Clare Hastings

A thematic analysis of theoretical models for translational science in nursing: Mapping the field

The quantity and diversity of conceptual models in translational science may complicate rather than advance the use of theory. This paper offers a comparative thematic analysis of the models available to inform knowledge development, transfer, and utilization. Literature searches identified 47 models for knowledge translation. Four thematic areas emerged: (1) evidence-based practice and knowledge transformation processes, (2) strategic change to promote adoption of new knowledge, (3) knowledge exchange and synthesis for application and inquiry, and (4) designing and interpreting dissemination research. This analysis distinguishes the contributions made by leaders and researchers at each phase in the process of discovery, development, and service delivery. It also informs the selection of models to guide activities in knowledge translation. A flexible theoretical stance is essential to simultaneously develop new knowledge and accelerate the translation of that knowledge into practice behaviors and programs of care that support optimal patient outcomes.

Clinical research nursing: A critical resource in the national research enterprise

Translational clinical research has emerged as an important priority for the national research enterprise, with a clearly stated mandate to more quickly deliver prevention strategies, treatments and cures based on scientific innovations to the public. Within this national effort, a lack of consensus persists concerning the need for clinical nurses with expertise and specialized training in study implementation and the delivery of care to research participants. This paper reviews efforts to define and document the role of practicing nurses in implementing studies and coordinating clinical research in a variety of clinical settings, and differentiates this clinical role from the role of nurses as scientists and principal investigators. We propose an agenda for building evidence that having nurses provide and coordinate study treatments and procedures can potentially improve research efficiency, participant safety, and the quality of research data. We also provide recommendations for the development of the emerging specialty of clinical research nursing.

Validating the Clinical Research Nursing Domain of Practice

PURPOSE/OBJECTIVES To develop and validate a taxonomy for the domain of clinical research nursing. DESIGN Survey. SETTING Clinical research settings in the United States. SAMPLE A purposefully selected expert panel of 22 nurses who were actively practicing or supervising in a clinical research environment. METHODS A study team consisting of nurses with experience in clinical research synthesized peer-reviewed articles, academic curricula, professional guidelines, position descriptions, and expert opinion. Using the Delphi technique, three rounds of surveys were conducted to validate the taxonomy. The three sequential questionnaires were completed over five months. MAIN RESEARCH VARIABLES Activities performed by nurses in a clinical research setting. FINDINGS A taxonomy for clinical research nursing was validated with five dimensions and 52 activities: Clinical Practice (4 activities), Study Management (23 activities), Care Coordination and Continuity (10 activities), Human Subjects Protection (6 activities), and Contributing to the Science (9 activities). CONCLUSIONS This study validated activities for direct care providers and nurses with the primary focus of research coordination. The findings identify a variety of activities that are unique to nurses in a clinical research setting. IMPLICATIONS FOR NURSING Nurses play an integral role in the clinical research enterprise. Validating a taxonomy for the specialty of clinical research nursing allows for roles to be compared across settings, competency requirements to be defined, and nursing organizations to be guided in the development of specialty certification.

Defining Clinical Research Nursing Practice: Results of a Role Delineation Study

Clinical research nursing is a specialty nursing practice focused on the care of research subjects and implementation of clinical research. A five‐dimensional model (Clinical Practice [CP], Study Management, Care Coordination and Continuity, Contributing to the Science [CS], Human Subjects Protection) has been validated nationally to represent the domain of clinical research nursing practice. The purpose of this study was to describe the frequency and importance of activities within each dimension as performed by nurses in clinical research and to describe differences between roles. One thousand and four nurses from the NIH Intramural Campus in Bethesda, Maryland, were invited to participate in an anonymous web‐based survey. Participants (N = 412) were predominantly female (90%) with ≥11 years research experience (70%). Two hundred eighty‐eight respondents (70%) identified themselves as clinical research nurses (CRNs) and 74 (18%) as research nurse coordinators (RNCs). CP activities were reported most frequent and important whereas CS activities were least frequent and important. CRN and RNC activity frequency differed across all dimensions (p < 0.001) with CRNs reporting significantly higher levels of CP activities and significantly lower levels in other dimensions. Delineating specialty activities and practice across roles enhances the understanding of nurses’ role in clinical research and provides groundwork for role‐based training. Clin Trans Sci 2011; Volume 4: 421–427

Measures that matter.

At a time when ready for college and ready for careers mean the same thing, it is no longer acceptable for large numbers of young people to graduate from high school without the knowledge and skills they need to be successful. Obviously, our nation’s high schools need to change. To do that, states need a new approach to the system of standards, tests, curriculum, and accountability in high school – one that makes college and career readiness the central driver and acknowledges where greater state leadership and resources are essential to success.

Developing the Research Pipeline: Increasing Minority Nursing Research Opportunities

The need to increase the number of minority nurses in policy and leadership positions in health care administration, academia, and research has been acknowledged. Limited academic and research training opportunities are available specifically designed to develop a cadre of minority nurse scientists to conduct the research needed to ultimately reduce health disparities within racial and ethnic minority populations. This article describes a collaborative approach to research career development at the doctoral level.

Searching for proof: Creating and using an actionable PICO question.

www.nursingmanagement.com Nursing Management • August 2014 9 A clearly stated research question or hypothesis is one of the critical first steps in designing a research study that can actually produce usable results. The question outlines where the study will be conducted, defines the population of interest, and determines the types of interventions that may be tested. It also helps the researcher select the measures that will be used to collect data and sets the stage for analysis methods. The question that guides a search of research evidence to support or refine management practice also plays a key role, similar to a research question, in structuring and guiding the search process. This guiding question is called a PICO question: (P) patient, population, or process of interest, (I) intervention or best practice to be assessed, (C) comparison group or unit, and (O) outcome or effect of interest. A format using the time factor (PICOT) is also sometimes used. The variable of time (T) is helpful if, for example, you’re interested in looking at the effect of an intervention over a particular period of time. For example: “In the adult oncology postoperative surgical patient population (P) is patient-controlled analgesia (I) compared with PRN medication (C) more effective (O) within the first 24 hours after surgery (T)?” In this example, the nurse leader is only interested in looking at the first 24 hours after surgery on an inpatient unit, so it’s appropriate to use time in the question to help narrow the search. If the time frame isn’t an important factor, stay with the PICO question format so as not to limit the search. When developing the PICO question for an evidence-based nursing management issue, the critical task is to ask the question using the correct terminology so that these key words can then be used to create a literature search with useful solutions. It’s a challenge to find the most relevant and useful information in the vast sea of databases and Internet information that now exists.1,2 Finding the right information in the most efficient manner is vital to successfully practicing evidence-based decision making in management and leadership. Knowing what key components to use in a search strategy will not only help develop that efficiency, but also guide the nurse leader in setting up an evaluation strategy to assess the impact of practice changes.

Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators

OBJECTIVES There has been limited research to document differences in roles between nurses and non-nurses who assume clinical research coordination and management roles. Several authors have suggested that there is no acknowledged guidance for the licensure requirements for research study coordinators and that some non-nurse research coordinators may be assuming roles that are outside of their legal scopes of practice. There is a need for further research on issues related to the delegation of clinical research activities to non-nurses. METHODS This study used nominal group process focus groups to identify perceptions of experienced research nurse managers at an academic health science center in the Southern United States about the clinical research activities that are being performed by non-nurse clinical research coordinators without supervision that they believed should only be performed by a nurse or under the supervision of a nurse. RESULTS A total of 13 research nurse managers volunteered to be contacted about the study. Of those, 8 participated in two separate nominal group process focus group sessions. The group members initially identified 22 activities that they felt should only be performed by a nurse or under the direct supervision of a nurse. CONCLUSIONS After discussion and clarification of results, activities were combined into 12 categories of clinical research activities that participants believed should only be performed by a nurse or under the direct supervision of a nurse.

Chapter 45 – Clinical Research Nursing: A New Domain of Practice

This chapter will describe the roles and contributions of nurses in the clinical research enterprise and will define the emerging specialty practice domain of clinical research nursing. The broad scope of practice settings in which nurses may engage in the care of participants in clinical research will be described, as will legal and ethical issues related to nursing practice in clinical research. Tools and resources that principal investigators and research project managers can use when considering or using nurses on a clinical research team will be presented based on work from the National Institutes of Health (NIH) Clinical Center and from collaborators in the National Clinical and Translational Science Award consortium.