Gender as a principle of the organization of clinical sleep research.

In 2014 the National Institutes of Health required researchers to examine sex as a biological variable. While this approach is necessary to ensure adequate and appropriate female inclusion in research studies, it puts researchers at high risk for attributing their findings to biological sex differences when instead they may be more appropriately attributed to the influence and expectations of gender. In this paper, we specify how gender works as a principle of the social organization of symptoms, experiences, research, and clinical practice using obstructive sleep apnea symptomology to illustrate these patterns. We draw from psychologist Sandra Bem's account differentiating three specific mechanisms of gender: gender polarization, androcentrism, and biological essentialism.

Action research: A mechanism for active engagement of clinical nurses in a program of research.

This study aimed to explore the outcomes of active participation in an action research project on building the research capacity of clinical nurses. In this qualitative research study, six registered nurses volunteered to participate in the action research team. None of the nurses reported having any prior research experience. This study was part of a larger three-phase project. The nurses were required to reflect on the data about their medication practice of phase 1, develop and implement a bundle of interventions in phase 2 to improve medication safety, and evaluate the effectiveness of these interventions in phase 3. We report the nurses' participation in Action Research during phase 2. Meeting minutes and six semistructured interviews were thematically analyzed. The results showed that after receiving support to enhance their research skills from the research team, the nurses were empowered to perform and lead clinical nursing research project. Nurses were able to take ownership of the research process and outcomes and were then able to translate their new research knowledge and skills into their clinical practice by building their own research capacity.

Guidance for the Reporting of an Intervention's Theory.

BACKGROUND: Interventions in clinical trials should be clearly and completely described to inform their evaluation in replication studies and implementation in clinical practice. Guidelines were developed to standardize the reporting of interventions, but failed to provide guidance on reporting of the theory of interventions. Further, space constraints imposed by many research journals often limit the comprehensive description of both the theoretical and operational aspects of interventions. PURPOSE: To address these gaps, we propose that the theory of interventions be published in separate conceptual papers that would provide an in-depth description of the health problem targeted by an intervention, the components comprising an intervention, the causal mechanism responsible for an intervention's impact on the outcomes, and the conditions necessary for the proper implementation and the effectiveness of an intervention. IMPLICATIONS: Such papers would assist in the critical appraisal of the adequacy, implementation, and evaluation of interventions. A description of the theory of interventions clarifies to health professionals what the interventions are about, who is likely to benefit from the interventions, how the interventions work and under what context.

Clinical research nurses' expectations and realities of their role: A qualitative evidence synthesis.

AIMS: To synthesise the available body of qualitative studies relating to clinical research nurses' experiences of their role. METHODS: A systematic search of the literature in five databases was undertaken: CINAHL, MEDLINE, EMBASE, PubMed and ProQuest. Thomas and Harden's three-stage approach to thematic analysis was followed using the ENTREQ statement for reporting. RESULTS: Nineteen studies reported in 20 papers (with a total of 232 nurses) were included in the synthesis. Three analytical themes with six subthemes were identified as follows: "identity"; "meeting targets"; and "patient advocate." CONCLUSIONS: Clinical research nurses experience isolation, and contributing to this is their perception of nonresearch nurses' lack of understanding for their role. This can result in difficulties when recruiting study participants. Clinical research nurses can experience internal conflict between being a patient advocate and adhering to a trial protocol. RELEVANCE TO CLINICAL PRACTICE: Training is needed to help research nurses develop skills to face challenges in order to ensure safe and ethical care is provided to research participants while also ensuring high-quality data collected for the study.

Factores facilitadores y obstaculizadores para la investigación de enfermeras clínicas en Santiago de Chile / Facilitating factors and barriers for clinical research by nurses in Santiago, Chile

INTRODUCCIÓN: La investigación científica en enfermería aporta al conocimiento que sustenta el quehacer profesional y la autonomía de la profesión, mejora la calidad de atención en la gestión del cuidado del paciente. La literatura ha mostrado escasa producción científica de enfermería en los profesionales que trabajan en el área intrahospitalaria. OBJETIVO: Conocer los factores facilitadores y las barreras que impiden el desarrollo de la investigación científica en el profesional de enfermería. MÉTODO: Investigación descriptiva de corte transversal, los datos se obtuvieron al aplicar un instrumento español ya validado vía on line, aplicado a 71 enfermeras previo consentimiento informado y aprobación del comité de ética. Los datos fueron analizados por SPSS 15.0 y representados en tablas y gráficos. RESULTADOS: El 87,1% de los encuestados mostró una actitud positiva hacia la investigación donde la motivación es importante. Los conocimientos y cursos de posgrados facilitan el investigar, los resultados muestran que solo un 45,7% cree tener conocimientos para investigar y un 80% carece de formación en posgrado. Son barreras importantes a la hora de investigar la carga asistencial en un 65,7% y el no disponer del tiempo suficiente, 72,9%. CONCLUSIONES: Los factores facilitadores y obstaculizadores para la investigación de enfermería son similares a los reportados en otras publicaciones. Identificarlos y corregirlos permitiría formar profesionales más motivados y críticos, insertos en estructuras organizacionales y administrativas que los apoyen, permitiendo que la investigación sea la plataforma para que enfermería pueda contribuir a la calidad y gestión en el cuidado de los pacientes

INTRODUCTION: Scientific research by nurses provides new knowledge that is helpful for the professional autonomy, as well as improving the quality of patient care. It has been demonstrated in the literature that clinical nurses have minimal participation in scientific research. OBJECTIVE: To recognise the factors that facilitate or make it difficult to conduct scientific research in the clinical nurse community. METHOD: A cross-sectional descriptive study was conducted on a cohort of 71 clinical nurses, by applying a validated on-line questionnaire, after informed consent and Ethics Committee approval was obtained. Data results were analysed using SPSS 15.0 and presented with graphs and tables. RESULTS: The large majority (87.1%) of those surveyed had a positive attitude towards research, and motivation was the key factor to initiate it. The level of knowledge and the post-graduate degrees facilitated research projects. Only 45.7% believed that they had sufficient knowledge to perform research, and 80% of clinical nurses do not have advanced degrees. Important barriers for starting research are health care burden (65.7%), and not having enough time (72.9%). CONCLUSIONS: The factors that facilitate or make it difficult for research by nurses are similar to those reported in others studies. To recognise and fix them could lead to educating more critical and motivated nurses, with administrative and organisational structures that support and motivate them to perform research, as well as providing a nursing research database in order to contribute to the quality of care for patients

Holistic nursing competence scale: Turkish translation and psychometric testing.

AIM: This study aimed to culturally adapt and evaluate the reliability and validity of the Holistic Nursing Competence Scale for application in the Turkish context. BACKGROUND: Nurses are expected to assess well-being of individuals by considering physical, social, psychological, cultural and spiritual dimensions to enhance adaptation to diseases. In Turkey, no tools have been developed to date for the evaluation of competencies in holistic nursing in the country. METHODS: The study was conducted with 288 nurses working in two hospitals in Ankara equipped with over 500 beds. A confirmatory factor analysis was performed in order to identify whether the items and the sub-dimensions of the adapted scale complied with the original structure comprising 36 items and five sub-scales, namely 'general aptitude', 'staff education and management', 'ethically oriented practice', 'nursing care in a team' and 'professional development'. Cronbach's alpha value was used as an estimate for reliability analysis. RESULTS: Opinions of 11 experts were obtained for content validation of the scale, and the content validity index was 0.90. The adaptation was observed to be acceptable on the basis of structural equation model fit indices in confirmatory factor analysis. Cronbach's alpha value was estimated to be 0.97 and 0.90, respectively, for the complete scale. CONCLUSION: The study identified the Turkish version of Holistic Nursing Competence Scale as a valid and reliable tool for the evaluation of competence in holistic nursing among nurses. IMPLICATIONS FOR NURSING AND NURSING POLICY: The instrument may now be utilized as a tool of measurement in nursing practice, as well as in education and research, for identifying the level of competence in the holistic nursing practices among the nurses in Turkey.

Intensive care nurses' perceptions of various ethics concerns affecting clinical research.

BACKGROUND: Intensive-care unit (ICU) nurses have an important role in the recruitment of patients for scientific research and in the performance of clinical research. AIM: A study was conducted to examine ICU nurses' perceptions of ethics-related aspects of ICU-based research. The study focused on nurse attitudes and knowledge related to clinical research, with special emphasis on perceptions of the informed-consent process in ICU research. METHOD: The study applied a descriptive qualitative approach, involving semi-structured group interviews and theme-based inductive content analysis. Subjects were ICU nurses (n = 28) at a university hospital ICU who had experience with research protocols applied in that unit. FINDINGS: The nurses had mainly positive perceptions of clinical studies. They found research beneficial for future patients and for society. The nurses considered the information given to them about the studies inadequate. They were concerned about the fact that the consent for research is almost always obtained at the beginning of the ICU care, when patients and relatives are still in the crisis period. This limits the possibility of understanding and assimilating the information provided on the study. CONCLUSIONS: The role of ICU nurses in clinical studies should be more prominent and taken into account in the planning of ICU studies.

A Clinical Practice Perspective on Publishing in Oncology Nursing.

OBJECTIVE: To describe how clinical problems and observations can generate ideas for writing for publication. DATA SOURCES: Journal articles, publishers' information for authors, online publishing resources, personal experience. CONCLUSION: Ideas for publishable manuscripts can be generated from clinical practice dilemmas, patient or nursing outcome data, and reading professional materials or attendance at professional meetings. Publishing opportunities for novice writers include case reports, letters to editors, abstracts for professional conferences, and articles in a variety of newsletters and journals. IMPLICATIONS FOR NURSING PRACTICE: Nurses working in clinical practice settings have a wealth of opportunities for identifying topics suitable for publication.

Practical Tips for Facilitating Research in Clinical Nursing Practice.

Nursing research improves patient care, and clinical nurses have unique leadership perspectives regarding patient care and institutional needs. Clinical nurses involved in research are curious, are innovative, and implement the best practices. Many clinical nurses report lack of understanding of the research process, time, and institutional support as barriers to their involvement in research. This article presents practical strategies to encourage clinical nurses to develop and use research skills. J Contin Educ Nurs. 2018;49(7):294-296.

Research nurses contributions to research practice: an oncology nursing experience in Brazil

Background: The creation and evolution of research nurse, connected with some specialty, brings a new path to be covered and structured inside nursering. The position of Researcher Nurse was initially created decentralized only one Department. In past the years and after the role of work was being consolidating. This paper describes the creations and evolution of Research Nurses in the scene an Oncology Research Practice at a Cancer Center. Methods: Behind of a timeline description the information that in 10 years give us the number of participant departments increased, with an increase of the scientific production, besides the construction of the position of Research Nurses. Results: Throughout these years, integration and interdepartmental action were developed, with a role and seat in Biobanco, Ethics Committee in Research, Operative Systems of medical Informatics, as well as participation in multicentric, institutional projects within the Brazilian and world Oncology. Conclusions: The role of Research Nurses being

Supporting Clinical Nurses Through a Research Fellowship.

After reviewing the literature, nurses at the bedside seeking answers to clinical questions may find their inquiries remain unanswered. This article describes the yearlong Research Fellows Program in which candidates, funded for 12 hours per month of research release time, answered formal research questions in a curriculum designed to provide the skills to complete their study. Five have completed their studies; 1 has received a grant to continue. Two are in process of submitting manuscripts to journals.

[Realist evaluation for implementation research]. / Évaluation réaliste pour la recherche en implémentation.

The realist approach to evaluation can be useful faced with the complexity of health interventions in populations. Implementation is the process by which these interventions are put into practice. Scientific realism can provide an important contribution to the development of programme theories through implementation research, and help to reveal the distal and proximal mechanisms of programmes aimed at combatting social inequalities in healthcare.

Academic-Practice Partnerships: Driving and Supporting Educational Changes.

The 3 recognized missions of academic nursing-education, practice, and research-are not new. Yet, the continued separation of nursing education and service, with a lack of integration between schools of nursing and clinical practice, continues to be discussed as contributing to academic programs that produce graduates unready for clinical practice, research that does not adequately support clinical care needs, and isolation of both the nurse faculty from the clinical enterprise and clinicians from the education and research missions. Recently, academic-practice partnerships have been reemphasized as a concept and mechanism for supporting changes in nursing education and improving clinical care. This article highlights some of the driving forces behind the focus on academic-practice partnerships and summarizes 3 changes in education.

Educational Changes to Support Advanced Practice Nursing Education.

Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system.

Fostering Clinical Nurse Research in a Hospital Context.

Two components of the Magnet Recognition Program® are exemplary professional practice and the generation of new knowledge through research and clinical innovation. Within Magnet® institutions, exemplary professional practice is evidenced by collaboration. Hospitals and schools of nursing can develop collaborative relationships to promote a culture of inquiry in clinical care and generate research to advance nursing practice and nursing science. The authors describe a collaborative model between clinical nurses and an academic nursing research center that promotes involvement of clinical nurses in research.

Barreras internas de la organización en la implementación de la figura de la enfermera de práctia avanzada / Internal organizational barriers to implement the role of the advanced nurse practitioner

Introducción. El contexto sociosanitario está experimentando un proceso de transformación. Estos cambios hacen emerger roles enfermeros innovadores como la enfermera de práctica avanzada, formada para responder a las complejidades de la sociedad. Objetivo. Identificación de las principales barreras internas de la organización que dificultan el proceso de implementación de la figura de la enfermera de práctica avanzada. Se han identificado: «ambigüedad del rol», «barreras a nivel organizacional» y «factor humano». El conocimiento de estas barreras permite prevenir y fomentar una buena implementación del nuevo rol en la organización sanitaria. Conclusiones. La evolución del contexto hospitalario requiere de roles enfermeros de práctica avanzada. En el proceso de su implementación se identifican tres barreras internas a la organización que lo obstaculizan. Una reforma en la educación de Enfermería y en su ámbito laboral deberá incluir la práctica avanzada. La implementación del rol se logrará cuando la profesión pueda articular y describir la esencia y las características de este (AU)

Introduction. Nowadays the socio-sanitary context is experiencing a transformation process. These changes provoke the emergence of innovative nurses’ roles, such as the advanced nurse practitioner, with specific preparation and attributes adequate to give answers to a more complex society. Objective. We study the main internal organizational barriers that hinder the implementation process of the advanced nurse practitioner. We identify three of them: «ambiguity of the role», «organizational barriers» and «human factor». A better understanding of these barriers is essential to prevent them as well as to encourage an appropriate implementation of the new role in the health organization. Conclusions. The evolution of the hospital setting requires innovative nurses’roles, such as the advanced nurse practitioner. In its implementation process we identify three internal organizational barriers that hinder such process. A nursing education reform as well as a labor reform at the workplace level should include the advanced practice. The implementation of this new role will be achieved once the profession can articulate and describe its core and features (AU)