Clinical Research Nursing

Clinical research nursing is an important and rapidly growing specialty, which promotes and develops the vital role of nurses in the delivery of high-quality clinical research. Ensuring a vibrant clinical research culture throughout the health and social care system is essential to finding new and innovative solutions to health and care needs. This award is open to individual nurses or teams from the health and social care sector. It aims to recognise initiatives that contribute to achieving the NIHR’s strategic priorities outlined in Best Research for Best Health: the Next Chapter. Therefore we are looking for applications which reflect at least one of the following; Improving awareness and understanding of clinical research nursing by actively promoting the relationship between high-quality care and research outcomes, Demonstrating leadership to share best clinical research nursing practice locally, nationally or internationally, Dynamically connecting with colleagues to network best practice for clinical research nursing using a wide variety of media, Actively promoting patient involvement and engagement ensuring increased opportunities for patients, families and communities to access clinical research opportunities.

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Barnsley Hospital NHS Foundation Trust
Novel methods of recruiting research delivery staff in smaller hospitals

During the COVID-19 pandemic, our hospital faced the challenge of ensuring that the local population had access to vital research studies despite workforce shortages and travel restrictions. To address this issue, we undertook a review of our workforce and identified the need for additional personnel to safely deliver a large-scale COVID-19 vaccine study, this initial project has since evolved into an impactful project that has refined a process regarding how we do more focussed research studies to effectively roll-out vaccines better and deliver large scale research, which is unheard of in a small hospital such as Barnsley. Initially, we initiated a recruitment drive by sending a Trust-wide email, which resulted in over 200 staff members expressing interest in supporting the research study. Selection criteria were based on skills and availability, ensuring a capable team was assembled. Despite initial success, we encountered challenges related to workforce planning, training, and compliance. However, by leveraging internal resources and expertise, we overcame these obstacles and successfully delivered the study while prioritising patient safety. Our initiative showcased how smaller hospitals can contribute to large-scale research by harnessing internal talent. Looking ahead, we aim to further develop our NHS Professional (NHSP) internal research agency to create more opportunities for the local population and integrate research into the core business of the Trust. Additionally, we plan to expand our model by sharing resources with neighbouring Trusts through NHSP, thus extending research opportunities across multiple healthcare institutions. By continuing to innovate and engage our staff, we not only fulfil the NHS Long Term Plan mandate to provide research opportunities to all patients but also foster a culture of research awareness and job creation within the Trust.

Cardiff and Vale University Health Board
CART QUOL study – Building an army of nursing researchers

There is a paucity of nursing research across all of healthcare and the drive was to ensure that our team embraced projects that could be led by nurses, developing a number of nurse Principal Investigators across all of our team and haematology department as a whole. A number of underrepresented cancer groups across Wales needed a voice and there were a number of studies that came to our attention that our Consultants were too busy to take on but could easily be taken on by nurses. The Horizons study was first and conducted across three different disease sites, Early breast, Gynae logical and diffuse large b cell lymphoma. Following this Emma Williams conducted her own study on quality of life of patients having CART. Training followed of our TYA senior nurse to become nurse PI on the PROTECT study looking at fertility after chemotherapy. There is now a healthy portfolio of nurse led studies across the whole of the haematology department and a number of nurses are trained to be either PI's or Co Investigators. This initiative was highly commended by the Experimental Cancer Medicine Network during our recent funding rebid. Not only has this work given many more patients a voice and contributed heavily to real world evidence which is crucial in the current financial climate, it has boosted team morale and has led to our staff being chosen as nurses to contribute to the Inaugural DIDACT academy, celebrating clinical academics, which has been a first for nurses to be part of. The International Academy of Clinical Haematology has also invited Emma Williams as a Senior research lead to contribute to educational initiatives across the whole of haematology which has a global audience. Nurses are best placed to lead on research projects and must be encouraged at all levels.

Homerton Healthcare Hospital NHS Foundation Trust
Diversity and inclusion in research

There are gaps in inclusivity and diversity in research participation at Homerton Healthcare NHS FT. This phenomenon is not unique to Homerton but has been identified nationwide. However, what is unique is the demographic of Hackney. Our aim is to discover reasons why our recruitment to clinical trials is not reflective of our diverse community; and having done so seek solutions to support all our population in engaging with research. To prove our hypothesis that there was an inconsistency we conducted an audit on a sample of patients who had consented to research (evidence 1). This did highlight an inconsistency as anticipated. Following this we ran a research promotion event in the hospital foyer, at which we invited service users and staff to complete a questionnaire describing their knowledge of research within the Trust. We also asked for volunteers to join our focus groups. These focus groups enabled us to gather qualitative data informing us why certain members of the black and minority ethnic (BAME) did not engage with research. Our biggest challenge was engaging the local population in both the questionnaire completion and attendance at focus groups. We aimed to constitute the groups in a manner that reflected the demographic of service users at Homerton. To constitute a focus group, we eventually reached out through our hospital volunteer coordinator, and this did result in a lively focus group discussion. We discovered that the reasons for non-representation were multifactorial, including the visibility of research within the Trust, convenience of appointments and the language barrier. Our plans to rectify this mismatch include raising the profile of research within the Trust through highly visible notifications and engaging more service users from differing backgrounds to join regular focus groups with an ambition of making research representative of the local population of Hackney.

Leicestershire Partnership NHS Trust
Meaningful patient and public involvement for people with learning disability in the DECODE research study

Many communities remain underserved in research, including people with learning disabilities (PwLD). Researchers’ lack of awareness of the required adjustments to fully include PwLD in research, is often a key barrier to participatory research with this group. Sarah Rabbitte, an experienced learning disability (LD) nurse joined the DECODE (Develop and Enhance the Care Coordination for People with Intellectual Disabilities and Multiple Long-Term Conditions) project team as a research nurse to support the development and implementation of meaningful patient and public involvement (PPI) of PwLD. Four PPI groups were established and categorised into expert by experience groups. Group members were recruited from local networks for PwLD and Carers. Easy read information leaflets and posters were utilised to aid recruitment. Reasonable adjustments were made to accommodate the PPI groups. Meetings were scheduled at locations and venues with accessibility. Arrangements were put in place with a taxi company to provide pre-paid transport. PPI participants received training on how research benefits the NHS, research methods and data analysis relevant to the project. Easy read format with visual activities and support with individualised communication needs were utilised for training. PPI participants received regular feedback on the impact of their feedback on the project’s design and delivery. PPI participants were involved from the start of the project’s design. The recruitment strategy, data collection methods and analysis were co-designed with PwLD and their carers to ensure effective engagement with PwLD. PPI participants advised on the reasonable adjustments required for participants during focus groups and interviews. The DECODE project demonstrated ‘what good looks like’ in PPI of PwLD. Resources, reasonable adjustments and learning from the DECODE PPI activity are aspects that can and should be recommended for adoption as best practice in other research projects. Dissemination of this work has started and opportunities for adoption are being explored.

Marie Curie
Research nurses in
hospices – creating a positive research culture through improving research awareness, involvement and collaboration

The issue Providing opportunities for involvement in research is a key aspect of health and social care. However, this is often not the case in many palliative care settings. Whilst evidence suggests that patients receiving palliative care are keen to be involved in research, barriers include a lack of knowledge about research and a lack of research culture in organisations. What we did An innovative model was introduced at Marie Curie in 2016 where a Research Nurse, embedded within the clinical team, works alongside an academic research mentor. Five Research Nurses are now appointed across the UK and are part of the wider Policy & Research team. They aim to encourage and facilitate research to improve palliative and end of life care (PEoLC) for people living with terminal illness, and their caregivers. Challenges and outcomes The main challenges were engaging busy practitioners in research, managing various projects and collaborations, whilst developing our own research skills. Ongoing support from peers and academic mentors, and accessing learning and development opportunities, have been the main factors in overcoming these challenges. The dedicated hospice-based Research Nurses play a crucial role in fostering staff engagement with evidence utilisation and generation at the hospices, thereby nurturing a research culture. We serve as a bridge between clinical and research teams, ensuring that research activities are both pertinent and feasible for practice, and facilitating successful recruitment. Our leadership extends to developing and leading research initiatives supported by academic mentors. Future plans We will continue building engagement beyond the hospice walls and into community hospice teams and non-clinical teams, as well as the external partners. Our aim is to optimise the use of evidence across the organisation and ensure research and evaluation readiness and delivery across all teams.

Newcastle upon Tyne Hospitals NHS Foundation Trust
A national teenager and young adults with cancer co-produced educational resource for demystifying clinical trials, genomic testing and biobanking

In 2019 NHS England produced new service specifications for the Teenage and Young Adult (TYA) Cancer service. Within this document was a target of increasing entry into clinical trials, along with the imperative that all patients are offered both biobanking and genomic testing. Following on from this initiative the Experimental Cancer Medicine Centre (ECMC) Network strategy (2023) has prioritized creating a roadmap to improve access to clinical research for TYAs aged 13-24 with cancer. National statistics indicate TYAs are less likely to participate in cancer research studies, and the ECMC strategy aims to improve this. TYA patients, are less likely to participate in clinical trials and there are low levels of samples available for research. There are many complex reasons for this and it prevents patients accessing new innovative treatments, and not as much research is happening in TYA cancers. This is one reason why TYA cancer patients often experience lower survival rates compared to children or older adults. A pilot project started in 2022 aimed to better understand the challenges TYA patients experience when trying to access cancer research clinical trials, we decided to create a professional and patient partnerships to come up with ideas and solutions to address this national challenge. This work has shown that cancer TYA patients have very limited understanding around the basic concepts of clinical trial participation and as a consequence would not take part in one. A TYA PPI group was created through this work, and an online educational intervention was developed through a PPI co-production approach. The project identified essential information that patients and their family members felt would be useful to know before an initial clinical trial appointment, but in a format that they found accessible. Through this project the UK’s first TYA cancer clinical trials online educational resource was produced.

Sheffield Children's NHS Foundation Trust and Rotherham Doncaster and South Humber NHS Foundation Trust
0-19 research network: 2-year project

The 0-19 research network, 2-year project was necessary because; Specialist Community Public Health Nurses (SCPHN, [Health Visitors and School Nurses]) and the communities they worked were, despite being ideally placed, under-represented and underserved, in relation to research engagement, Engagement in research was limited and not core business, There was an appetite within these professions for greater engagement with research across all levels and that in areas (Sheffield Children's and RDaSH), who had an identified lead for capacity building and an established local Community of Research Practice (CoRP) had opportunity for personal growth/learning within the domain of research. The initiative was facilitated using funds awarded (Clinical Research Network), in April 2022, to build research capacity and capability within 0-19 services, and to support the delivery of studies in public health research, aligning with the national CNO strategic plan for research. The objectives of the project to support the aims were; Creation of research champion that develop CoRP, Facilitation of events to create networking opportunities, supporting the co-produce research and priority setting, Engagement with Higher Education Institutes (HEIs) to support the development of early career researchers and establish links with potential academic supervisors, Development of a potential sustainable prototype model which could be used to development other networks, Create a web presence to increase our visibility, Develop further the project planning group of core members to operationalise the project deliverables regionally. To identify if this was achieved an evaluation was commissioned and completed as part of the project. Challenges; Stepping out of comfort zones, Being required to balance competing demands, time, and responsibility and this wasn’t easy, As senior nurse leaders feeling novice. Future plans; Consider sustainability and Continued engagement with Higher Education Institutes (HEI’s) and regional champions.

St George’s University Hospitals NHS Foundation Trust
Engagement, collaboration, enthusiasm and teamwork – embedding critical care research in clinical practice

We wanted to build a culture that fosters research collaboration and engagement across the critical care directorate and where research was valued and embraced in clinical practice. Thus, permitting expansion of our research portfolio and opportunities for all service users. We developed a research delivery workforce structure that enabled engagement and collaboration with clinical staff. Our approach was to ensure the research team was made up of clinical intensive care nurses who were seconded 50% of their time to research. These opportunities enabled nurses to gain an understanding of the research process, appreciate the value of research and more importantly lead by example. Building excellent working relationships with staff, facilitating engagement and buy-in from all members of the multidisciplinary team, despite workload pressures. Clinical research can be particularly challenging in intensive care as service users are often critically ill and therefore research may not be seen as a priority during the acute phase of the ICU admission. However, eligibility for research is often time critical and therefore only available in this acute phase. In addition, our service users are from a diverse population with a variety of clinical needs, across three intensive care units. With engagement, collaboration and enthusiasm we are overcoming these challenges. Patients are now being highlighted to the research team, sometimes even before they have been admitted to intensive care and we are seeing engagement from clinical team members that were previously reluctant. We plan to increase our research portfolio to accommodate the needs of all our service users so that our diverse population is fairly represented, and all patients offered the opportunity to participate in research. To support participation in the NIHR Associate PI scheme. To develop local research ideas tailored to our service users that focus on enhancing efficiency and promoting sustainability without compromising care.

University College London Hospitals NHS Foundation Trust
STAR – Sickle Cell and Thalassaemia Alliance for Research

People with Sickle cell and thalassaemia (SCD/THAL) have long faced inequity of care. This has been the subject of several reports including: The-National-Confidential-Enquiry-into-Patient-Outcomes-and-Death (NCEPOD) 2008 Report: A-sickle-cell-Crisis? And more recently, the No-One-is Listening-Report (2021). These reports highlighted multiple failings but the lack of understanding/knowledge around SCD as well as poor equity of access to care figured heavily. We had already recognised the inequity of access to clinical research across North Central London (NCL), with studies centred at the UCLH hub, no research activity at North Middlesex (NMUH) and adult only research at Whittington Health (WH) despite these being some of largest centres nationally. Although patients could be referred to UCLH this was rare.  Evidence shows that clinically research-active hospitals have better patient care outcomes and patients tend to be better informed about their condition and treatment. Research improves clinical practic/reduces the cost of healthcare/drives policy change.    The Sickle Cell and Thalassemia Alliance for Research (STAR) was created in 2023 with funding from CRN North Thames and support from the UCLH BRC to promote a culture of research understanding and engagement and provide equity of access particularly for underserved communities.  Following funding approval, we appointed nurses working cross-site supporting research training/engagement/education/study-set-up/promotion of culture change. The main challenge was working with hospitals with sometimes very limited R&D/HR support. There was also a considerable amount of work to break the negative barriers that were in place where the teams had not historically been research active. Despite this, the team has had fantastic success with very significant patient engagement and successful study set up/recruitment (attached). Our plans are to support further hospitals in this initiative. The NIHR CRN is keen to develop this model to other CRN sectors.

University Hospitals Birmingham NHS Foundation Trust
Recruitment video for VitDalize

Patient recruitment to clinical trials within Critical Care is a challenging aspect of the research nurse’s role. This is mainly due to the inability of patients to consent for themselves and due to the sedative effects of medications. Therefore, third-party consent, assent is required in most cases. During the pandemic in 2020, many acute care organisations restricted patient visitors to mitigate cross infection. This provided an additional barrier to patient recruitment to trials on Critical Care as third-party conversations were often conducted over the telephone, removing the face-to-face interaction with a member of the research team. This was additionally problematic across University Hospitals Birmingham (UHB), a large acute care trust which serves a diverse population, many of whom are non-English speaking and may require translational intervention to facilitate patient participation. A team of senior research delivery nurses recognised and highlighted issues with remote trial discussions with one particular high recruiting trial ( Vit Dalize) and wanted to explore other means of communication methods. The physical presence and interaction which accompanied face to face patient recruitment was apparent, therefore the nurses thought a trial video would, in parallel with written information bridge this gap. Therefore, lead by research nurses in collaboration with patient stakeholders, a trial specific video was made. Following ethical approval, the video was added to the trial as an additional recruitment strategy which enabled translation to several different languages, if required. The video has been utilised nationally and positive feedback has been received from research delivery teams and patient stakeholders. The initiative has been adopted across other NIHR funded trials, has had an international impact and has driven further research work within this area.

University Hospitals Coventry and Warwickshire NHS Trust
Enhancing research visibility – driving ideas to action

The Research and Development (R&D) Shared Decision Making (SDM) Council at University Hospital Coventry and Warwickshire (UHCW) NHS Trust is composed of non-clinical and clinical research staff from a diverse cultural background. The council acts as a platform to foster positive change through collaborative decision-making and improvement projects, as well as the development of staff. The Pathway to Excellence® SDM framework is being utilized for this project to foster a positive practice environment, promoting excellence in nursing and midwifery, approved by the Chief Nursing Officer for England. The aim is to enhance research visibility at UHCW, fostering collaboration and knowledge sharing, ultimately improving patient outcomes, by addressing the issue of limited awareness among healthcare staff and leadership. The implementation of the UHCW improvement (UHCWi) methodology has improved the visibility of research within the hospital. Through ongoing evaluation and feedback, data-driven decisions are made to enhance research efforts and patient care, ensuring continuous excellence. Despite resistance from staff members and limited resources, we persevered in balancing research activities with clinical responsibilities. Our delivery phase focused on showcasing research, educating staff, raising awareness, and engaging staff through initiatives like Research on the Go trolleys in ward areas and Research in Your Area Showcase Events. These efforts increased research visibility, encouraged staff involvement, and fostered collaboration among researchers, clinicians, and stakeholders. The study phase involved pre surveys, event surveys, and case studies to gather feedback and measure the impact of initiatives; this data informed decisions and identified improvement areas. In the act phase, we utilized event surveys and case studies, promoted the Research in Your Area Showcase, educated staff about research opportunities, and monitored progress for continuous improvement. Our future involves expanding research training programs and empowering clinical staff to become 'Research Ambassadors', facilitating strategic communication, Health Awareness Day campaigns and impactful presentations.