1 Nurse Researcher or Clinical Research Nurse: Understanding the Difference Claudia D. Smith, PhD, RN, NE-BC Director, Nursing Research St. Luke s Medical Center
2 An Alternate Title for the Presentation: Differentiating the Roles of the Nurse Researcher and the Clinical Research Nurse
3 Learner Objectives Discuss the difference between a nurse researcher and a clinical research nurse. Compare responsibilities of nurse researchers to those of clinical research nurse. Describe importance of each nursing role.
4 Clinical Research Nurse (CRN) Definition: Clinical Research Nurses are staff nurses who have a central focus on care of research participants. They support study implementation within the context of a care delivery setting, or specialty care programs with a clinical research focus. 1
5 Domain of CRNs Care provided to research participants Support protocol implementation Support data collection Ensure human subject protection 1
6 Dimensions of CRN Domain Domain Dimensions of CRN Clinical practice Human Subjects protection Contributing to the Science Care Coordination and Continuity Study Management
7 Clinical Practice Dimension Overview: Using the nursing process, provide direct nursing care and support to research participants, their families, and significant others. Care requirements are determined by: scope of study participation clinical condition of the patient requirements and clinical effects of research procedures
8 Clinical Practice Dimension 1. Provide direct nursing care 2. Provide teaching to participants and family 3. Monitor participant and report potential adverse events 4. Record data in approved source document 1
9 Study Management Dimension Overview: Manage clinical and research support activities in order to assure patient safety, address clinical needs and assure protocol integrity, and accurate data collection. 1. Participate in study development 2. Participate in participant recruitment 3. Participate in eligibility screening 4. Coordinate & facilitate specimen collection
10 Study Management Dimension 5. Develop education materials 6. Perform QA to assure data integrity 7. Participate in report preparation for regulatory/monitoring agencies 8. Facilitate communication among sites 9. Facilitate communication among team 10. Contribute to development of case report forms 11. Participate in database development 12. Comply with national guidelines
11 Study Management Dimension 13. Collect data based on study endpoints 14. Facilitate scheduling & coordination of study procedures 15. Provide nursing expertise to team 16. Protect confidentiality of participant data 17. Participate in site/audit visits 18. Support grant & budget development 19. Oversee study personnel 20. Record data on approved documents
12 Study Management Dimension 21. Facilitate processing & handling of research specimens 22. Identify clinical care implications during study development 23. Participate in the identification and reporting of research trends 1
13 Care Coordination & Continuity Dimension Overview: Coordinate research and clinical activities to meet clinical needs, complete study requirements and manage linkage with referring and primary care providers. 1. Facilitate education of team on study requirements 2. Collaborate with team to create & communicate plan of care for safe & effective collection of data
14 Care Coordination & Continuity Dimension 3. Coordinate participant study visits 4. Provide nursing leadership on the team 5. Coordinate meeting and activities in the context of the study 6. Coordinate referrals to appropriate interdisciplinary services outside immediate team 7. Communicate impact of study procedures on research participants
15 Care Coordination & Continuity Dimension 8. Provide nursing expertise to communitybased health care personnel related to study participation 9. Facilitate participant questions and concerns 10. Provide indirect nursing care in the context of research participation 1
16 Human Subjects Protection Dimension Overview: Facilitate informed participation by diverse participants in research. 1. Facilitate initial and ongoing informed consent process. 2. Support participant in defining his/her reasons and goals for participating. 3. Collaborate with interdisciplinary team to address ethical concerns.
17 Human Subjects Protection Dimension 4. Coordinate research activities to minimize subject risk. 5. Serve as Institutional Review Board (IRB) member. 6. Manage their own potential ethical and financial conflicts of interest. 1
18 Research Nurse Coordinators (RNC) Definition: Research Nurse Coordinators are nurses primarily responsible for study coordination and data management, with a central focus on managing subject recruitment and enrollment, consistency of study implementation, data management and integrity, and compliance with regulatory requirements and reporting. 1 Usually manage more than one study at a time.
19 Research Nurse Coordinators (RNC) Practice roles Clinical data coordinator Clinical research assistant Clinical research monitor Research assistant Involves all aspects of working with pharmaceutical/medical/nursing research 1
20 Nurse Researcher Definition: Nurse researcher is a registered nurse with advanced education and training in the conduct of research. A Nurse Researcher is a scientist who conducts research that specifically improves the field of nursing. The nurse researcher identifies research questions, designs and conducts scientific studies, collects and analyzes data, and reports their findings. 2, 3
21 Nurse Researcher Definition: Nurse researcher is a registered nurse with advanced education and training in the conduct of research. A Nurse Researcher is a scientist who conducts research that specifically improves the field of nursing. The nurse researcher identifies research questions, designs and conducts scientific studies, collects and analyzes data, and reports their findings. 2, 3
22 Nurse Researcher Roles & Responsibilities Often rely on grants to fund their work, which requires writing grant proposals and then meeting certain grant reporting requirements. Often teach in academic or clinical settings Write articles and research reports for nursing, medical, and other professional journals and publications.
23 Nurse Researcher Characteristics: Opportunity to design and conduct groundbreaking studies and projects Drawbacks: Some work is temporary or part time, travel may be required, work can be tedious. Position may rely on availability of grant money. 2 Desirable skills: Strong observation and analytical skills, detail-oriented. Grant writing experience is helpful.
24 Education of Nurse Researchers Research-focused doctorate Pursue intellectual inquiry Conduct independent research to extend knowledge Expected to plan & launch independent program of research Seek support initially Involve others in work Practice-focused doctorate Highest level of nursing practice with ability to translate knowledge into tailored complex clinical interventions to meet health & illness needs Evaluate translation of research into practice Collaborate with scientists on new health policy research opportunities. Focus on evaluation & use of research, not conduct of research 3
25 Nurse Researcher Employers: Pharmaceutical companies, contract research organizations, teaching and university hospitals, educational institutions, temporary technical placement agencies 2, and Magnet designated hospitals. Nurse researchers bring a holistic perspective involving a bio-behavioral, interdisciplinary, and translational approach to science.
26 Differentiating Nursing Research from other Research So, what s the Difference?
27 Research: Biomedical vs. Nursing Biomedical 1. Discovery of disease causation and cure 2. Improve diagnostic and therapeutic modalities 3. Discovery of new devices and pharmaceuticals Nursing 1. Use philosophical and theory-based approaches 2. Behaviors & responses to care 3. Understand & ease symptoms 4. Prevent, delay onset & progression of disease /disability 5. Find effective ways to achieve & sustain optimal health
28 Research: Biomedical vs. Nursing Biomedical 1. Discovery of disease causation and cure 2. Improve diagnostic and therapeutic modalities 3. Discovery of new devices and pharmaceuticals Nursing 6. Promote health and wellbeing thru healthy lifestyles 3 7. Advance quality and excellence in health care 8. Provide scientific basis for practice of nursing 9. Professional socialization & educational processes that prepare nurses & nurse scientists to succeed 5
29 Research: Biomedical vs. Nursing Biomedical 1. Discovery of disease causation and cure 2. Improve diagnostic and therapeutic modalities 3. Discovery of new devices and pharmaceuticals Nursing 10. Improve clinical settings where care is provided Improve physical environment living conditions 12. Social factors socioeconomic position & resources 13. Discrimination factors 14. Availability of social networks 15. Access to & use of various health services
30 Similarities Between Them Both Nursing AND Biomedical Research Committed to rigorous scientific inquiry Provides a significant body of knowledge Shape health policy Impact world-wide health of people
31 Scope of Nursing Research Encompasses a wide scope of scientific inquiry; clinical research, health systems & outcomes research, and nursing education research. Clinical research, based on biological, behavioral, & other types of investigations, provides the scientific basis for the care of individuals across the life span and occurs in any setting where nursing care is provided. Health systems & outcomes research examine the availability, quality, & costs of health care services as well as ways to improve the effectiveness and appropriateness of clinical practice. Nursing education research focuses on how students learn the professional practice and discipline of nursing as well as how to improve educational strategies to prepare clinicians and scientists.
32 The Changing Face of Research Complex health problems need more than a singlediscipline research approaches. Nursing, social science, & biomedical research approaches make unique and independent contributions to the public's health. Interdisciplinary research is an essential characteristic of nursing research because of it s multiple perspectives. Complex problems in human health require interprofessional approaches.
33 The Changing Face of Research Nurses uniquely qualified to lead & participate in interdisciplinary research teams Education includes courses from all health-related disciplines; physiology, pharmacology, psychology, & sociology. Focus on integrating these disciplines in providing comprehensive care. Some diseases are better prevented than treated. Others simply cannot be cured. Suffering and irreversible changes (i.e. aging) are part of the human experience. Health can be far better maintained when it is viewed in the broader context of lifestyle, culture, and socioeconomics.
34 So, Who s Most Important? The Clinical Research Nurse or The Nurse Researcher?
35 Importance: CRN or NR? CRNs and NRs are both important! Both are necessary Different education Different roles Different responsibilities Different perspectives
36 What Questions Do You Have?
37 References 1 CRN 2010 Domain of Practice Committee Building the Foundation for Clinical Research Nursing: Domain of Practice for the Specialty of Clinical Research Nursing National Institutes of Health Clinical Center, Nursing and Patient Care Services. Available at: 2 Nurse Researcher: Overview. Available at: 3 AACN Position Statement on Nursing Research. American Association of Colleges of Nursing. Available at: 4 National Institute of Nursing Research. (2003). Making a Difference, NINR Research Results. Available from: 5 Longest, B.B., Jr. (2002). Health policymaking in the United States (3 rd ed.). Chicago, IL: Health Administration Press. The Association of University Programs in Health Administration/Health Administration Press.
National Institutes of Health Clinical Center Nursing and Patient Care Services Building the Foundation for Clinical Research Nursing DOMAIN OF PRACTICE FOR THE SPECIALTY OF CLINICAL RESEARCH NURSING 9/4/2009
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