Doing clinical research: the challenges and benefits

A qualitative exploration of challenges recruiting older adults for Being Your Best, a co-designed holistic intervention to manage and reduce frailty: lessons learnt amidst the COVID-19 pandemic in Melbourne, Australia

OBJECTIVES

Researchers face numerous challenges when recruiting participants for health and social care research. This study reports on the challenges faced recruiting older adults for Being Your Best, a co-designed holistic intervention to manage and reduce frailty, and highlights lessons learnt amidst the COVID-19 pandemic.

DESIGN

A qualitative study design was used. Referrer interviews were conducted to explore the recruitment challenges faced by the frontline workers. An audit of the research participant (aged ≥65) database was also undertaken to evaluate the reasons for refusal to participate and withdrawal from the study.

SETTING

Hospital emergency departments (EDs) and a home care provider in Melbourne, Australia.

PARTICIPANTS

Frontline workers and older adults.

RESULTS

From May 2022 to June 2023, 71 referrals were received. Of those referrals, only 13 (18.3%) agreed to participate. Three participants withdrew immediately after baseline data collection, and the remaining 10 continued to participate in the programme. Reasons for older adult non-participation were (1) health issues (25.3%), (2) ineligibility (18.3%), (3) lack of interest (15.5%), (4) perceptions of being 'too old' (11.2%) and (5) perceptions of being too busy (5.6%). Of those participating, five were female and five were male. Eleven referrer interviews were conducted to explore challenges with recruitment, and three themes were generated after thematic analysis: (1) challenges arising from the COVID-19 pandemic, (2) characteristics of the programme and (3) health of older adults.

CONCLUSION

Despite using multiple strategies, recruitment was much lower than anticipated. The ED staff were at capacity associated with pandemic-related activities. While EDs are important sources of participants for research, they were not suitable recruitment sites at the time of this study, due to COVID-19-related challenges. Programme screening characteristics and researchers' inability to develop rapport with potential participants also contributed to low recruitment numbers.

TRIAL REGISTRATION NUMBER

ACTRN12620000533998; Pre-results.

Barriers to conducting and publishing research among nursing faculty members at Shaqra University, Saudi Arabia: A qualitative study

AIM

To identify barriers to conducting and publishing research among nursing faculty members at Shaqra University, Saudi Arabia.

DESIGN

A qualitative descriptive design was used.

METHODS

This qualitative descriptive study was conducted on 12 nursing faculty members from two nursing colleges at Shaqra University, a public university located in Riyadh region, SA, under the supervision of the Ministry of Education. Data were collected between September and October 2021 using semi-structured interviews and analysed thematically using content analysis.

RESULTS

Three themes emerged in the study, namely (I) individual/personal barrier, (II) institutional barrier and (III) external factors. Barriers to conducting and publishing research included lack of time due to a high teaching load and lack of administrative and financial support. The present findings suggest that nursing faculty members in SA are facing many barriers hindering them from carrying out and publishing research activities. Such barriers need to be urgently addressed through different strategies, including allocating facilities and funds for research, motivating faculty members towards research, and ongoing education and training on research.

Experiences of nurses and coordinators in a childhood obesity prevention trial based on motivational interviewing within Swedish child health services

Purpose

To explore the experiences of nurses and coordinators in the PRIMROSE childhood obesity prevention trial, and to understand the factors that might help to improve the outcome of future primary prevention of obesity.

Methods

Using a qualitative approach, data were obtained by interviewing nine intervention nurses and three regional study coordinators. All participants were female. The interviews were transcribed and analysed using content analysis.

Results

Two themes emerged: The nurses experienced that it was rewarding to participate in the trial, but challenging to combine the intervention with regular work; and The study coordinators experienced that they were in a difficult position handling the conflicting needs of the research group and the nurses’ commitment to usual child health care services. The importance of support, encouragement, briefer and simpler intervention, and adaptation of the training in motivational interviewing to the setting was emphasized. Stress and lack of time were major barriers to deliver the intervention as intended.

Conclusions

Although the PRIMROSE intervention was developed in collaboration with representatives from the child health services, and additional research funding was provided to compensate for time spent working with the trial, nurses experienced stress and time constraints. .

Barriers and Facilitators of Research in Pediatric Sports Medicine Practitioners: A Survey of the PRiSM Society

Background

Barriers and facilitators to research in sports medicine (SM) by physicians and allied health (AH) professions such as physical therapists and athletic trainers are understudied. The purpose of this research was to examine and compare research barriers, facilitators, and other research related facets including interests, comfort, knowledge, and resources among SM physicians and AH practitioners.

Study Design

Cross-sectional survey.

Methods

The survey was sent to Pediatric Research in Sports Medicine (PRiSM) members. The survey was designed to ask respondents to identify their top barrier and facilitator to conducting research. Research interest (binary), self-rated comfort reading research articles (0-100 scale), self-rated knowledge conducting research independently (0-100 scale), and available research resources were evaluated. Descriptive statistics, chi-square, and t-tests were used to compare the responses between SM physicians and AH practitioners. The value of p<0.05 was set as a statistically significant criterion.

Results

The response rate was 35.7% (N=100). For both SM physicians and AH practitioners, the greatest research barrier was a lack of time. However, the leading research facilitators differed in the two professions. The top research facilitator for SM physicians was availability of research personnel, while availability of research mentoring was selected as a prime facilitator by AH practitioners. There were no differences in research interest between SM physicians (87.0%) and AH practitioners (95.5%, p=0.267). However, self-rated comfort reading research articles was higher in SM physicians (75.6±20.6) than AH practitioners (60.6±28.3, p=0.018). There were no differences in self-rated knowledge conducting research independently between SM physicians (70.2±18.6) and AH practitioners (63.4±24.6, p=0.163).

Conclusion

Lack of time was the top research barrier for both SM physicians and AH practitioners. Regarding research facilitators, having available time was the main facilitator for SM physicians while availability of mentoring was the leading facilitator in AH practitioners.

Level of Evidence

3.

Research Ready Grant Program (RRGP) protocol: a model for collaborative multidisciplinary practice-research partnerships

Background

Little attention has been given to the process of implementing or evaluating a structured academic–clinician (university–health service) research capacity-building (RCB) model within healthcare settings. We have developed a model for collaborative multidisciplinary practice–research partnerships called the Research Ready Grant Program (RRGP). The RRGP is informed by Cooke’s (BMC Fam Pract 6:44, 2005) RCB framework and principles. The aim of the study outlined in this protocol is to conduct a process and outcome evaluation of the programme. We will explore how the RRGP's structured mentor model contributes to RCB of clinician-led multidisciplinary research teams. We will identify key factors at the organization, team and individual levels that affect research capacity of health professionals working in one regional health service district. This protocol describes the RRGP design and outlines the methods we will employ to evaluate an RCB programme, the RRGP, delivered in a regional health service in Australia.

Methods

The study will adopt an exploratory concurrent mixed-methods approach designed to evaluate the process of implementing an RCB model across one regional hospital and health service. Both quantitative and qualitative data collection methods over a 12-month period will be implemented. Data triangulation will be applied to capture the complex issues associated with implementing collaborative multidisciplinary practice–research partnerships.

Discussion

The RRGP is an innovative RCB model for clinicians in their workplace. It is expected that the programme will facilitate a culture of collaborative multidisciplinary research and strengthen hospital–university partnerships.

Research capacity-building for clinicians: understanding how the research facilitator role fosters clinicians' engagement in the research process

Background

There is evidence reporting more positive outcomes from research capacity-building (RCB) programmes that include a research facilitator role. Further, it has been suggested that research facilitator roles can be a useful strategy in building the research capacity of healthcare clinicians. However, until now, little attention has been applied to identifying the characteristics of the research facilitator role and how this role contributes to clinicians’ engagement with the research process. The aim of this present study is to explore the characteristics required of the research facilitator role in the educational workshop phase of an RCB programme.

Methods

This qualitative study employed an inductive approach and utilized face-to-face interviews to gather data from a purposely selected cohort. Professionally transcribed responses were thematically analysed.

Results

The role of the research facilitator emerged as comprising two main themes: (1) facilitating the research process and (2) engaging expert clinicians as novice researchers. Pragmatically, analysis of data led to the development of a table outlining the responsibilities, skills and attributes related to each theme. Conceptually, theme 1 encapsulates the research facilitators’ skills and experience and their role as knowledge brokers and cocreators of knowledge. Theme 2 provides insight into the clinician-centric approach the research facilitators utilized to build and foster relationships and support the clinicians through their research journey.

Conclusion

This study reports on the characteristics of the research facilitator role in one phase of an RCB programme in one regional health service district in Australia and explains how the role fosters clinicians’ engagement with the research process. Findings from this study will inform the development of future RCB programmes, which is important considering that clinicians’ increased engagement with the research process is vital for developing a sound evidence base to support decision-making in practice and leads to higher levels of skills and greater ability to perform useful research.

Mixed methods systematic review: Factors influencing research activity among nurses in clinical practice

AIM

This study aimed to identify, evaluate and summarise current evidence in relation to the factors that influence the conducting of research by nurses in clinical practice.

DESIGN

This study used mixed methods systematic review.

DATA SOURCES

CINAHL, EMBASE, MEDLINE, Scopus and ASSIA, with dates limited from 2015 to 2020, were used to conduct a systematic search of the literature.

REVIEW METHODS

The Joanna Briggs Institute approach was followed, with results reported according to the Preferred Reporting System for Systematic Reviews and Meta-Analyses. The associated checklist for systematic reviews was also used. A standardised data extraction tool was then used, with quality appraisal guided by the Mixed Methods Appraisal Tool, with a subsequent convergent qualitative synthesis.

RESULTS

Sixteen papers were identified for inclusion, nine quantitative, six qualitative and one mixed methods. Four themes were identified: research competence and culture, proactive research mentorship, research resources and making a difference. These were critically discussed in relation to barriers and enablers to the conduct of research by nurses in clinical practice. Commonly cited barriers included a lack of research knowledge, confidence and access to resources, particularly protected time, while enablers such as educational partnerships, identifying research-motivated clinical nurses and access to research role models were also apparent in the literature.

CONCLUSIONS

Globally, nurses in clinical practice are clearly motivated to engage in the research process despite apparent barriers that have a significant impact on productivity. Nevertheless, there are also enablers to building research capacity apparent that offer methodological and structural approaches to empower this group to conduct research.

Research ability and research motivation of postgraduate nursing students in traditional Chinese medicine colleges

Aim

To investigate the relationship between research ability and research motivation of postgraduate nursing students in traditional Chinese medicine colleges and identify other factors that may have an impact on the research ability of postgraduate nursing students.

Design

A cross‐sectional electronic survey was used to collect data from 191 postgraduate nursing students.

Methods

A total of 191 postgraduate nursing students from seven traditional Chinese medicine colleges were investigated from October to November 2020 using self‐rated scales for research ability and research motivation. The relationship between the variables affecting the research ability of postgraduate nursing students in traditional Chinese medicine colleges was determined.

Results

There was a positive correlation between the score of self‐rated research ability and research motivation among 191 postgraduate nursing students in traditional Chinese medicine colleges. Multiple stepwise regression analysis showed that grade, research motivation, age and active participation in class discussions were the main factors affecting the self‐rated research ability.

Conclusion

The self‐rated research ability of postgraduate nursing students in traditional Chinese medicine colleges is positively correlated with research motivation. According to the research motivation orientation, adopting targeted training methods and establishing correct professional understanding may improve the research ability of postgraduate nursing students.

A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine

BACKGROUND

There are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards.

METHODS

Ten databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework.

RESULTS

Of the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic.

CONCLUSIONS

Several overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.

Factors affecting research utilisation of nurses and midwives working in North Gondar and West Gojjam Zone public hospitals, Ethiopia: a cross-sectional study

BACKGROUND

Research utilisation in clinical decision-making is crucial to enhance quality healthcare, professional development and cost-effective health service. Nurses and midwives have a vital role in research utilisation. However, many factors influence research utilisation of nurses and midwives.

OBJECTIVES

To determine research utilisation and identify factors that affect research utilisation among nurses and midwives.

METHODS

An institutional-based, cross-sectional study was conducted from 23 May to 30 June 2019. A total of 631 nurses and midwives participated in the study. Categorical variables were coded with dummy variables and multiple linear regression model was carried out. The level of significance was set at p value less than or equal to 0.05 with 95% CI.

RESULTS

Participants' total mean score in the research utilisation scale was 2.27 (SD±0.77) and their mean age was 28.41 (SD±4.71) years. The study revealed that 70.4% (444) of participants had poor research utilisation. Self-efficacy in research utilisation skills (B=0.86, 95% CI 0.75 to 0.97), support for research utilisation (B=0.4, 95% CI 0.25 to 0.55), attitude (B=0.23, 95% CI 0.07 to 0.38), barriers to research utilisation (B=-0.63, 95% CI -0.72 to -0.54), nursing/midwifery work index (B=0.07, 95% CI 0.04 to 0.11) and hospital's level of healthcare (B=4.5, 95% CI 2.13 to 6.9) were statistically significantly associated factors of research utilisation.

CONCLUSIONS

This study revealed poor research utilisation among nurses and midwives. Barriers to research utilisation, supporting factors for research utilisation, attitude, self-efficacy in research utilisation skills, hospital's level of healthcare and nursing/midwifery work index were found to be statistically significant predictors of research utilisation. The most common barriers to research utilisation were insufficient time and inability to understand statistical terms used in research articles.

Challenges and enablers of the embedded researcher model

PURPOSE

The embedded researcher is a healthcare-academic partnership model in which the researcher is engaged as a core member of the healthcare organisation. While this model has potential to support evidence translation, there is a paucity of evidence in relation to the specific challenges and strengths of the model. The aim of this study was to map the barriers and enablers of the model from the perspective of embedded researchers in Australian healthcare settings, and compare the responses of embedded researchers with a primary healthcare versus a primary academic affiliation.

DESIGN/METHODOLOGY/APPROACH

104 embedded researchers from Australian healthcare organisations completed an online survey. Both purposive and snowball sampling strategies were used to identify current and former embedded researchers. This paper reports on responses to the open-ended questions in relation to barriers and enablers of the role, the available support, and recommendations for change. Thematic analysis was used to describe and interpret the breadth and depth of responses and common themes.

FINDINGS

Key barriers to being an embedded researcher in a public hospital included a lack of research infrastructure and funding in the healthcare organisation, a culture that does not value research, a lack of leadership and support to undertake research, limited access to mentoring and career progression and issues associated with having a dual affiliation. Key enablers included supportive colleagues and executive leaders, personal commitment to research and research collaboration including formal health-academic partnerships.

RESEARCH LIMITATIONS/IMPLICATIONS

To support the embedded researcher model, broader system changes are required, including greater investment in research infrastructure and healthcare-academic partnerships with formal agreements. Significant changes are required, so that healthcare organisations appreciate the value of research and support both clinicians and researchers to engage in research that is important to their local population.

ORIGINALITY/VALUE

This is the first study to systematically investigate the enablers and challenges of the embedded researcher model.

A Feasibility Study Of Administering The Electronic Research And Development Culture Index To The Multidisciplinary Workforce In A UK Teaching Hospital

Purpose

The study aims were: (i) to convert the Research and Development Culture Index (a validated rating instrument for assessing the strength of organizational Research and Development culture) into electronic format (eR&DCI), and (ii) to test the format and assess the feasibility of administering it to the multidisciplinary (allied health professionals, doctors and nurses) workforce in a National Health Service Hospital (NHS) in the United Kingdom (UK) by trialing it with the workforce of the tertiary Children’s Hospital within the organization.

Population and methods

The eR&DCI was emailed to all professional staff (n=907) in the Children’s Hospital. Data were analyzed using IBM SPSS Statistics 22.

Results

The eR&DCI was completed by 155 respondents (doctors n=38 (24.52%), nurses n=79 (50.96%) and allied health professionals (AHPs) n=38 (24.52%)). The response rate varied by professional group: responses were received from 79 out of 700 nurses (11%); 38 out of 132 doctors (29%) and 38 out of 76 AHPs (50%). Index scores demonstrated a positive research culture within the multidisciplinary workforce. Survey responses demonstrated differences between the professions related to research training and engagement in formal research activities.

Conclusion

This is the first study to assess the feasibility of assessing the strength of an organization’s multidisciplinary workforce research and development (R&D) culture by surveying that workforce using the eR&DCI. We converted the index to “Online Surveys” and successfully administered it to the entire multidisciplinary workforce in the Children’s Hospital. We met our criteria for feasibility: ability to administer the survey and a response rate comparable with similar studies. Uptake could have been increased by also offering the option of the paper-based index for self-administration. Results of the survey are informing delivery of the research strategy in the Children’s Hospital. This methodology has potential application in other healthcare contexts.

Exploring the research culture in the health information management profession in Australia

BACKGROUND

Research is an important activity that informs knowledge and practice. The research culture within the Australian Health Information Management (HIM) profession has not been previously reported.

OBJECTIVE

This study explored the perceptions of HIM practitioners about research in their role to establish if there is a research culture in the Australian HIM profession.

METHOD

An online survey was distributed to the HIM community using a snowball recruitment strategy.

RESULTS

Of the 149 respondents, more than half (54%) identified they possessed research skills from prior education, whilst 40% considered they had a strong knowledgebase in conducting research. However, only a quarter of respondents indicated that they should undertake research in their role. Barriers to undertaking research included recognition, organisational support and time.

DISCUSSION

The findings from this study reflected other studies within clinical workforces. The lack of recognition and support to incorporate research into practitioner roles has implications for the profession and its body of knowledge.

CONCLUSION

Advocating for research to be incorporated into practitioner roles is required to inform knowledge and practice. Increased professional development opportunities may create a stronger research culture within the HIM profession in Australia and strengthen the position of the profession within health.

Effects of Spirulina supplementation on obesity: A systematic review and meta-analysis of randomized clinical trials

OBJECTIVE

Evidence has suggested that Spirulina supplementation may affect anthropometric indices. Therefore, a systematic review and meta-analysis was performed to summarize published randomized clinical trials which assess the effect of Spirulina supplementation on obesity.

SETTING

Pertinent studies were identified using Embase, Scopus, ISI Web of Science, PubMed and Cochrane library databases up to May 2019. Mean Differences (MD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods.

RESULTS

Results of 5 studies (7 treatment arms) showed a significant reduction in weight (MD: -1.56 Kg, 95% CI: -1.98 to -1.14) after Spirulina supplementation. Subgroup analysis based on health status revealed that weight change in obese subjects (MD: -2.06 Kg, 95% CI: -2.45 to -1.68) was greater than overweight participants (MD: -1.28 Kg, 95% CI: -1.62 to -0.93) following Spirulina supplementation. Also, pooled analysis showed that Spirulina supplementation led to a significant reduction in body fat percent (MD: -1.02, 95% CI: -1.49 to -0.54) and waist circumference (MD: -1.40, 95% CI: -1.40 to -1.39), but not in body mass index and waist to hip ratio.

CONCLUSION

Spirulina supplementation significantly reduces body weight, especially in obese individuals.

Caught between a rock and a hard place: An intrinsic single case study of nurse researchers' experiences of the presence of a nursing research culture in clinical practice

AIMS AND OBJECTIVES

To explore how nurse researchers in clinical positions experience the presence of a nursing research culture in clinical practice.

BACKGROUND

Higher demands in the hospitals for increasing the quality of patient care engender a higher demand for the skills of health professionals and evidence-based practice. However, the utilisation of nursing research in clinical practice is still limited.

DESIGN

Intrinsic single case study design underlined by a constructivist perspective.

METHODS

Data were produced through a focus group interview with seven nurse researchers employed in clinical practice in two university hospitals in Zealand, Denmark, to capture the intrinsic aspects of the concept of nursing research culture in the context of clinical practice. A thematic analysis was conducted based on Braun and Clarke's theoretical guideline.

RESULTS

"Caught between a rock and a hard place" was constructed as the main theme describing how nurse researchers in clinical positions experience the presence of a nursing research culture in clinical practice. The main theme was supported by three subthemes: Minimal academic tradition affects nursing research; Minimal recognition from physicians affects nursing research; and Moving towards a research culture.

CONCLUSIONS

The nurse researchers in this study did not experience the presence of a nursing research culture in clinical practice, however; they called for more attention on removing barriers against research utilisation, promotion of applied research and interdisciplinary research collaboration, and passionate management support.

RELEVANCE TO CLINICAL PRACTICE

The results of this case study show the pressure which nurse researchers employed in clinical practice are exposed to, and give examples on how to accommodate the further development of a nursing research culture in clinical practice.

Moving beyond 'not enough time': factors influencing paediatric clinicians' participation in research

BACKGROUND

Increasing the amount of clinical research that occurs in healthcare settings has been identified as an important mechanism to improve healthcare outcomes. While clinicians are key persons in achieving this aim, research participation amongst clinicians is generally limited.

AIMS

To identify the factors (barriers and facilitators) influencing clinician research participation and determine how professional culture impacts on these factors.

METHODS

Forty clinicians working at a tertiary children's hospital participated in six discipline-specific focus groups. Thematic analysis was performed using an inductive process based in grounded theory.

RESULTS

Four major themes (cultural factors, personal factors, resources and solutions) and 16 subthemes were identified. Participants described how the current health system discourages clinician research. They reported that their research participation requires personal sacrifice of their own time; income or career progression. Research participation was seen to compete with other priorities in clinicians' workload and is disadvantaged because of the primacy of clinical work and the lack of immediate tangible benefit from research projects. Solutions suggested by our participants included better alignment of clinical and research goals, improved availability of research mentors and collaborative opportunities. Nurses and allied health professionals reported a changing professional culture that values research. Only doctors identified research participation to be important for career progression.

CONCLUSIONS

For clinician research participation to flourish, significant changes in healthcare structure and priorities will be required that result in research becoming more embedded in healthcare delivery. Initiatives to improve collaboration between clinicians and universities may also support these aims.

Ground-up-top down: a mixed method action research study aimed at normalising research in practice for nurses and midwives

Background

Improving health, patient and system outcomes through a practice-based research agenda requires infrastructural supports, leadership and capacity building approaches, at both the individual and organisational levels. Embedding research as normal nursing and midwifery practice requires a flexible approach that is responsive to the diverse clinical contexts within which care is delivered and the variable research skills and interest of clinicians. This paper reports the study protocol for research being undertaken in a Local Health District (LHD) in New South Wales (NSW) Australia. The study aims to evaluate existing nursing and midwifery research activity, culture, capacity and capability across the LHD. This information, in addition to input from key stakeholders will be used to develop a responsive, productive and sustainable research capacity building framework aimed at enculturating practice-based research activities within and across diverse clinical settings of the LHD.

Methods

A three-phased, sequential mixed-methods action research design underpinned by Normalization Process Theory (NPT).

Participants will be nursing and midwifery clinicians and managers across rural and metropolitan services. A combination of survey, focus group, individual interviews and peer supported action-learning groups will be used to gather data. Quantitative data will be analysed using descriptive statistics, correlation and regression, together with thematic analysis of qualitative data to produce an integrated report.

Discussion

Understanding the current research activity and capacity of nurses and midwives, together with organisational supports and culture is essential to developing a productive and sustainable research environment. However, knowledge alone will not bring about change. This study will move beyond description of barriers to research participation for nurses and midwives and the promulgation of various capacity building frameworks to employ a theory driven action-oriented approach to normalisation of nursing and midwifery research practice. In doing so, our aim is to make possible the utilisation, generation and translation of practice based research that informs improved patient and service delivery outcomes.

Electronic supplementary material

The online version of this article (10.1186/s12912-017-0249-8) contains supplementary material, which is available to authorized users.

Describing the implementation of an innovative intervention and evaluating its effectiveness in increasing research capacity of advanced clinical nurses: using the consolidated framework for implementation research

Background

Despite advanced nursing roles having a research competency, participation in research is low. There are many barriers to participation in research and few interventions have been developed to address these. This paper aims to describe the implementation of an intervention to increase research participation in advanced clinical nursing roles and evaluate its effectiveness.

Methods

The implementation of the intervention was carried out within one hospital site. The evaluation utilised a mixed methods design and a implementation science framework. All staff in advanced nursing roles were invited to take part, all those who were interested and had a project in mind could volunteer to participate in the intervention. The intervention consisted of the development of small research groups working on projects developed by the nurse participant/s and supported by an academic and a research fellow. The main evaluation was through focus groups. Output was analysed using thematic analysis. In addition, a survey questionnaire was circulated to all participants to ascertain their self-reported research skills before and after the intervention. The results of the survey were analysed using descriptive statistics. Finally an inventory of research outputs was collated.

Results

In the first year, twelve new clinical nurse-led research projects were conducted and reported in six peer reviewed papers, two non-peer reviewed papers and 20 conference presentations. The main strengths of the intervention were its promptness to complete research, to publish and to showcase clinical innovations. Main barriers identified were time, appropriate support from academics and from peers. The majority of participants had increased experience at scientific writing and data analysis.

Conclusion

This study shows that an intervention, with minor financial resources; a top down approach; support of a hands on research fellow; peer collaboration with academics; strong clinical ownership by the clinical nurse researcher; experiential learning opportunities; focused and with needs based educational sessions, is an intervention that can both increase research outputs and capacity of clinically based nurses. Interventions to further enhance nursing research and their evaluation are crucial if we are to address the deficit of nurse-led patient-centred research in the literature.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-017-0214-6) contains supplementary material, which is available to authorized users.

Recruitment for a hospital-based pragmatic clinical trial using volunteer nurses and students

BACKGROUND/AIMS

Recruitment of subjects is critical to the success of any clinical trial, but achieving this goal can be a challenging endeavor. Volunteer nurse and student enrollers are potentially an important source of recruiters for hospital-based trials; however, little is known of either the efficacy or cost of these types of enrollers. We assessed volunteer clinical nurses and health science students in their rates of enrolling family members in a hospital-based, pragmatic clinical trial of cardiopulmonary resuscitation education, and their ability to achieve target recruitment goals. We hypothesized that students would have a higher enrollment rate and are more cost-effective compared to nurses.

METHODS

Volunteer nurses and student enrollers were recruited from eight institutions. Participating nurses were primarily bedside nurses or nurse educators while students were pre-medical, pre-nursing, and pre-health students at local universities. We recorded the frequency of enrollees recruited into the clinical trial by each enroller. Enrollers' impressions of recruitment were assessed using mixed-methods surveys. Cost was estimated based on enrollment data. Overall enrollment data were analyzed using descriptive statistics and generalized estimating equations.

RESULTS

From February 2012 to November 2014, 260 hospital personnel (167 nurses and 93 students) enrolled 1493 cardiac patients' family members, achieving target recruitment goals. Of those recruited, 822 (55%) were by nurses, while 671 (45%) were by students. Overall, students enrolled 5.44 (95% confidence interval (CI): 2.88, 10.27) more subjects per month than nurses (p < 0.01). After consenting to participate in recruitment, students had a 2.85 (95% CI: 1.09, 7.43) increased chance of enrolling at least one family member (p = 0.03). Among those who enrolled at least one subject, nurses enrolled a mean of 0.51(95% CI: 0.42, 0.59) subjects monthly, while students enrolled 1.63 (95% CI: 1.37, 1.90) per month (p < 0.01). Of 198 surveyed hospital personnel (127 nurses, 71 students), 168/198 (85%) felt confident conducting enrollment. The variable cost per enrollee recruited was $25.38 per subject for nurses and $23.30 per subject for students.

CONCLUSIONS

Overall, volunteer students enrolled more subjects per month at a lower cost than nurses. This work suggests that recruitment goals for a pragmatic clinical trial can be successfully obtained using both nurses and students.

Nurses' Research Capacity, Use of Evidence, and Research Productivity in Acute Care: Year 1 Findings From a Partnership Study

OBJECTIVE

The aim of this study was to compare baseline and year 1 findings from a research-focused academic-service partnership (ASP) designed to increase research capacity, evidence-based practice (EBP) use, and research productivity.

BACKGROUND

Few combined individual and organizational best practices could be found that successfully sustain EBP. An ASP model, using structural and enabling processes, was evaluated.

METHODS

Using a nonexperimental pretest-posttest design, 67 acute care nurses who participated at baseline were resurveyed, and year 1 focus groups were conducted.

RESULTS

Knowledge increased from baseline to year 1, and nurses who participated on a committee with an embedded scientist were more knowledgeable at year 1 than those who did not. While EBP confidence and self-reported EBP use did not improve, research productivity increased 33%. Year 1 focus groups identified facilitators and barriers.

CONCLUSION

Findings support some EBP benefits related to a research-focused ASP including research productivity; however, implementation barriers and contextual factors may have limited potential outcomes.

The effects of collaborative research-based programming on public health nurses and their practice

The study aim was to evaluate a collaborative research-based program for public health nurses. The program was initiated by a college of nursing to address public health issues. Participants were 33 public health nurses who completed a questionnaire survey; data for 25 respondents were analyzed both quantitatively and qualitatively. To understand the experiences of nurses in depth, three group interviews were conducted with 14 nurses. Qualitative analysis revealed three major themes: (i) opportunities for learning from collaboration; (ii) developing competence of changes in practice; and (iii) openness to continuing practice improvement. Study participants reported practical changes and new openness to continued practice improvement. Thus, schools of nursing and public health nurses should welcome and invite opportunities to collaborate to address practice issues using research-based information. Because changing practice can only occur step by step, nursing educators and practitioners should cultivate an environment that expands professional development and addresses practice improvement.

Strategies to successfully recruit and engage clinical nurses as participants in qualitative clinical research

BACKGROUND

Research conducted in the clinical area promotes the delivery of evidence-based patient care. Involving nurses as participants in research is considered essential to link patient care with evidence-based interventions. However recruitment is influenced by nurses' competing demands and understanding engagement strategies may assist future research.

AIM

This reflective analysis aimed to understand influencing factors and strategies that support successful recruitment nurses in clinical research.

METHOD

A reflective analysis of research notes and focus group data from research with oncology nurses was completed.

RESULTS

This research identified that gaining support from key staff, understanding work constraints and developing a rapport with nurses is important. Establishing clear relevance and benefits of the research and being flexible with research requirements enabled nurses to participate in the research.

CONCLUSION

Clear information and a willingness to accommodate the demands and dynamic nature of the environment, ensures ongoing support and engagement of nurses in the clinical setting as participants in research.

Embedding research in clinical practice: differences in attitudes to research participation among clinicians in a tertiary teaching hospital

Despite a drive to increase research in healthcare settings, clinician participation in research remains infrequent. This paper describes an online survey comparing attitudes with research participation among clinicians (doctors, nurses and allied health professionals) at an Australian tertiary children's hospital. Differences between professional groups support the existence of different professional cultures surrounding research, suggesting that multiple strategies are required to improve participation in research.

Building the research capacity of clinical physical therapists using a participatory action research approach

BACKGROUND

This 2-year study explored the experiences of clinical physical therapists who used a participatory action research (PAR) approach to learn about the practice of clinical research.

OBJECTIVES

The aim of this study was to explore the experiences of physical therapists who were conducting clinical research, facilitated by a PAR approach.

DESIGN

A mixed-methods research design was used.

METHODS

Physical therapists completed questionnaires, were interviewed, and participated in focus groups prior to and after the 1-year intervention and 1 year later. The research facilitator took field notes. Questionnaire data were analyzed descriptively, and themes were developed from the qualitative data. Twenty-five therapists took part in 4 self-selected groups.

RESULTS

Three groups actively participated in the PAR research projects (n=14). The remaining 11 therapists decided not to be involved in clinical research projects but took part in the study as participants. After 1 year, one group completed the data collection phase of their research project, and a second group completed their ethics application. The third group ceased their research project but hosted a journal club session. At completion of the study, the experiences of the physical therapists were positive, and their confidence in conducting research and orientation toward research had increased. The perceptions of physical therapists toward research, relationships among individuals, and how the clinical projects were structured influenced the success of the projects.

LIMITATIONS

Only physical therapists of one hospital and no other health care practitioners were included in this study.

CONCLUSIONS

Fourteen physical therapists divided among 3 PAR groups were overall positive about their experiences when they conducted a research project together. This finding shows that a PAR approach can be used as a novel tool to stimulate research participation in clinics.

Strategies from bedside nurse perspectives in conducting evidence-based practice projects to improve care

This article presents the bedside nurses' perspectives on their experience with conducting an evidence based practice project. This is especially important in the climate of hospitals working to achieve Magnet Recognition. The facilitators and barriers to project design and completion are discussed in detail. Strategies to overcome barriers are presented. Facilitators for bedside nurses include motivation and professional development. Most common barriers were lack of time and limited knowledge about the process. Interventions aimed at research utilization can be successful when mindful of commonly understood barriers to project completion with steps taken to resolve those barriers.

Clinical nurses' attitudes towards research, management and organisational resources in a university hospital: part 1

AIM

The aim of this study was to determine clinical nurses' interest in and motivation for research. An additional aim was to identify management and organisational resources in order to improve nurses' research capacity in practice.

BACKGROUND

Clinical nurses find conducting research challenging, which accords with observations of the continuing research-practice gap.

METHODS

This descriptive cross-sectional survey sampled 364 clinical nurses from a university hospital on the west coast of Norway.

RESULTS

The response rate was 61%. An increasingly positive attitude towards research emerged (40%), despite the fact that few were engaged in research-based activities. Clinical nurses emphasised that lack of designated time (60%), interest (31%) and knowledge (31%) constituted important research barriers, as did lack of research supervision and support (25%). Research supervision was one of the most significant needs to enhance clinical nurses' research skills, management and organisation of research activities (30%).

CONCLUSION

Conscious efforts strategically built on clinical and academic collaborative networks are required to promote and sustain clinical nurses' research capacity.

IMPLICATION FOR NURSING MANAGEMENT

The findings of this survey should be useful in the building of clinical nurses' research capacity.

Overcoming challenges for nurse-led research in the neonatal intensive care unit

Nurse researchers have made considerable contributions to the science of nursing. Conducting studies in the clinical environment is the best way to determine what interventions are most effective. Because most research is conducted by nurses from academic settings, they often are not viewed as credible by nurses in clinical practice, nor are they accepted readily into the neonatal intensive care unit (NICU) to conduct research. This article addresses the barriers to implementing and conducting studies in the NICU setting, and provides suggestions for creating collaborative and mutually satisfying relationships between nurse researchers and healthcare staff in the NICU. Partnerships built on mutual respect are necessary to have successful research outcomes, and to continue to build knowledge for the best neonatal care.

Putting the "evidence" in evidence-based practice: meeting research challenges in community psychiatric settings

Every psychiatric client deserves access to treatments that have evidence of efficacy, but in psychiatric nursing, this evidence remains sparse. To address this deficit, researchers must commit to conducting high quality, community-based psychiatric nursing intervention investigations. In service of this goal, the authors draw upon their research experiences in community psychiatric settings to suggest options for overcoming system-, clinician-, and client-related research barriers in community psychiatric settings.