Clinical Academic Research Internships: what works for nurses and the wider nursing, midwifery and allied health professional workforce

Nurse-led research and innovation is key to improving health experiences and outcomes and reducing health inequalities. Clinical academic training programmes for nurses to develop research and innovation skills alongside continued development of their clinical practice are becoming increasingly established at national, regional and local levels. Though widely supported, geographical variation in the range and scope of opportunities available remains. It is imperative that clinical academic opportunities for nurses continue to grow to ensure equity of access and opportunity so that the potential of nurse-led clinical academic research to improve quality of care, health experience and health outcomes can be realised. In this paper we describe and report on clinical academic internship opportunities available to nurses to share internationally, a range of innovative programmes currently in operation across the UK. Examples of some of the tangible benefits for patients, professional development, clinical teams and NHS organisations resulting from these clinical academic internships are illustrated. Information from local evaluations of internship programmes were collated to report what has worked well alongside ‘real-world’ set-up and sustainability challenges faced in practice. Clinical academic internship schemes are often opportunistically developed, making use of hybrid models of delivery and funding responsive to local needs and available resources. Key enablers of successful clinical academic internship programmes for nurses were support from senior clinical leaders and established relationships with local universities and wider organisations committed to research capacity building

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Sharing and surviving the resuscitation : parental presence during resuscitation of a child in PICU : the experiences of parents and nurses

Parents’ presence and participation in their child’s care in the paediatric intensive care unit (PICU) is now commonplace. Despite parents expressing a deep need to be with their child particularly during periods of crisis, it is precisely at these times that they are often prevented from staying. The growing debate regarding family presence during a cardiopulmonary (CPR) resuscitation attempt continues to be controversial and conflicting. Current knowledge is mostly derived from quantitative studies conducted in the adult intensive care or emergency environments. The experiences of parents of children in the PICU, and the nurses caring for them are unknown. Using van Manen’s hermeneutic phenomenological approach, this study describes the phenomenon of parental presence during resuscitation of a child in PICU for eight Australian parent couples and six nurses. Experiential descriptions, obtained in tape-recorded unstructured interviews were subjected to two layers of analysis. Thematic analysis provided the phenomenological description in seven themes. Four themes refer to the parents’ experience in Being only for a child; Making sense of a living nightmare; Maintaining hope: facing reality and Living in a relationship with staff. Three themes describe the nurses’ experience: Under the parents’ gaze; Walking in their shoes and Holding parents in mind. A second layer of hermeneutic analysis revealed parents’ and nurses’ collective experience to have their being in four elements of the phenomenon. These elements are Being in chaos; Struggling to connect; Being for another and Being complete. The final description of the parents’ and nurses’ experience of parental presence during resuscitation in PICU as Sharing and surviving the resuscitation is drawn from the findings from each of these layers of meaning. The findings from this study conclude that the parents’ inherent need to be with their child overrode their anxieties of the resuscitation scene, curbing their feelings of chaos. Parental presence however, was a complex and dynamic concept that required a new relationship between parents and nurses. Implications of this study include recommendations for improving staff knowledge and education, as well as practical interventions for enhanced support for both parents and nurse

Post-traumatic symptomatology in parents with premature infants: a systematic review of the literature.

The emotional distress resulting from the experience of giving birth toa preterm infant (gestational age , 37 weeks) and the subsequent neonatal unithospitalisation may be a traumatic experience for parents. In the present systematicliterature review, studies on parental posttraumatic symptomatology following birth ofa premature infant were reviewed. A total of 5 studies were identified. All studiesreviewed found that posttraumatic symptomatology is quite common in parents orprimary caregivers of premature infants. However, methodological weaknesses ofrelevant studies (e.g. use of convenience samples, lack of pre – delivery assessments)make it difficult to draw consistent conclusions regarding prevalence of posttraumaticsymptomatology in this population group or whether the experience of a premature birthcould be responsible for the development of PTSD. Directions for future research are discussed

Community midwives’ and health visitors’ experiences of research recruitment: a qualitative exploration using the Theoretical Domains Framework

Background: Successful research is frequently hampered by poor study recruitment, especially in community settings and with participants who are women and their children. Health visitors and community midwives are well placed to invite young families, and pregnant and postnatal women to take part in such research, but little is known about how best to support these health professionals to do this effectively. Aim: This study uses the Theoretical Domains Framework to explore the factors that influence whether health visitors and community midwives invite eligible patients to take part in research opportunities. Method: Health visitors (n=39) and community midwives (n=22) working in four NHS Trusts and one community partnership in England completed an anonymous, online survey with open-ended questions about their experiences of asking eligible patients to take part in research. Qualitative data were analysed using directed content analysis and inductive coding to identify specific barriers and enablers to patient recruitment within each of the 14 theoretical domains. Findings: Six key TDF domains accounted for 81% of all coded responses. These were (a) environmental context & resources; (b) beliefs about capabilities; (c) social/professional role and identity; (d) social influences; (e) goals; (f) knowledge. Key barriers to approaching patients to participate in research were time and resource constraints, perceived role conflict, conflicting priorities, and, particularly for health visitors, negative social influences from patients and researchers. Enablers included feeling confident to approach patients, positive influence from peers, managers and researchers, beliefs in the relevance of this behaviour to health care and practice, and good knowledge about the study procedures, its rationale and the research topic. The findings suggest that to improve research recruitment involving health visitors and community midwives a package of interventions is needed to address the barriers and leverage the enablers to participant approach

Post-traumatic symptomatology in parents with premature infants: a systematic review of the literature.

The emotional distress resulting from the experience of giving birth toa preterm infant (gestational age , 37 weeks) and the subsequent neonatal unithospitalisation may be a traumatic experience for parents. In the present systematicliterature review, studies on parental posttraumatic symptomatology following birth ofa premature infant were reviewed. A total of 5 studies were identified. All studiesreviewed found that posttraumatic symptomatology is quite common in parents orprimary caregivers of premature infants. However, methodological weaknesses ofrelevant studies (e.g. use of convenience samples, lack of pre – delivery assessments)make it difficult to draw consistent conclusions regarding prevalence of posttraumaticsymptomatology in this population group or whether the experience of a premature birthcould be responsible for the development of PTSD. Directions for future research are discussed

Establishing the contribution of nursing in the community to the health of the people of Scotland: integrative literature review

Aim.  This paper is a report of an integrative literature review to explore the evidence base for nursing in the community.Background.  The Scottish Executive (2005) in Scotland (UK), announced that a review of nursing in the community should be undertaken to inform implementation of the policy Delivering for Health. This policy called for a fundamental shift in the focus of care away from acute hospitals into the community where health care in the future will be concentrated. To inform this review of nursing in the community, the Scottish Executive commissioned a literature review.Methods.  An integrative literature review was carried out during 2006 (February to April). We carried out an extensive literature search using multiple electronic databases and hand-searched key texts to find suitable systematic reviews and primary quantitative and qualitative papers for review (1996–March 2006). We included English language publications describing systematic reviews and primary empirical research about community nurses' contributions to the health of people.Findings.  Seventy-three papers (12 systematic reviews and 61 studies) met our inclusion criteria. All of the studies were scored as either ‘low’ or ‘medium’ quality. None merited a ‘high’ quality rating.Conclusions.  There is little research evaluating the impact of community nursing actions. Adequately resourced research is needed to strengthen the evidence base to support nurses in the community in delivering effective and efficient care that meet the health needs of people and communitie