential. In 2012, 28% of UK emergency departments met the 80% standard for recruitment to trials set by the National Institute for Health Research. Research nurses play a vital role in the conduct of high-quality research, and it has been argued that dedicated research nurses are needed if clinical trials are to recruit successfully to target. REVIEW QUESTION: What are research nurses' experiences of obtaining consent from or for patients participating in emergency care research? A qualitative evidence review. METHODS: A qualitative integrative literature review with a narrative synthesis of the evidence. PRISMA guidelines for reporting systematic qualitative reviews (Appendix S1) were followed. A search of five electronic databases was performed in December 2018 along with a hand search which yielded 125 citations: 10 papers and one PhD thesis met the review eligibility criteria. Methodological quality of the selected studies was evaluated, and data were extracted and synthesised. RESULTS: Three themes were identified: Access, Organisation and Timing. Research nurses encountered both general and specific barriers when seeking to obtain consent for participation in research. In particular, it was found there was lack of experience among staff of working in emergency research and with securing deferred consent. The distinction between nurse researchers with a clinical role and those dedicated to solely to research only is often not clear and warrants further investigation. CONCLUSION: Nurse researchers with and without a clinical role can make a positive difference in recruitment to trials in emergency care. The involvement of dedicated research nurses in the consent process can increase recruitment to emergency care research. Experience of recruiting to clinical trials in nonemergency settings does not seem to help when recruiting for trials in emergency care. RELEVANCE TO CLINICAL PRACTICE: There is a need for greater understanding of the experiences of dedicated research nurses in emergency care settings and in particular with regard to deferred consent.

A new curriculum for a new era of nursing education.

The need for curriculum reform, a common theme in the nursing and health sciences literature for a number of years, is becoming urgent. This article describes an innovative undergraduate nursing curriculum. Central to the curriculum revision were the adoption of a conceptual approach, the institution of clinical experiences driven by conceptually based learning, and a focus on experiences across population groups and practice settings. An innovative, Web-based community was developed as a platform for the curriculum.

Healthcare assistants: the new registration route.

A number of locally organised schemes now exist to help healthcare assistants access programmes leading to qualified nursing status. Although some schemes have been operating for some time, little has been done to evaluate their effectiveness. However, drawing on the literature that has addressed indicators of successful completion among entrants taking a more conventional route into nursing, it is possible to predict which individuals are most likely to complete courses and course-related factors that encourage successful completion.

Good management. Corporate governance: 'the hospital is listening'.

Homerton University Hospital trust, a first-wave foundation, commissioned a specialist consultancy to devise an induction programme for the governors. It was vital to tailor activities to individual needs while retaining overall consistency. A concluding exercise demonstrated that the majority agreed they had overcome initial hesitancy.

Staying afloat: surviving curriculum change.

In response to calls for nursing education reform, a content-based curriculum was changed to a concept-based curriculum, using Kanter's 7 skills for effective change model. The skills include tuning in to the environment, challenging the prevailing organizational wisdom, communicating a compelling aspiration, building coalitions, transferring ownership to a working team, learning to persevere, and making everyone a hero. The authors describe the steps taken to successfully accomplish this arduous task.

Chlamydia screening in Wellington Family Planning Association (FPA) clinics: a demonstration project.

AIMS: To demonstrate that enhanced screening for Chlamydia over and above the usual opportunistic screening in family planning (FPA) clinics is feasible, practical, and acceptable. METHODS: Over a 6-month period from November 2004 to May 2005, all under-25-year-olds attending three Wellington FPA clinics in New Zealand were offered Chlamydia urine testing. Staff interviews before and after the study were carried out to assess the impact of enhanced screening on clinic routines. Interviews were conducted with 50 clients to assess the acceptability to young persons. Additional questions were asked of 22 Chlamydia-positive clients to ascertain the acceptability of the procedures for follow up. RESULTS: From a total of 4674 participants, a valid urine test was carried out on 2533 (54%). The most common reason for exclusion was having passed urine in the last hour. Positive tests were detected in 212 (8%). A positive result was more likely in those with a history of partner change or in Maori and Pacific ethnic groups; it was least likely in those who always used condoms. For the staff, time constraints were the most important barrier to screening. The procedures were acceptable to clients. CONCLUSIONS: We demonstrated that improvements in Chlamydia screening are feasible, practical and acceptable to clients

An action research project to evaluate the clinical practice facilitator role for junior nurses in an acute hospital setting.

It has been well documented that newly qualified nurses require support in developing confidence and professional competence. Although preceptorship models have gone some way in addressing this need, innovative and flexible models of facilitation and development are also required to respond to local demands. In the project reported here a number of supernumerary clinical practice facilitators (CPFs) were appointed to support both healthcare assistants and newly qualified registered nurses to enhance their competence and clinical skills. It was anticipated that they might also encourage awareness of other professional issues, such as evidence-based practice, as well as having a positive influence on the clinical learning environment and staff morale. This article describes how an action research approach was used to establish the CPF role in a variety of clinical areas across a large inner-city National Health Service Trust. It outlines the evaluation undertaken and the further contribution that such roles could provide.

The effect of sex education on teenagers in St. Kitts and Nevis

Knowledge of sexual matters is one of several key factors capable of influencing teenage reproductive behavior. This article reports the results of initial and followup surveys designed to test such knowledge among adolescent students in St. Kitts and Nevis before and after they received a family life/sex education course in the mid-1980s. This course provided information about fundamentals of human reproduction and contraception, human growth and development, emotional development, and issues of adolescent sexuality. (AU)

Teenage sexuality: perceptions and attitudes of the youth of Tobago

This is the result of a survey conducted in 1986 in Tobago employing quantitative and qualitative data collection methodologies. Information was collected from approximately 150 young males and females, 15 to 22 years of age, resident in Tobago

Abortion research issues for the Caribbean

This paper uses the experience of a recent study conducted in Barbados, where the termination of pregnancy is relatively unrestricted, to highlight some of the constraints to conducting abortion-related research in the english-speaking Caribbean region. The author also suggests issues which should be included in the research agenda and possible methodological approaches.

Teenage sexuality: perceptions and attitudes of the youth of Tobago

This is the result of a survey conducted in 1986 in Tobago employing quantitative and qualitative data collection methodologies. Information was collected from approximately 150 young males and females, 15 to 22 years of age, resident in Tobago

Abortion research issues for the Caribbean

This paper uses the experience of a recent study conducted in Barbados, where the termination of pregnancy is relatively unrestricted, to highlight some of the constraints to conducting abortion-related research in the english-speaking Caribbean region. The author also suggests issues which should be included in the research agenda and possible methodological approaches. (AU)