Evidence shows that hospitals that encourage research by nurses provide better care, but ongoing pressures means it is not always seen as a priority, warns a member of the profession behind a new strategy aimed at strengthening the clinical research nursing workforce.
Clare Meachin, deputy chief operating officer for the South London Clinical Research Network, said awareness of the role and contribution of research nurses had vastly improved in recent years, but there were still barriers to overcome. Research was “not necessarily high on the agenda” in many trusts struggling to provide day-to-day patient care, she noted.
“We understand there are significant clinical challenges within the hospital context – people are seeing more patients and clinical care has to be a priority – making sure patients are seen and well cared for as they come through the door,” she told Nursing Times.
Exclusive: New strategy will emphasise role played by research nurses
“But we also know that at ‘research active’ trusts, the quality of the care does improve and there is a direct correlation between whether a trust is research active and higher quality of care,” she said.
A survey, carried out in 2016 by Nursing Times, identified workforce pressures, education structures and negative perceptions as factors all holding back nurse involvement in vital research and innovation that could benefit patient care (see box below).
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However, it also found that 98% of respondents said nurse-led research or research by nurses was “vital” or “important” to furthering best practice among the profession, and 68% were either “very” or “fairly interested” in a career that involved research as part of their job.
“There is a direct correlation between whether a trust is research active and higher quality of care”
Ms Meachin is one of three nurses leading on the new strategy for the National Institute for Health Research (NIHR), which is due to be published in early October. It will set out priorities for the clinical research nurse workforce up to 2020, updating a previous strategy for 2015 to 2017.
She told Nursing Times that a key part of the older version of the strategy had been about “improving awareness of what a research nurse actually does”.
“We believe we have made some great inroads,” she said. “We are seeing some changes, both in perception of what a clinical research nurse does and how they do it – but we still have a bit of a way to go.”
One of the new strategy’s aims is to emphasise research nurses’ key role in innovation and service improvement, not just in the UK but also as part of international research and development.
“We want to make sure we have that culture of improvement and want to actively encourage nurses to see problems, challenges and solutions within the clinical workplace,” said Ms Meachin.
The strategy has been informed by feedback from current frontline research nurses, with a draft document drawn up by a working group of a dozen or so leading nurses with a passion for the area.
“We really need to look at the career pathways for nurses who are becoming research nurses”
Ms Meachin herself has led the process with two other nurses – Susan Hamer, director of nursing, learning and organisational development for the NIHR’s Clinical Research Network, and Chris Oxnard, deputy chief operating officer for Yorkshire and Humber Clinical Research Network, and associate director of nursing at the NIHR Clinical Research Network.
Other core strands in the strategy include how to share best practice effectively, the need to embrace technology and to ensure patients and the public can play an active role in research.
Ms Meachin said the strategy was also about training, by ensuring clinical research nurses working in primary, secondary, community and social care had the right skills and opportunities to progress.
“One of the things we do know is that – although it has improved – we really need to look at the career pathways for nurses who are becoming research nurses,” said Ms Meachin, who worked as a research nurse for many years.
“These are people that have continued to have a clinical component to their job within a context of research,” she said. “We’re not people just sitting behind desks with a computer – we’re actually nurses who are out there seeing the patients. What we want to ensure is these clinical research nurses have the right skills.”
“We really need to ensure we’re developing nurses to lead our workforce in the future”
Like other areas of nursing, Ms Meachin noted that clinical research has been hit by falling numbers in recent years.
“We have got a nursing workforce which is reducing dramatically year-on-year and an ageing workforce who are due to retire over the next 10 years,” she said. “So, we want to ensure we can keep some really good quality clinical research nurses.”
An important part of this work was developing the “next generation of leaders in the research nursing workforce”, she said – through initiatives like the NIHR’s Advanced Leadership Programme for band 6 and 7 nurses and other practitioners.
“We’re very aware that we need to get the best leaders locally, nationally and internationally, so we really need to ensure we’re developing nurses to lead our workforce in the future,” said Ms Meachin.
She noted that it was also vital that research nurses made the most of technology to improve the collection and analysis of patient data in a safe and timely way – as well as exploring the role of technology in delivering and improving patient care.
Ms Meachin also said the clinical research nursing strategy tied in with a new digital strategy currently being drawn up by NIHR and due to be published soon, which emphasised the need for nurses and others to “embrace the digital way of doing things”.
“I would want a clinical research nurse to read this and think ‘gosh, this is the direction in which I wish to go’”
When it came to involving patients in studies and trials, she told Nursing Times it was important that research was “happening where the patients are”.
“This is about patients coming into the hospital and feeling empowered to say to the nurse specialist or doctor, ‘do you have any research in my area at the moment? I really want to take part’,” she said. “It is about empowering our patients to have a voice too.”
She said she hoped the nursing research strategy, which will provide the basis for other more detailed work, would be read by individual nurses, trusts and NHS leaders.
“I would want a clinical research nurse to read this and think ‘gosh – this really makes sense to me – this is the direction in which I wish to go’,” said Ms Meachin.
“I would love the trust to see this and say, ‘yes this is what we want to embrace, because we can see this is going to have an impact on patient care’,” she said.
She added: “I would also like the NHS to say, ‘we can see this is really important – this workforce is important and the research nurses deliver is incredibly important too’.”
Survey: How healthy is the state of nursing research?
Last year, Nursing Times asked readers about their involvement and views on research by nurses. In partnership with the NIHR and Health Education England, we surveyed 650 nurses.
- 98% said nurse-led research or research by nurses was “vital” or “important” to furthering best practice among the profession
- 68% said they were either “very” or “fairly interested” in a career that involved research as part of the job, and nearly half said they had considered conducting their own clinical research
- 74.4% said they would be interested in finding out more about opportunities to get involved in clinical research
- 63% said they did not think there were enough opportunities for nurses to develop a career in clinical research
- Asked what the biggest challenges to nurses getting involved in clinical research, 39% cited a lack of time, 17% said a lack of information on opportunities, and 11% a lack of staff cover
Research survey graphs
Biography: Clare Meachin
Clare Meachin is the deputy chief operating officer for the NIHR’s South London Clinical Research Network and has worked for it since its inception in 2006.
She originally trained as a registered nurse at Barts Health NHS Trust. She has worked in neurology and neurosurgery and general medicine, and spent four years in Nigeria running a leprosy hospital and a motherless babies home.
Returning to the UK, her interest in research began following three years working with injecting drug users on the streets of Oxford and a funded project to look at the incidence of mental illness in the homeless population.
Following a move to Devon, she worked as lead research nurse managing a research team of 50 across all specialties and, alongside this, she also studied for a MSc in Clinical Education. More recently she was the lead research manager within a busy research active district general hospital.