Many nurses lack confidence and skills in evaluating or undertaking research. A support group in Cambridge helps nurses embrace research to ensure their practice is always evidence-based
Nurses are expected to use research evidence in their daily practice, yet not all have the skills and confidence to do so. While many contribute to research, few have opportunities to develop their own research ideas. Nurses are often employed as researchers in universities and find themselves isolated from their peers. This article describes the formation of a group that brings together, across a geographical area, nurses and allied health professionals from clinical practice and academic institutions who have a common interest in research. It details how the group has evolved and highlights the impact it has had on helping its members to advance their own research proposals. It provides top tips for others who are interested in establishing similar groups.
Citation: Buck J (2017) A network to link and inspire nurses interested or active in research. Nursing Times [online]; 113: 3, 46-48.
Author: Jackie Buck is lecturer in adult nursing, University of East Anglia; honorary research associate, Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine; and co-founder, Cambridge Nurses in Research.
- This article has been double-blind peer reviewed
- Scroll down to read the article or download a print-friendly PDF here (if the PDF fails to fully download please try again using a different browser)
Cambridge is recognised globally as an ancient seat of learning, and healthcare research undertaken in its hospitals and universities has produced many highly innovative diagnostic and therapeutic interventions that are of great benefit to patients. The city is home to Addenbrooke’s Hospital, situated on the rapidly expanding Cambridge Biomedical Campus. The campus houses world-class biomedical research, patient care and education on a single site, and many commercial companies are relocating there so they can be alongside the 12,000-strong community of health professionals and research scientists. According to its website, the campus will become one of the world’s leading biomedical centres by 2020.
Research nursing in Cambridge
With a local research profile, it is not surprising that many nurses and an increasing number of midwives and allied health professionals in Cambridge lead, coordinate and generally support research. While it is difficult to gain an accurate figure for how many work in research across the city, there are approximately 200 research nurses and senior research nurses employed at Cambridge University Hospitals Foundation Trust (CUHFT); an additional 15 nurses and midwives and four AHPs have been supported via fellowships from the National Institute of Health Research (NIHR) to complete a master’s degree in clinical research course since 2010.
Anglia Ruskin University School of Nursing and Midwifery, also in Cambridge, is home to nursing professors and other nurse and AHP academics, while many others working in research roles at the University of Cambridge are, or have been, nurses. This is not reflected in their job titles, so they are difficult to quantify.
Until recently, no explicit nursing research was undertaken at the University of Cambridge, but this is changing thanks to the establishment, in 2013, of the Florence Nightingale Foundation Chair in Clinical Nursing Practice Research. This has led to the development of a Clinical Nursing Research Group (CNRG) headed by Professor Christi Deaton. However, despite all this activity, research nurses in Cambridge remained a largely hidden professional group.
Research skills among nurses
Although research is now embedded in the undergraduate nursing curriculum and, in general, is positively perceived (Ryan, 2016), this has not always been the case. As a result, many nurses are practising today with little research knowledge, yet are expected to be able to appraise and use research.
One of the cornerstones of creating a workforce comprising individuals who are able to assess research evidence – or even conduct research themselves – is thought to be creating and sustaining a culture and environment that are conducive to learning and the application of new knowledge (Melnyk and Fineout-Overholt, 2015; Greenhalgh, 2014). Sadly, some nurses still encounter cultural resistance towards research, mainly from management, which ultimately affects their ability to make sure their practice is fully evidence based or to initiate their own research (Ryan, 2016).
Cambridge Nurses in Research
The need for a forum to bring together nurses and AHPs involved in research was initially recognised in 2013 by nursing lecturer-turned-researcher Aileen Walsh and nurse and researcher Sue Boase, both of whom were based at the University of Cambridge. They observed that many nurses working in research do so in isolation, often cut off from their nursing peers. There was also an awareness that many clinically-based nurses who are not research active cite lack of knowledge and confidence as being among the reasons why – despite the fact that evidence-based practice is fundamental to their role (Nursing and Midwifery Council, 2015) – they do not engage in research or access research evidence to support their practice.
Our small group is made up of a handful of clinical nurses and nurse university researchers from local NHS organisations and universities. We thought the isolation of research nurses and AHPs, and lack of confidence among other nurses and AHPs, might be alleviated by linking up those working in disparate research settings. This would allow them to build connections with clinical nurses interested in research who might be unsure where to begin (Breimaier et al, 2011; Gerrish et al, 2008; Roxburgh, 2006).
With the above issues in mind, we set out to establish a group to provide a resource for nurses and AHPs, in and around Cambridge, who were involved, or considering becoming involved, in research. In 2013, Cambridge Nurses in Research (CNiR) was born. We hoped this would ultimately raise the capacity of the nursing body to use and undertake research.
Developing the group
We initially held a couple of meetings to assess interest and establish the needs of the group, sending invitations as widely as possible to include:
- Nurses and AHPs in primary and secondary care, community services; mental health trusts; acute trusts;
- Academics from both local universities.
These meetings, which would usually attract about 40 attendants, highlighted the scale of the task, as we listened to nurses with strong desires to carry out research but weak knowledge of research theories and processes.
Other nurses wanted to be part of a wider group, as the isolation they felt was sometimes demoralising, whether they were research nurses cut off from their nurse peers or clinically based nurses whose interest in research was not shared by their colleagues. We also became aware that status and parity for some nurses and AHPs was sometimes lacking – there is still a lack of parity in medically-led research.
We drew up a ‘wish list’ for CNiR, developed terms of reference to guide us, and set about working out how to achieve our aspirations. The terms of reference proved extremely helpful as a source to revisit whenever we felt the group’s development was drifting.
Over 2014, CNiR met approximately every two months, using meetings largely to disseminate information. We also tried to focus on issues the group had said they needed to know more about, such as mentorship in research. Group discussions during these meetings led to the development of a clinical evaluation of the electronic patient record system that had been recently introduced at Addenbrooke’s Hospital; this evaluation has been carried out by the CNRG at the University of Cambridge.
Towards the end of the year, attendance to meetings was dwindling and we realised we had to act to resurrect the enthusiasm that had been so evident earlier on. Feedback from group members suggested more structure was needed.
In 2015 we made some significant changes to CNiR. We established a regular day, time and venue for a monthly lunchtime meeting and arranged talks, inviting guest speakers (Box 1) to tell us about their research on a range of topics of interest to the whole group. These topics included:
- The ethics review process;
- Literature searching;
- The Foundation of Nursing Studies innovative practice and evaluation programme;
- NIHR schemes to gain research experience/training, including funding streams to support master’s degrees, Health Education England internships, and Collaborations for Leadership in Applied Health Research and Care (CLAHRC) fellowships;
- Applying for research funding;
- The availability of short courses in research methods and processes.
Box 1. Guest speakers
Guest speakers at CNiR meetings have included:
- Nicky Lambert, Middlesex University
- Alison Leary, London South Bank University
- Gerry Lee, King’s College London
- Helen Courtney-Pratt, University of Tasmania
- Sarah Redsell, Anglia Ruskin University
These lunchtime meetings also provided a supportive setting for members to share their research ideas, present projects in development and receive valuable feedback. Practice-based projects discussed to date have ranged from introducing new equipment in a ward to proposals for PhD fellowships on subjects including:
- Using the iPad to aid communication in intensive care;
- Reducing noise in the neonatal intensive care unit;
- Advanced care planning with frail older people in the community;
- Patient-centred nutritional assessment and dietary advice for patients with liver cirrhosis.
We secured some funding from the research and development department of CUHFT to support CNiR meetings, and organised a networking event to bring together researchers from across the Eastern region, with generous funding from the CNRG. A website was also developed to provide an information source for, and about, group members.
Benefits of the group
The feeling of collegiality in CNiR has created a positive environment for discussion and debate about research locally that simply did not exist before in our professions. Feedback from group members is largely positive and some have credited the group with inspiring them to apply for fellowships and giving them the confidence to pursue their own research funding – this is illustrated in feedback from one group member:
“CNiR has been an important lifeline for me. Working as a single research nurse with medical colleagues, it provides inspiration from the nurses already balancing working clinically and academically, and inspiration from the guest speakers. It provided me with the confidence to apply for, and win, a fellowship in order to conduct my own research study. It gave me skills by providing a safe environment to prepare an application and practise my presentation. In addition, the CNiR provides peer support, as some aspects of research in my job can be isolating. But mainly [it provides] the belief […] that after many years of trying to have a clinical academic career and move from research nurse to nurse researcher, it may still be possible!” (Allison Bentley, research nurse and 2016 NIHR CLAHRC fellow)
046 048 innov cambridge nt150217
The group’s achievements align well with the aims of the nursing profession in general, as reflected in the recently launched framework for nursing, midwifery and care staff Leading Change, Adding Value. This framework lists leading and driving research to provide evidence of the impact of what we do as one of 10 key aspirations to bring about better patient outcomes and greater equality (NHS England, 2016).
For the moment we are happy with the pace of the group’s development and pleased with the growing membership. We currently have over 150 members on our mailing list – over a third are in university posts and almost 60% are NHS clinicians or other practitioners (mostly nurses working in secondary care, some nurses working in primary care, and some AHPs, mainly physiotherapists and dietitians).
The biggest challenge for us is that we run the group in addition to our day jobs and, as such, have limited capacity, but steady improvements in attendance and positive feedback from members motivate us to continue.
Nurses and AHPs can, and should, be at the heart of patient-focused research. Those of us with experience of, and a passion for, research are in an excellent position to encourage and champion those in frontline care to fulfil their research potential and support and encourage each other.
We believe the closer you are to the problem, the closer you are to the solution, and that supporting nurses to become more conversant with research at all levels will only bring benefit. Research shows us that nurses who become research active often do so to bring about changes in practice, which leads to better care for patients (Woodward et al, 2007). We are pleased to be able to play a small part in facilitating this.
Box 2 offers advice for others interested in setting up a similar informal researcher support and information network.
Box 2. Top tips for setting up a research network
- Be open and inclusive: cast the net wide – do not see barriers to joining, only opportunities
- Stick with the same time and venue each month so meetings become a habit; this also reduces administration time, as it is often easier to arrange all meetings in one booking
- Think big but start small: be realistic about what the group can achieve if this is in addition to regular work
- Be flexible and interactive in terms of programming and scheduling events, and seek regular feedback – if things are not working out, make changes
- Do not give up: people will dip in and out according to workload, interests and career aspirations
- Acknowledgements: The author would like to thank and acknowledge the other co-founders of the Cambridge Nurses in Research group and current steering members: Claire Adams, Sue Boase, Jane Fleming, Sara Jones, Alexandra Malyon, Petra Polgarova and Aileen Walsh.
- Although nurses are expected to always ensure their practice is evidence based, not all have sufficient research knowledge and skills to do this
- Nurses conducting research in the NHS or universities often work in isolation
- A network for nurses and allied health professionals who are interested in research, or actively engaged in it, can help to build a research culture, enabling networking and information sharing
- Supporting clinically active nurses and AHPs to pursue research training and apply for research funding can help to change practice
Breimaier HE et al (2011) Nurses’ wishes, knowledge, attitudes and perceived barriers on implementing research findings into practice among graduate nurses in Austria. Journal of Clinical Nursing; 20: 11/12, 1744-1756.
Gerrish K et al (2008) Developing evidence-based practice: experiences of senior and junior clinical nurses. Journal of Advanced Nursing; 62: 1, 62-73.
Greenhalgh T (2014) How to Read a Paper: The Basics of Evidence-based Medicine. Oxford: Wiley Blackwell.
Melnyk B, Fineout-Overholt E (2015) Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. Philadelphia PA: Lippincott Williams and Wilkins.
NHS England (2016) Leading Change, Adding Value: A Framework for Nursing, Midwifery and Care Staff.
Nursing and Midwifery Council (2015) The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives.
Roxburgh M (2006) An exploration of factors which constrain nurses from research participation. Journal of Clinical Nursing; 15: 5, 535-545.
Ryan EJ (2016) Undergraduate nursing students’ attitudes and use of research and evidence-based practice – an integrative literature review. Journal of Clinical Nursing; 25: 11/12, 1548-1556.
Woodward V et al (2007) The perceptions and experiences of nurses undertaking research in the clinical setting. Journal of Research in Nursing; 12: 3, 227-244.