ABSTRACT
Pediatric medicine often struggles to receive adequate research funding for its small, yet vulnerable population of patients. Remarkable discovery in pediatric oncology is credited in large part to the collaborative structure of its research community. The Children's Oncology Group conducts studies supported by the National Cancer Institute. The clinical research associate (CRA) discipline comprises professionals who support administrative duties, regulatory duties, subject management, and data collection at individual research sites. The purpose of this study was to identify factors associated with CRA retention, as the group continues to have high turnover and position vacancy. A cross-sectional survey design was used to characterize the most frequently cited reasons CRAs gave when considering leaving or staying within their position. Results suggest that low salary, unmanageable workload, lack of career advancement and professional development, and lack of research commitment from the medical team were associated with intent to leave CRA positions. The most frequently cited reasons for staying at their job were the meaningfulness and interest in the work, a supportive principal investigator, and enjoyment working with colleagues. CRAs reported serious but eminently solvable issues that can be addressed using practical and low-cost solutions to improve job satisfaction and retention.
Subject(s)
Job Satisfaction , Nursing Research/organization & administration , Nursing Staff, Hospital/psychology , Nursing Staff, Hospital/statistics & numerical data , Oncology Nursing/organization & administration , Pediatric Nursing/organization & administration , Personnel Turnover/statistics & numerical data , Adolescent , Adult , Child , Child, Preschool , Clinical Trials as Topic , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
BACKGROUND: Diaper dermatitis is one of the most common skin problems in children often caused by irritants that promote skin breakdown, such as moisture and faecal enzymes. It has been estimated that the incidence of diaper dermatitis is as high as 50% in children receiving chemotherapy. The scientific literature suggests a variety of preventative measures, but only a minority are systematically tested and supported by clinical evidence. AIM: The purpose of this paper is to adapt and implement a skincare guideline to better prevent diaper dermatitis in the paediatric oncology population. METHODS: The Knowledge to Action process was used to guide the adaptation and implementation of the new guideline. As part of this process, different tools were used to identify and review selected knowledge (Appraisal of Guidelines Research Evaluation instrument), to tailor and adapt knowledge to the local context (ADAPTE process), to implement interventions (Registered Nurses' Association of Ontario toolkit) and to evaluate outcomes (qualitative analysis). The main outcomes measured included implementation of the guideline and nursing practice change. RESULTS: The guideline was successfully implemented as reported by nurses in focus group sessions and as measured by changes in nursing documentation. CONCLUSION: The implementation of the guideline was successful on the account of the interplay of three core elements: The level and nature of the evidence; the context in which the research was placed; the method in which the process was facilitated.
