Evaluation of the joint nurse scientist role across academia and practice

Exploring the Roles, Functions, and Work Experiences of Nurse Scientists in the Veterans Health Administration

OBJECTIVE

The aim of this project was to describe nurse scientists' roles, functions, and work experiences in the Veterans Health Administration (VHA).

BACKGROUND

Nurse scientists play a critical role in shaping the culture of clinical inquiry and closing the gap between knowledge and practice.

METHODS

A cross-sectional survey was used to collect information on sociodemographics, workload, research, clinical practice, education, and time/effort. Data were examined using descriptive statistics and χ2 analyses.

RESULTS

One hundred forty-four nurse scientists completed the survey. These nurse scientists serve dynamic and critical roles in conducting research, implementing evidence-based practice, and reforming policy. Research effort was limited due to workload and infrastructure constraints. Better research infrastructure was associated with higher research productivity and funding.

CONCLUSIONS

This survey highlights the needs and challenges nurse scientists experience in conducting research and advancing VHA's mission. Given the national shortage of PhD-prepared nurses, long-term strategies are needed to attract, hire, and retain nurse scientists in healthcare systems.

Looking back to move forward: Creating a blueprint for success for nurse scientists in the Veterans Health Administration

AIM

The purpose of this manuscript is to report the findings of a qualitative content analysis of interviews with VA Nurse Scientists about work life experiences, barriers, and facilitators across the enterprise.

BACKGROUND

The VA enterprise is widely variable in terms of size, services, research activity, and budget. For this reason, the roles of nurses with a research-focused doctorate are also quite diverse.

METHODS

We purposively sampled 18 PhD prepared Nurse Scientists based on a variety geographic locations, titles, and years in the field and who conduct research. We conducted semi-structured interviews over the virtual platform, WebEx. Interviews, averaging 1 h in length, were conducted between April and May 2021. We analyzed interviews using deductive and inductive content analysis.

RESULTS

We found five key factors affecting VA Nurse Scientists. Each factor emerged as an important issue influencing whether Nurse Scientists reported being successful, supported, and productive in their research. These include having: 1) mentorship, 2) supportive leadership 3) available resources, 4) respect and understanding from clinical and research colleagues who understand a Nurse Scientist's role in research, and 5) a career pathway.

CONCLUSIONS

VA Nurse Scientists are leaders and innovators who generate evidence to improve health outcomes and promote equity in health and health care of Veterans, their families, and caregivers. Results from this project suggest that many Nurse Scientists need additional mentorship, resources, and networks to advance their development, increase their funding success, and maximize the impact of their role, ultimately enhancing care of Veterans and their families.

Characteristics and duties of clinical research nurses: a scoping review

Introduction

The characteristics and duties of clinical research nurses (CRNs) are constantly developing and changing with the progress of medical technology and increasing needs in patient care. With the continuous deepening and standardization of clinical trials, the importance and status of CRNs during the whole process of clinical trials are also increasingly valued.

Methods

A scoping review of studies related to the characteristics and duties of CRNs was conducted to clarify relevant roles and concepts. An electronic search was conducted on three English databases (PubMed, Web of Science, Embase) and two Chinese databases (CNKI and Wanfang database) in December 2023. Two authors independently screened the literature, extracted information from the included literature, and summarized and reported the findings.

Results

A total of 26 articles published between 1991 and 2023 were analyzed, and four characteristics of CRNs were identified as participants and managers of clinical trials, caregivers and protectors of subjects, coordinators of research teams, and educators. Basic knowledge, skills and literacy, communication and coordination ability, and advanced research ability are the competencies required for CRNs.

Conclusion

Further studies should focus on the importance of various characteristics of CRNs, so as to improve the quality of clinical trials and promote clinical evidence-based practice.

Maximizing Nurse Scientist Role Potential in Health Care Organizations

Before Magnet designation, nurse scientists functioned primarily in academia. The Magnet model's emphasis on new knowledge required that health care organizations demonstrate knowledge generation to achieve and sustain designation. The nurse scientist role definition and function within health care organizations continues to evolve, which contributes to a lack of clarity about who and how nurses generate new knowledge. The purpose of this scoping review was to (1) identify nurse scientist role components in the context of 2 theoretical models (Thompson's Knowledge Brokering Model and Edward's Research Appreciation, Accessibility, and Application Model), (2) explore the strengths and barriers associated with existing nurse scientist practice models in US health care organizations, and (3) describe a unique, expanded practice model applied within Stanford Health Care's Office of Research and its implications for building new knowledge and innovation capacity with recommendations for ongoing role development.

Nursing leadership and influence in practice domains at a Veterans Affairs Health Care System

BACKGROUND

Studies in Veteran populations have examined disparities in health service use, care quality, outcomes and increased demands for behavioral health.

PURPOSE

The purpose is to describe the development of nursing leadership roles that influenced practice improvements and demonstrated outcomes related to health disparities in a Veterans Affairs (VA) population over a 12-year period.

METHODS

The Sundean and colleagues' concept analysis of nurse leadership influence was applied to frame the initiative process and impacts.

DISCUSSION

Antecedents and processes that facilitated leadership development included mentorship, disparities expertise, partnerships, consultation, scholarship, dissemination, advocacy, education, and strong coauthor collaboration. Improvements and outcomes included access to services, improved health indicators, tools, workforce, funding, innovations, and nurse investigator studies, consistent with VA priorities and policy related to disparities and equity. Limitations and barriers were addressed.

CONCLUSION

This initiative models' strategies to increase nurse leadership in health equity and care transformation in health systems and community practices.

A scoping review on the nurse scientist role within healthcare systems

BACKGROUND

The role of the nurse scientist in the clinical setting is not well defined, which contributes to variability in role implementation, scope, administration, funding, and affiliation across healthcare sites.

AIMS

The aim of this scoping review was to identify attributes of the clinical nurse scientist role and its operationalization in the clinical setting through available evidence.

METHODS

A comprehensive, computerized search of the literature in PubMed, Medline, and CINAHL was conducted in early May 2020 by a medical research librarian and repeated in July 2021 and April 2022. The 5-step framework described by Arskey and O'Malley guided the review methodology. Two reviewers conducted an independent screen of all articles, followed by a full-text review of eligible articles by two independent reviewers each using a standardized data extraction template. Themes were then organized and synthesized using descriptive content analysis from the included articles.

RESULTS

A final sample of 55 full-text articles were included in the review. Overall, the findings suggest that the nurse scientist role in a clinical setting can be challenging to implement in complex healthcare environments. Successful models include the nurse scientist in a leadership role, alignment of research with institutional priorities, and strong support from senior leadership.

LINKING EVIDENCE TO ACTION

Findings suggest that standardized guidelines are lacking to govern the implementation of the nurse scientist role in the clinical setting. To succeed, the nurse scientist role must be valued and supported by organizational leaders. Further, access to resources to build infrastructure must be provided. The magnitude and scope of individual organizational support can be tailored based on the resources of the institution; however, the foundation of having institutional leadership support is critical to role success of the clinical nurse researcher.

Clinical practice experience of doctor of philosophy nurses in South Korea: a qualitative study

Purpose

This study aimed to gain a broader understanding of the clinical practice experience of Doctor of Philosophy nurses working in nursing positions.

Method

Participants were 15 full-time nurses who are current Doctor of Philosophy candidates or have acquired a Doctor of Philosophy in nursing. Data were collected through face-to-face interviews and the participants’ diaries, which were analysed using a descriptive qualitative method.

Results

The patient care experiences of Doctor of Philosophy nurses in clinical practice were grouped into four themes: “providing evidence-based and patient-specific education,” “proactively taking responsible for communicating with patients,” “enhancing the quality of nursing through reflective attitudes,” and “advocating for patients using a multifaceted approach.” The factors facilitating or inhibiting clinical practice were identified with three themes.

Conclusion

This study revealed that the Doctor of Philosophy nurses used the knowledge and experience they gained in their Doctor of Philosophy nursing programme to serve as role models for the advancement of nursing education and evidence-based practice.

A scoping review of outcomes of operational success for nurse scientists in clinical practice settings

BACKGROUND

The nurse scientist in the clinical setting is a role that has evolved over recent decades to encompass the concomitant development of personal research programs and the facilitation of staff and advanced practice nurse research in health care settings. However, the definition, operationalization, and measures of success are extremely variable.

PURPOSE

To identify the defining features and characteristics of the nurse scientist role in clinical practice settings as represented in the existing literature.

METHODS

We conducted a scoping review using PubMed and CINAHL databases. We initially identified a total of 3345 references from 1976 to June 2020, 217 of which were published from 2005-2020. We used the Joanna Briggs Institute (JBI) framework to explore the state of the science of the role of nurse scientists in practice settings.

DISCUSSION

Approximately 100 articles met the criteria for full-text analysis, and the final review consisted of 20 descriptive analytic studies addressing the nurse scientist role definition, operationalization, and outcome measures.

CONCLUSION

Findings suggest that nurse scientist roles serve to promote health system success through a host of research-focused activities that conceivably contribute to improved patient care outcomes. Work is needed to support the cost of requisite resources and infrastructure and to increase acceptance of the role as part of a tenure-earning track in academic settings that also stand to benefit.

A pragmatic evaluation of a public health knowledge broker mentoring education program: a convergent mixed methods study

Background

Public health professionals are expected to use the best available research and contextual evidence to inform decision-making. The National Collaborating Centre for Methods and Tools developed, implemented, and evaluated a Knowledge Broker mentoring program aimed at facilitating organization-wide evidence-informed decision-making in ten public health units in Ontario, Canada. The purpose of this study was to pragmatically assess the impact of the program.

Methods

A convergent mixed methods design was used to interpret quantitative results in the context of the qualitative findings. A goal-setting exercise was conducted with senior leadership in each organization prior to implementing the program. Achievement of goals was quantified through deductive coding of post-program interviews with participants and management. Interviews analyzed inductively to qualitatively explain progress toward identified goals and identify key factors related to implementation of EIDM within the organization.

Results

Organizations met their goals for evidence use to varying degrees. The key themes identified that support an organizational shift to EIDM include definitive plans for participants to share knowledge during and after program completion, embedding evidence into decision-making processes, and supportive leadership with organizational investment of time and resources. The location, setting, or size of health units was not associated with attainment of EIDM goals; small, rural health units were not at a disadvantage compared to larger, urban health units.

Conclusions

The Knowledge Broker mentoring program allowed participants to share their learning and support change at their health units. When paired with organizational supports such as supportive leadership and resource investment, this program holds promise as an innovative knowledge translation strategy for organization wide EIDM among public health organizations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-022-00267-5.

Building the Science to Guide Nursing Administration and Leadership Decision Making

OBJECTIVE

The aim of this study was to identify the challenges, barriers, and solutions for conducting nursing administration and leadership science (NALS) research.

BACKGROUND

Evidence from leadership science should be at the forefront of nurse leaders' decision making. Yet, challenges remain in building the evidence and moving it into nursing administration and leadership practice.

METHODS

This study used a Delphi technique with open-ended questions and direct content analysis to evaluate survey responses of members of the Association for Leadership Science in Nursing and American Organization for Nursing Leadership.

RESULTS

Open-ended responses were coded to yield super categories and supportive codes for areas with limited evidence to guide leadership practice and the challenges for conducting NALS research.

CONCLUSIONS

These findings provide future directions for continuously driving NALS research and for building and leveraging leadership science to support nursing administration decision making.

Who Advances Nursing Science in Practice Settings and How?

Nurse scientist (NS) roles in clinical practice settings are key components of The Future of Nursing and ANCC Magnet® recognition. Despite increased opportunities for NS roles, leveraging these roles to advance nursing science remains at an early stage. We describe opportunities and challenges for NSs in clinical practice settings, highlighting the value of a strong partnership with chief nurse officers as critical for the success of NSs and outcomes associated with these roles.

The Epistemic Dignity of Knowledge Developed Through Nursing Practice

In this article, I revisit a philosophical idea from Intermodernism about generating knowledge through nursing practice and examine how this may enhance the epistemic dignity of knowledge. Epistemic dignity is an evaluation of knowledge (formalized in theories) as possessing quality and worth as scientific knowledge and as held in esteem by a disciplinary community and others. The philosophical turn toward the practice of science is discussed along with contemporary work on theoretical virtues as qualities of scientific theory. In addition, I suggest that what we may refer to as uniquely nursing knowledge is knowledge that is generated through nursing practice and ground in disciplinary perspective.

Defining the role of individuals prepared as a doctor of nurse practice in symptoms science research

PURPOSE

The Doctor of Nursing Practice (DNP) programs have grown exponentially for the last 10 years across the United States. However, the intra-professional collaboration among DNP and PhD scholars is not clearly demonstrated in the literature as it relates to frequency, training models, and the outcomes of these collaborations on translation. The purposes of this paper are to: (1) examine the role for DNP nurses in symptom science research and (2) describe training models to cultivate the PhD-DNP collaboration to strengthen the translation of discoveries from nursing research, to facilitate implementation of discoveries, and to improve clinical practice of nurses.

METHODS

A targeted review of the literature was conducted to identify, (1) the role of the DNP, (2) examples of PhD-DNP collaborations, (3) training models that support collaborations, and (4) the outcomes of these intra-professional collaborations.

RESULTS

Two articles reported on PhD-DNP collaboration within a university setting; however, they did not address how the partnership was modeled. One additional article described an academic-hospital partnership model aimed at MSN-prepared advanced practice nurses (APRN) by which outcomes were measured. No examples were found outside of academic settings. The National Institute of Nursing Research (NINR) has established the Symptom Science Center (SSC) with an interest in training the next generation of symptom scientists. By developing a training curriculum through the NINR SSC, DNP-prepared students and practitioners can be exposed to the research enterprise and potentially develop early partnerships with PhD-prepared students and scholars that lead to research translation.

CONCLUSION

The NINR Department of Intramural Research (DIR) and National Institutes of Health Clinical Center are dedicated to building stronger ties between PhD- and DNP-prepared scientists. The SSC can serve as an optimal platform to promote the collaboration of PhD and DNP nurses to advance symptom science translation.

CLINICAL RELEVANCE

Nurses have a remarkable role in early detection of disease progression. Training opportunities to cultivate the PhD-DNP collaboration have significant relevance for expediting the translation of nursing science to nursing practice.

What place does nurse-led research have in the COVID-19 pandemic?

AIM

Reflect upon the visibility of nursing-led research during the COVID-19 pandemic.

BACKGROUND

The emerging SARS-CoV-2 infection has galvanized collaborative and multidisciplinary efforts in clinical and research practice worldwide. The scarce evidence-base to manage patients with COVID-19 has included limited nurse-led research.

INTRODUCTION

Clinical research nurses have greatly contributed to the delivery of COVID-19 research, yet the number of COVID-19 nursing-led research papers appears to be limited, with even fewer nurse-led research projects funded.

METHODS

Authors' views and PubMed search on 'COVID-19 and nursing'.

FINDINGS

There is a dearth of nursing-led research. Most papers describe the nursing contribution to COVID-19 care, changes in nursing working arrangements and emotional burden. There are opportunities to explore the consequences to vulnerable population groups of public health measures implemented to stop the progress of the COVID-19 pandemic.

DISCUSSION

Workforce gaps, limited integration in research structures and clinical redeployment may have hampered nurse-led research. COVID-19 may exacerbate staffing deficits by disrupting the education pipeline, obstructing the transition from clinical to academic practice, particularly in areas where clinical academic roles are yet to emerge.

CONCLUSION

The absence of nurse-led research in COVID-19 can be explained by chronic, underlying factors and the features of the pandemic response. Emerging models of care, effective staffing and inequalities related to COVID-19 appear obvious research areas. Nursing leadership needs to strengthen its political voice and lobbying skills to secure nurse-led research funding.

IMPLICATIONS FOR NURSING POLICY

Embracing international nursing research, strengthening collaborations and lobbying policymakers for investment in nurse-sensitive research would enhance the response to COVID-19.

Essential oncology nursing care along the cancer continuum

Oncology nurses are at the heart of tackling the increasing global burden of cancer. Their contribution is unique because of the scale and the diversity of care roles and responsibilities in cancer care. In this Series paper, to celebrate the International Year of the Nurse and Midwife, we highlight the contribution and impact of oncology nurses along the cancer care continuum. Delivering people-centred integrated care and optimal communication are essential components of oncology nursing care, which are often played down. More oncology nurses using, doing, and leading research will further show the key nursing impact on care as part of a team. The oncology nurse influence in saving lives through prevention and early detection of cancer is noteworthy. Supportive care, the central pillar of oncology nursing, enables and empowers people to self-manage where possible. Globally, oncology nurses make a great positive difference to cancer care worldwide; their crucial contribution throughout the continuum of care warrants the inclusion and promotion of nursing in every country's cancer strategy. 2020 is the year of the nurse: let us take this learning to the future.

Emerging roles for research intensive PhD prepared nurses: Beyond faculty positions

Research-intensive PhD programs need to prepare nurse scientists to bridge the chasms between research, and practice and policy in an increasingly complex healthcare system. In practice, nurse scientists are critical to building capacity for research, promoting excellence in patient-centered care, and achieving or exceeding national quality benchmarks. Moreover, they provide methodological expertise and insight to address pressing clinical questions. PhD-prepared nurses also leverage their research expertise and practice knowledge to transform health policy in roles as organizational executives and leaders, advocates, and communicators. Re-envisioning nursing PhD curricula is required to ensure that PhD students are capable of not only conducting rigorous and impactful science, but launching careers across sectors of healthcare. Here, we summarize viewpoints of a special session from the October 2019 PhD Summit "Re-Envisioning PhD Programs of the Future" sponsored by the University of Pennsylvania School of Nursing and literature to invigorate thinking about ways to promote career transitions into nontraditional vital positions for nurse scientists. Advancing the health of patients and communities depends on preparing the next generation of nurse scientist to pursue career trajectories outside of traditional academic institutions.