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Peralta G, Sánchez-Santiago B. Navigating the challenges of clinical trial professionals in the healthcare sector. Front Med (Lausanne) 2024; 11:1400585. [PMID: 38887672 PMCID: PMC11181308 DOI: 10.3389/fmed.2024.1400585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/13/2024] [Indexed: 06/20/2024] Open
Abstract
Clinical trials (CTs) are essential for medical advancements but face significant challenges, particularly in professional training and role clarity. Principal investigators, clinical research coordinators (CRCs), nurses, clinical trial pharmacists, and monitors are key players. Each faces unique challenges, such as maintaining protocol compliance, managing investigational products, and ensuring data integrity. Clinical trials' complexity and evolving nature demand specialized and ongoing training for these professionals. Addressing these challenges requires clear role delineation, continuous professional development, and supportive workplace environments to improve retention and trial outcomes. Enhanced training programs and a collaborative approach are essential for the successful conduct of clinical trials and the advancement of medical research.
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Affiliation(s)
- Galo Peralta
- Central Support Unit, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Blanca Sánchez-Santiago
- Clinical Pharmacology Service, Clinical Trials Unit, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
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Salmanton-García J, Stewart FA, Wipfler P, Hofstraat SHI, Bruijning-Verhagen P, Cornely OA. Education pathways and key tasks for research nurses in Europe, results from a VACCELERATE online survey. Nurse Educ Pract 2024; 77:103953. [PMID: 38598884 DOI: 10.1016/j.nepr.2024.103953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/19/2024] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
AIM This article aims to provide a comprehensive overview of the educational pathways and responsibilities of research nurses in Europe, particularly focusing on their essential role in conducting research in clinical settings, including clinical trials, while adhering to ethical and regulatory standards. BACKGROUND Research nurses play a crucial role in clinical research settings, especially in clinical trials, ensuring adherence to ethical and regulatory standards. Understanding their educational pathways and responsibilities is essential for promoting consistency and quality in research practices across Europe. DESIGN Between October and November 2022, relevant European nursing education authorities, including those focused on research nursing, were contacted to participate in an online cross-sectional survey. The survey aimed to gather information about research nurse education and training in their respective countries. METHODS The study followed a cross-sectional design. Contacts were made with European nursing education authorities based on recommendations from the VACCELERATE National Coordinators and the VACCELERATE Site Network. Participating organizations were invited to complete an online survey regarding research nurse education in their countries. RESULTS Responses were obtained from 37 European countries, a response rate of 74%. The most common terms used to refer to nurses involved in clinical trials and epidemiological studies were "study nurse" (62%) and "clinical research nurse" and "research nurse" (43% each). The requirements to become a research nurse varied across countries, with a nursing degree necessary in 87% of countries and Good Clinical Practice (GCP) courses mandatory in 81%. Local providers of research nurse courses existed in 84% of countries, coordinated by online organisations (51%) or universities/hospitals (46%). The most common tasks assigned to research nurses were the administration of investigational medicinal products (from 78% in observational studies to 89% in phase IV trials) and blood sample processing (84% in phase II and IV trials). CONCLUSIONS This study provides valuable insights into research nurse education and tasks in European countries. It highlights the need for standardisation to enhance consistency and quality of training across Europe.
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Affiliation(s)
- Jon Salmanton-García
- Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Fiona A Stewart
- Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Pauline Wipfler
- Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Sanne H I Hofstraat
- University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | - Oliver A Cornely
- Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
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Medina-Aedo M, Segura-Carrillo C, Torralba-Martinez E, Buitrago-García D, Solà I, Pardo-Hernandez H, Bonfill X. Randomized controlled trials in nursing conducted by Latin American research teams: A scoping review. J Nurs Scholarsh 2024; 56:331-340. [PMID: 37965861 DOI: 10.1111/jnu.12943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/16/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Randomized controlled trials (RCTs) are the cornerstone of systematic reviews and other evidence synthesis. RCT identification remains challenging because of limitations in their indexation in major databases and potential language bias. Scientific production in Latin American nursing is steadily increasing, but little is known about its design or main features. We aimed to identify the extent of evidence from RCTs in nursing conducted by Latin American research teams and evaluate their main characteristics, including potential risk of bias. DESIGN Scoping review with risk of bias assessment. METHODS We conducted a scoping review including a comprehensive electronic search in five relevant databases. We completed a descriptive data analysis and a risk of bias assessment of eligible studies using Cochrane's guidance. RESULTS We identified 1784 references of which 47 were RCTs published in 40 journals. Twenty (42.6%) RCTs were published in journals in English. Chronic diseases were the most common health conditions studied (29.7%). Fifteen (31.9%) RCTs had a high risk of bias. Thirty (75%) journals were included in the Journal Citation Report (JCR) catalog and 5 (16.7%) were journals classified under nursing category. Twenty-one (52.5%) journals explicitly required CONSORT checklist recommendations for RCTs reporting. CONCLUSION Publication of RCTs in nursing by Latin American authors has increased. Most journals where RCTs are published are in English and not specific to nursing. Searches in journals of other disciplines may be necessary to facilitate identification of RCTs in nursing. CONSORT statements need to be actively promoted to facilitate rigorous methodology and reporting of RCTs. CLINICAL RELEVANCE STATEMENT This study highlights the need for an increased research focus on RCTs in nursing in Latin America, and the importance of enhancing the reporting quality of these studies to support evidence-based nursing practice.
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Affiliation(s)
- Melixa Medina-Aedo
- Department of Paediatrics Obstetrics & Gynaecology and Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristian Segura-Carrillo
- Departamento de Trabajo Social, Universidad de Concepción, Concepción, Chile
- Universitat Autònoma Barcelona, Barcelona, Spain
| | - Elena Torralba-Martinez
- Department of Paediatrics Obstetrics & Gynaecology and Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diana Buitrago-García
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Hospital Universitario Mayor Mederi, Bogotá, Colombia
| | - Ivan Solà
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB SantPau), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Universitat Autònoma Barcelona, Barcelona, Spain
| | - Hector Pardo-Hernandez
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB SantPau), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Universitat Autònoma Barcelona, Barcelona, Spain
| | - Xavier Bonfill
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB SantPau), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Universitat Autònoma Barcelona, Barcelona, Spain
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Kohara I, Fujiwara N, Tamaki S, Nakahama H, Nosaki A, Hosoya M, Yabuki M, Yamamoto M, Kojima C, Fujiwara K. Development of a Japanese Scale that Evaluates the Level of Nursing Support Provided to Patients for Decision-Making in Cancer Clinical Trials. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1548-1556. [PMID: 37024607 DOI: 10.1007/s13187-023-02297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Clinical nurses need learning programs that are useful in nursing support for patients' decision-making (NSPDM) regarding cancer clinical trials (CCTs). The usefulness of the learning program can be evaluated if the practices of NSPDM before and after participation in the learning program can be compared. We developed a scale to measure the level of self-assessed NSPDM regarding participation in a CCT. Thirty-two items of scale were developed in Japanese based on previous literature. Based on the results of a pilot study, items with similar meanings were removed and the validity of the 26 scale items was statistically examined in terms of construct validity and reliability. The study population was clinical nurses and included clinical research nurses. We received 102 valid responses from clinical nurses. Based on the bias of the boxplot distribution and the ceiling and floor effects for the items analysis of the 26-item draft scale, 17 items remained. Exploratory factor analysis (EFA) revealed that the scale consisted of three subscales and 17 items. Regarding fit indices of the model, the goodness-of-fit index (GFI), adjusted GFI (AGFI), comparative fit index (CFI), and root mean square error of application (RMSEA) were 0.775, 0.704, 0.477, and 0.081, respectively. The Cronbach's alpha coefficient for the overall scale was 0.951, with subscales ranging from 0.820 to 0.942. The validity and reliability of this scale were acceptable. This scale may be helpful to evaluate the usefulness of learning programs, i.e., the practice level of NSPDM.
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Affiliation(s)
- Izumi Kohara
- School of Nursing, Jichi Medical University, Tochigi, Japan.
| | - Noriko Fujiwara
- Department of Palliative Medicine and Advanced Clinical Oncology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Shuko Tamaki
- Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroko Nakahama
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Nosaki
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Miki Hosoya
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Midori Yabuki
- Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
| | - Mayumi Yamamoto
- Department of Nursing, Jichi Medical University Hospital, Tochigi, Japan
| | - Chiemi Kojima
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
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Nasr AS, McCarthy AM, Manworren RCB, Sorce LR, Ersig AL, Hinderer KA, Calamaro C, Gettis MA, Hanrahan K, Hayakawa J, Heitschmidt M, Middour-Oxler B, Staveski SL, Mandrell BN, LaFond CM, Hernandez TL. Variability in qualifications for principal investigator status in research studies by nurses: A call for clarification. J Pediatr Nurs 2023; 68:18-23. [PMID: 36328915 DOI: 10.1016/j.pedn.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To describe existing guidance for qualifications of principal investigator s (PI s) of human subjects research and explore how they are operationalized for pediatric nurse scientists and clinical nurses in children's hospitals. DESIGN AND METHODS After reviewing federal regulations, accreditation guidelines, and the literature, a convenience sample of members of the National Pediatric Nurse Scientist Collaborative (NPNSC). Participants completed a 33-item survey that included questions about Institutional Review Board (IRB), guidelines, and policies for PI status at their affiliated children's hospitals. RESULTS The survey was electronically disseminated to 179 members of NPNSC through the Collaborative's listserv. Of the 39 members who responded, 90% hold a PhD and 80% practice in a free-standing children's hospital, nearly all of which (93%) are recognized as Magnet® hospitals. While the majority of respondents indicated that nurse scientists and other nurses were allowed to be PIs of research studies, educational requirements for PI status varied, with 3% requiring a PhD, 15% a baccalaureate degree, and 10% a graduate degree. 54% of respondents reported there was no degree requirement for PI status; however15% reported that even doctorally prepared nurse scientists cannot serve as PIs of research studies at their affiliated children''s hospitals. CONCLUSIONS The survey identified substantial variability in requirements for PI status and potential barriers to pediatric nurses conducting independent research as PIs at children's hospitals. PRACTICE IMPLICATIONS Operationalizing existing guidance will expand inclusion of nurse scientist expertise in human subjects research.
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Affiliation(s)
- Annette S Nasr
- Stanford Children's Hospital, 180 El Camino Suite 384 M/C 5950, Palo Alto, CA 94304, USA; School of Nursing, University of California San Francisco, Family Health Care Nursing, 2 Koret Way N411Y, San Francisco, CA 94143, USA.
| | | | - Renee C B Manworren
- Ann & Robert H. Lurie Children's Hospital of Chicago, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 101, Chicago, IL 60611, USA.
| | - Lauren R Sorce
- Ann & Robert H. Lurie Children's Hospital of Chicago, USA; Department of Pediatrics, Division of Pediatric Critical Care, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave, Box 85, Chicago, IL 60611, USA.
| | - Anne L Ersig
- University of Wisconsin-Madison School of Nursing, 701 Highland Ave, Madison, WI 53705, USA.
| | - Katherine A Hinderer
- Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA; Department of Pediatrics, University of Connecticut School of Medicine, 200 Academic Way, Farmington, CT 06106, USA.
| | - Christina Calamaro
- Children's Healthcare of Atlanta, 1575 Northeast Expressway, Atlanta, GA 30329, USA; Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Margaret A Gettis
- Children's Healthcare of Atlanta, Scottish Rite Campus, 1001 Johnson Ferry Road, Atlanta, GA 30342, USA.
| | - Kirsten Hanrahan
- University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Jennifer Hayakawa
- Children's Hospital of Orange County, 1201 W. La Veta Ave, Orange, CA 92868, USA.
| | - Mary Heitschmidt
- Rush University College of Nursing, 600 South Paulina, AAC 1080, Chicago, IL 60612, USA; Rush University System for Health, 1620 W Harrison St, Chicago, IL 60612, USA.
| | - Brandi Middour-Oxler
- Emory University School of Medicine, Department of Pediatrics, 1400 Tullie Road NE, Suite 7305, Atlanta, GA 30329, USA; Children's Healthcare of Atlanta, Egleston Hospital, 1405 Clifton Rd NE, Atlanta, GA 30322, USA.
| | - Sandra L Staveski
- School of Nursing, University of California San Francisco, Family Health Care Nursing, 2 Koret Way N411Y, San Francisco, CA 94143, USA; Benioff Children's Hospital, Family Health Care Nursing, Mission Bay, 1975 4th Street, San Francisco, CA 94158, USA.
| | - Belinda N Mandrell
- St. Jude Children's Research Hospital, Department of Pediatric Medicine, Division of Nursing Research, 262 Danny Thomas Place, Memphis TN 38501, USA.
| | - Cynthia M LaFond
- Ascension, Nursing Center of Excellence 4600 Edmondson Road, St. Louis MO 63134, USA.
| | - Teri L Hernandez
- College of Nursing; Department of Medicine, Division of Endocrinology, Metabolism and Diabetes; Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13120 E 19th Ave Mail Stop C288, Aurora, CO 80045, USA.
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Hale A, Barton B, Serino-Cipoletta J, Sheldon Y, Vessey JA. Direct care nurses' perceptions of their roles in clinical research: An integrated review of the literature. J Nurs Scholarsh 2021; 54:104-116. [PMID: 34811882 DOI: 10.1111/jnu.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 05/06/2021] [Accepted: 08/17/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To review the extant literature relevant to perceptions by direct care nurses toward clinical research endeavors. DESIGN An integrative review guided by the socioecological model was conducted. METHODS Five databases were searched to identify relevant peer-reviewed articles; there was no limitation on publication date. FINDINGS The final sample (N = 9) was systematically appraised. Numerous barriers to direct care nurses' ability to perform study activities on clinical research trials were encountered at all levels: (1) personal-comprehension, education, and training; (2) interpersonal-communication issues within or from the study team, failure to advocate for the patient; (3) organizational-lack of leadership support, knowledge, and time; and (4) community-insufficient guidance and oversight by research-governing bodies. CONCLUSIONS Direct care nurses report numerous barriers to completing protocol-administered activities for their patients participating in clinical research. A dearth of robust research exists in describing the reasons for, or persistence of, barriers faced by direct care nurses to assisting with research, and there have been little to no interventions to address them. CLINICAL RELEVANCE As translational research evolves and becomes more complex, there is the need to ensure both the care of clinical research participants and the integrity of the research. Direct care nurses are critical to this endeavor, and potential barriers they face may have significant ramifications for the research enterprise. Recognition of these barriers and eventual interventions designed to address them are needed.
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Affiliation(s)
- Andrea Hale
- Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Brenda Barton
- Clinical Research Operations Center, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Yvonne Sheldon
- Department of Pediatric Newborn Medicine, , Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Judith A Vessey
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts, USA.,Pediatric Medical Services, Boston Children's Hospital, Boston, Massachusetts, USA
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Steinberg H. Oncology Nurse Coordinators in Clinical Trials - Shaking up the Melanoma Team. Asia Pac J Oncol Nurs 2020; 7:250-254. [PMID: 32642495 PMCID: PMC7325773 DOI: 10.4103/apjon.apjon_19_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/30/2020] [Indexed: 11/17/2022] Open
Abstract
In recent years, melanoma research has undergone a renaissance. The disease that was once viewed, at least in a metastatic setting, as intractable and untreatable is now revealing its molecular “weaknesses.” The year 2011 was a landmark year for melanoma therapy, with the introduction of two new agents – the anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) antibody ipilimumab and the BRAF (V-raf murine sarcoma viral oncogene homolog B1) inhibitor vemurafenib. These two agents were shown to confer a survival benefit, which was followed by the approval by the Food and Drug Administration (FDA). In 2014, other immune checkpoint inhibitors, such as pembrolizumab and nivolumab, were approved for the treatment of metastatic melanoma. By 2019, the FDA had also approved pembrolizumab as adjuvant therapy. Target therapy and immunotherapy are now the standard of care for melanoma patients. Clinical trials are currently ongoing for new neoadjuvant therapies. Rapidly evolving knowledge will perhaps downgrade melanoma to the level of a chronic, manageable disease from the intractable “black cancer,” it was in the past and a disease that struck fear into the hearts of those who were diagnosed. Changes in immunotherapy treatments were followed by a large volume of clinical trials. This situation has resulted in the need for changes in the roles of existing melanoma multidisciplinary team members, including the clinical trials nurse (CTN). The role of the CTN is not suitable for these new conditions. A new role and tasks need to be established, evolving the CTN into an oncology nurse coordinator (ONC). In this article, we have described the role and responsibilities of an ONC and the changes that have taken place within the multidisciplinary melanoma team.
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Affiliation(s)
- Hani Steinberg
- Department of Oncology, Sharett Institute of Oncology, Hadassah Hebrew University Hospital, Kiryat Hadassah, Jerusalem, Israel
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Ness E. The Oncology Clinical Research Nurse Study Co-Ordinator: Past, Present, and Future. Asia Pac J Oncol Nurs 2020; 7:237-242. [PMID: 32642493 PMCID: PMC7325777 DOI: 10.4103/apjon.apjon_10_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/08/2020] [Indexed: 11/04/2022] Open
Abstract
Clinical research nursing is a specialty practice that has evolved over the past century. Clinical research nurses (CRNs) work directly (e.g., direct care provider and advance clinician) or indirectly (e.g., manager, educator, and study co-ordinator) to support clinic research. For more than 50 years, oncology nurses have contributed to the body of evidence describing and validating the responsibilities and importance of the nurse in clinical research, especially the study co-ordinator role. This article will focus on the CRN study co-ordinator role in oncology clinical trials highlighting the historical evolution of the role, the contributions of dedicated members of the Oncology Nursing Society, and the future landscape of clinical research nursing through the International Association of CRNs.
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Affiliation(s)
- Elizabeth Ness
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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Manda-Taylor L, Liomba A, Taylor TE, Elwell K. Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi. J Empir Res Hum Res Ethics 2020; 14:152-168. [PMID: 30866724 DOI: 10.1177/1556264619830859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures.
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CE: Original Research: The Clinical Research Nurse: Exploring Self-Perceptions About the Value of the Role. Am J Nurs 2020; 119:24-32. [PMID: 31361266 DOI: 10.1097/01.naj.0000577324.10524.c9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: Background: Clinical research nursing is an emerging specialty practice. Clinical research nurses (CRNs) work to make protocol-related care safe for the research subjects while simultaneously maintaining protocol fidelity. They must continuously balance the needs of the research subjects and the study requirements. PURPOSE The purpose of this qualitative study was to describe CRNs' perceptions of the value of their role. METHODS Two focus groups were conducted with a purposive sample of 18 CRNs. An interview guide consisting of eight open-ended items was used. Data analysis used critical elements from Krueger's systematic steps for analyzing focus group data. RESULTS Five major themes emerged from 168 coded statements contained within the focus group transcripts: comprehensive nursing care of research subjects, training and education of research subjects and staff, contributions to clinical science, unique combination of clinical and critical thinking skills, and CRN practice attributes. Subcategories were also identified. In general, participants felt strongly about the value they added.Clinical research nursing requires the use of a variety of abilities and skills, including critical thinking and problem solving, as well as clinical and research knowledge. The CRNs in this study described incorporating these and other elements into their practice, which they associated with their specialized role. The five themes that emerged help elucidate the importance and utility of including CRNs on research teams. CONCLUSIONS The unique combination of applied research knowledge and expert clinical skills sets the specialty of clinical research nursing apart. The study findings, in particular the five themes, provide an evidence-based framework that will be useful in the development of competencies for CRN specialty practice. In helping to bring research findings to bear on clinical care, the impact of CRNs' practice extends beyond the individual patient to larger patient populations.
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Basketter V, Benney M, Causer L, Fleure L, Hames D, Jones S, Patel K, White L. Continuous, comprehensive and crucial care: The role of the CNS in the metastatic castration-resistant prostate cancer patient pathway. ACTA ACUST UNITED AC 2019; 27:S1-S8. [PMID: 29461871 DOI: 10.12968/bjon.2018.27.sup4b.s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Several treatment options are now available to men with metastatic castration-resistant prostate cancer (mCRPC). While survival rates for mCRPC continue to improve, patients are faced with increasingly complex treatment pathways and decisions. The clinical nurse specialist (CNS) plays a crucial role in navigating patients with mCRPC through their treatment pathway and fulfils a number of key responsibilities, including providing holistic care and support to patients and their families, educating and communicating with them in a timely and effective manner, and liaising with other healthcare professionals to seamlessly coordinate patient treatment. However, increasing patient caseloads and administrative duties are leaving CNSs with little time to fulfil their supportive role. Additional resources are needed in order to both promote and preserve this supportive role, thus ensuring that mCRPC patients receive the best possible care.
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Affiliation(s)
- Vanessa Basketter
- Advanced Prostate Cancer Nurse Specialist, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Miranda Benney
- Macmillan Uro-oncology Clinical Nurse Specialist, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Louise Causer
- Clinical Nurse Specialist for Radioisotope Therapy, Royal Marsden NHS Foundation Trust, London, UK
| | - Louisa Fleure
- Lead Urology Clinical Nurse Specialist/Prostate Cancer Advanced Nurse Practitioner, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - David Hames
- Advanced Prostate Cancer Specialist Nurse, Leicester Royal Infirmary, Leicester, UK
| | - Sarah Jones
- Prostate Advanced Nurse Practitioner, Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, UK
| | - Kamlesh Patel
- Urology Trainee Nurse Clinician, Christie NHS Foundation Trust, Manchester, UK
| | - Lisa White
- Advanced Prostate Cancer Clinical Nurse Specialist, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Zhou Q, Ratcliffe SJ, Grady C, Wang T, Mao JJ, Ulrich CM. Cancer Clinical Trial Patient-Participants' Perceptions about Provider Communication and Dropout Intentions. AJOB Empir Bioeth 2019; 10:190-200. [PMID: 31180295 DOI: 10.1080/23294515.2019.1618417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To study the relationship between cancer patient/research participants' perceptions of communication with their research nurse and doctor and (1) participants' thoughts of dropping out from their cancer clinical trials (CCTs), (2) how informed they felt before and during their clinical trial participation, and (3) trust in their researchers. Methods: We surveyed 110 adult cancer patients who were enrolled in cancer clinical trials by using 15 modified items from the Medical Communication Competence Scale measuring information exchange and relational communication. Retention was measured by two items: ever thought about dropping out (yes/no) and likelihood of remaining enrolled in the clinical trial (5-point Likert item). We asked how well informed about the trial participants felt at enrollment, at the date they filled out the survey, and about changes in the trial. Results: Patient-participants with thoughts of dropping out from their CCTs rated their communication with research doctors lower than those who did not have thoughts of dropping out (4.14 versus 4.46, t = 2.22, p = 0.03). Patient-participants' intention to remain enrolled was correlated with more favorable scores on relational communication (such as contributing to a trusting relationship and showing compassion) with research doctors (r = 0.20, p = 0.04) and nurses (r = 0.25, p = 0.01). Communication with doctors was also associated with how informed patient-participants felt during their clinical trials. Conclusions: Relational communication with research doctors and nurses was significantly related to thoughts about remaining enrolled or dropping out of a clinical trial among adult participants in cancer treatment clinical trials. Practice Implications: Relational communication with cancer patients advances retention in research.
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Affiliation(s)
- Qiuping Zhou
- a George Washington University , Washington , DC , USA
| | | | - Christine Grady
- c National Institutes of Health, Bioethics, Clinical Center , Bethesda , Maryland , USA
| | - Tianhao Wang
- d Perelman School of Medicine, University of Pennsylvania , Philadelphia , Pennsylvania , USA
| | - Jun J Mao
- e Memorial Sloan Kettering Cancer Center , New York , New York , USA
| | - Connie M Ulrich
- d Perelman School of Medicine, University of Pennsylvania , Philadelphia , Pennsylvania , USA.,f School of Nursing, University of Pennsylvania , Philadelphia , Pennsylvania , USA
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Kao CY, Hamilton B, Lin YF, Hu WY. Ward-Based Nurses' Knowledge and Attitudes Toward Clinical Trials: A Survey Study in Taiwan. J Nurs Scholarsh 2019; 51:489-496. [PMID: 31106525 DOI: 10.1111/jnu.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2018] [Indexed: 11/28/2022]
Abstract
PURPOSES Clinical trial education has not been extensively integrated into nursing education systems. Acute care nurses may lack sufficient knowledge when caring for admitted trial patients, which may negatively influence their attitudes toward clinical trials. The aim of this study was to explore ward-based nurses' knowledge and attitudes toward clinical trials. DESIGN AND METHODS Ward-based nurses working in medical, surgical, and intensive care units in a medical center in Taiwan were approached to complete a questionnaire. The questionnaire was developed by the research team and included four parts: demographics, experience with clinical trials, clinical trial knowledge, and attitudes toward clinical trials. FINDINGS A total of 161 nurses responded. Nearly 90% of the nurses accessed trial information in their workplace. Nearly 80% of the respondents had experience with caring for trial patients, but the mean score of clinical trial knowledge was 4.5 out of a possible score of 10. For attitudes toward clinical trials, the mean score for positive beliefs was 39.7, and the mean score for negative expectations was 42.5, both out of a possible score of 55. The results indicated that respondents typically tended to hold a negative attitude toward clinical trials, especially in regard to the side effects of study drugs and communication with investigators. CONCLUSIONS Knowledge deficits of ward-based nurses concerning trial participation is apparent. Continuing education for ward-based nurses is necessary to promote implementation of clinical trials and reduce negative expectations related to clinical trials. CLINICAL RELEVANCE One way to improve nurses' knowledge is to integrate clinical trial education into nursing education systems, which will provide more channels through which nurses can understand how a trial works, including the risks, benefits, and participant protection. Through such educational initiatives, ward-based nurses may develop more positive beliefs regarding clinical trials and provide higher quality clinical trial care to participants.
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Affiliation(s)
- Chi-Yin Kao
- Lambda Beta-at-Large , Assistant Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bridget Hamilton
- Associate Professor, Department of Nursing, University of Melbourne, VIC, Australia
| | - Yi-Fung Lin
- Registered Nurse, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Yu Hu
- Lambda Beta-at-Large , Professor, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Iribarren S, Stonbraker S, Larsen B, Santos I, Faria R, Santos F, Binfa L, Larson E. Clinical nursing and midwifery research in Latin American and Caribbean countries: A scoping review. Int J Nurs Pract 2018; 24:e12623. [PMID: 29436102 PMCID: PMC5880717 DOI: 10.1111/ijn.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/12/2017] [Accepted: 12/27/2017] [Indexed: 11/28/2022]
Abstract
AIM To identify and describe published, nursing-led and midwifery-led, clinical research that has been conducted in Latin America and the Caribbean. BACKGROUND Peer-reviewed published research may correspond to and elucidate country's realities, priorities, and needs. DESIGN A 6-stage scoping review methodology was used to search scientific databases using an applied search strategy. DATA SOURCES Five databases were searched for articles published in English, Spanish, or Portuguese conducted in a Latin American or Caribbean country between January 1, 2006 and June 14, 2016. REVIEW METHODS Articles were independently considered for inclusion by 2 researchers, data extracted, and study characteristics described. RESULTS Of 6922 articles identified, 404 were included. The majority were conducted in Brazil (90.6%) followed by Chile (2.5%). Most were nurse-led (95.8%) and were implemented in hospitals (48.6%). Studies frequently explored patient knowledge or characterized patient populations (61.3%) and commonly assessed chronic disease (19.3%) or maternity/child health outcomes (15.9%). CONCLUSION Findings revealed a large number of publications but an uneven geographical distribution of nurse-led clinical research and an evident gap of midwifery-related research in Latin America and the Caribbean. Results may be used to build research agendas to promote nursing and midwifery research capacity and further establish evidence-based practice.
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Affiliation(s)
- Sarah Iribarren
- Assistant Professor, Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington, USA; Postdoctoral Research Fellow, Columbia University School of Nursing, New York, NY, USA
| | - Samantha Stonbraker
- Postdoctoral Research Fellow, Columbia University School of Nursing, New York, NY, USA; Director of Research, Clinica de Familia La Romana, La Romana, Dominican Republic
| | - Brandon Larsen
- DNP student, Columbia University School of Nursing, New York, USA
| | - Islane Santos
- BSN Student, Science without Borders Scholarship / CAPES, Brazil
| | - Renata Faria
- BSN Student, Science without Borders Scholarship / CAPES, Brazil
| | - Fernanda Santos
- Professor, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil
| | - Lorena Binfa
- Associate Professor, Department of Women´s and Newborn Health Promotion-School of Midwifery. Faculty of Medicine. University of Chile, Chile
| | - Elaine Larson
- Associate Dean for Research, Anna Maxwell Professor of Nursing Research, Columbia University School of Nursing, Professor of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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15
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Davoodvand S, Abbaszadeh A, Ahmadi F. Patient advocacy from the clinical nurses' viewpoint: a qualitative study. J Med Ethics Hist Med 2016; 9:5. [PMID: 27471588 PMCID: PMC4958925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 05/28/2016] [Indexed: 11/29/2022] Open
Abstract
One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients' health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy.
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Affiliation(s)
- Shirmohammad Davoodvand
- PhD Candidate in Nursing, Razi Nursing and Midwifery College, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Abbaszadeh
- Professor, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; ,Corresponding Author: Abbas Abbaszadeh. Address: Nursing and Midwifery College, Shahid Beheshti University of Medical Sciences, ValiAsr Street, Tehran, Iran. P.O. Box: 1996835119. Tel: 98 21 88202520. Fax: 98 21 88202521
| | - Fazlollah Ahmadi
- Professor, Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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16
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Olsen DP, Lehto RH, Chan RR. Ethical Case Study of the Researcher-Participant Relationship in End-of-Life Research. West J Nurs Res 2016; 38:1205-20. [PMID: 27006191 DOI: 10.1177/0193945916639590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nurse-researchers studying interventions for patients at the end-of-life may become close with participants due to the nature of interactions within the research protocol. In such studies, participants may request further interactions that would constitute clinical care beyond the scope of the protocol. Nurse-researchers may feel a conflict of values between their obligation to the research goals and their inclinations and obligations as nurses to care for their patients. Nurse-researchers in this situation aspire to honor the bonds developed through close contact and ensure participants receive standard of care while maintaining standards of research ethics. Analysis of a case and review of applicable concepts in research ethics, including ethical relationships, therapeutic misconception, equipoise, and population vulnerability, are used to develop recommendations regarding the decision parameters for similar cases.
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Nalubega S, Evans C. Participant views and experiences of participating in HIV research in sub-Saharan Africa: a qualitative systematic review. ACTA ACUST UNITED AC 2015. [DOI: 10.11124/01938924-201513050-00016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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18
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Galassi AL, Grady MA, O'Mara AM, Ness EA, Parreco LK, Belcher AE, Hastings CE. Clinical research education: perspectives of nurses, employers, and educators. J Nurs Educ 2014; 53:466-72. [PMID: 25050563 DOI: 10.3928/01484834-20140724-04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 05/14/2014] [Indexed: 11/20/2022]
Abstract
The aim of this study was to understand the current environment around clinical research relating to nursing education and practice. This descriptive study analyzed data from 33 in-depth interviews with faculty members, nurse executives, staff development directors, and practicing nurses, as well as an online interactive brainstorming session with 28 deans of schools of nursing (or their designee). Patterns and themes that emerged within each group were identified and analyzed in relation to study objectives. Central themes emerged around participants' knowledge and attitudes about clinical research education for baccalaureate nursing students, factors enhancing or inhibiting inclusion of clinical research content in baccalaureate nursing programs, and professional roles nursing students could expect to assume after graduation. Although the participants agreed that mastery of clinical research knowledge and related skills is important, there was no agreement whether nurses should receive this education and training in baccalaureate programs or in staff development.
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Scott J. Therapeutic misconceptions and misestimations in oncology: a clinical trial nurse's guide. Clin J Oncol Nurs 2013; 17:486-9. [PMID: 24080047 DOI: 10.1188/13.cjon.486-489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Therapeutic misconceptions and misestimations occur frequently in oncology clinical trials and can potentially compromise informed consent. Despite the increased awareness of these issues in medical literature, many practitioners and nurses continue to be unfamiliar with these concepts. This article will define therapeutic misconceptions and misestimations, explore contributing factors, and explain how they can be prevented by clinical trial nurses.
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Affiliation(s)
- Jennifer Scott
- Cancer Treatment Center, Saint Francis Medical Center, Grand Island, NE
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20
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Weschler D. Subject advocacy and the clinical trials nurse. Nursing 2013; 43:1-3. [PMID: 23411541 DOI: 10.1097/01.nurse.0000427099.98269.b7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Dana Weschler
- Hahnemann University Hospital, Philadelphia, PA, USA
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Abstract
The clinical trial nurse (CTN) can have a substantial amount of responsibility for clinical trials and can perform many roles in the management of clinical trials. Although new opportunities for the registered nurse in clinical trials have emerged in recent years, there remains to be a dearth of literature surrounding the important roles of the CTN in clinical trials. The CTN is a specialty-nursing role that is unfamiliar to many, including some nurses. Therefore, it is important to address this gap in the literature and enlighten the nursing profession and others about the roles of the nurse in clinical trials. This article aims to explore and provide an overview of the CTN's role in safety reporting. Safety reporting is a significant component of clinical trials by protecting the rights, safety, and welfare of subjects. The CTN integrates and utilizes his or her knowledge, experience, skills, and sound ethical principles when performing the duties of this role. This allows the CTN to be a vital member in the safety-reporting process and in the protection of subjects.
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22
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Site-based research in acute heart failure. Heart Fail Clin 2012; 7:545-51. [PMID: 21925438 DOI: 10.1016/j.hfc.2011.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The conduct of clinical trials in acute heart failure has arrived at a critical point. Traditional systems used to conduct clinical trials have been described as inefficient, lacking infrastructure, and enormously expensive. In this article, the authors describe an alternative model: the development of a site-based research (SBR) unit, an operating business unit responsible for conducting a portfolio of research projects in a therapeutic area. The SBR is responsible for financial accountability, regulatory compliance, and academic productivity.
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Hastings CE, Fisher CA, McCabe MA, Allison J, Brassil D, Offenhartz M, Browning S, DeCandia E, Medina R, Duer-Hefele J, McClary K, Mullen N, Ottosen M, Britt S, Sanchez T, Turbini V. Clinical research nursing: a critical resource in the national research enterprise. Nurs Outlook 2011; 60:149-156.e1-3. [PMID: 22172370 DOI: 10.1016/j.outlook.2011.10.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 10/03/2011] [Accepted: 10/13/2011] [Indexed: 12/31/2022]
Abstract
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.
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Affiliation(s)
- Clare E Hastings
- National Institutes of Health Clinical Center, Bethesda, MD 20892, USA.
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Bevans M, Hastings C, Wehrlen L, Cusack G, Matlock AM, Miller-Davis C, Tondreau L, Walsh D, Wallen GR. Defining clinical research nursing practice: results of a role delineation study. Clin Transl Sci 2011; 4:421-7. [PMID: 22212223 DOI: 10.1111/j.1752-8062.2011.00365.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- Margaret Bevans
- National Institutes of Health Clinical Center, Nursing and Patient Care Services, Bethesda, Maryland, USA.
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Fisher JA, Kalbaugh CA. Altruism in clinical research: coordinators' orientation to their professional roles. Nurs Outlook 2011; 60:143-8, 148.e1. [PMID: 22083045 DOI: 10.1016/j.outlook.2011.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/12/2011] [Accepted: 10/03/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Research coordinators have significant responsibilities in clinical trials that often require them to find unique ways to manage their jobs, thus reshaping their professional identities. The purpose of this study was to identify how research coordinators manage role and ethical conflicts within clinical research trials. METHODS A qualitative study combining observation and 63 semistructured interviews at 25 research organizations was used. RESULTS Altruism is a recurring theme in how research coordinators define and view their work. CONCLUSION Altruism is adopted by research coordinators to: (1) Teach patient-subjects the appropriate reasons to participate in clinical research, (2) minimize the conflict between research and care, and (3) contest the undervaluation of coordinating. Altruism is a strategy used to handle the various conflicts they experience in a difficult job, and it has become part of the professional identity of clinical research coordinators.
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Affiliation(s)
- Jill A Fisher
- Center for Biomedical Ethics & Society, Vanderbilt University, Nashville, TN 37203, USA.
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Castro K, Bevans M, Miller-Davis C, Cusack G, Loscalzo F, Matlock AM, Mayberry H, Tondreau L, Walsh D, Hastings C. Validating the clinical research nursing domain of practice. Oncol Nurs Forum 2011; 38:E72-80. [PMID: 21356644 DOI: 10.1188/11.onf.e72-e80] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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