Creating Clinical Research Protocols in Advanced Practice: Part I, Identifying the Fit and the Aim

摘要

The term "advanced practice nurse" (APN) encompasses nurses with graduate level preparation typically focused on direct patient care, or oversight of direct patient care, in a clinical practice setting. Examples include the certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), and most commonly, nurse practitioners (NPs). The versatility and independence represented by these very different practice arenas is one of the most valuable assets of advanced practice nursing. Yet, the same virtue can become a vice for APNs interested in research or clinical inquiry as an integral component of their everyday practice. Three common and often unanticipated challenges include (1) clinical practice isolation, (2) limited preparation for independent research or improvement science design, and (3) time constraints, either to pursue funding or to engage in unfunded clinical inquiry. As a result, nurses with the most experience and exposure to patients' problems are often the least likely to have critically needed peer support, methodological skills (eg, study design), or funded time to develop a protocol (eg, nonacademic roles). The purpose of this series is to creatively explore considerations in protocol development and to propose approaches that may be particularly well suited to clinical inquiry projects for APNs. Part 1 in this 3-part series addresses the initial steps of protocol development and presents solutions for the challenges uniquely associated with clinical practice isolation.