Authors

  1. Kapu, April N. DNP, APRN, ACNP-BC, FAAN
  2. Ivory, Catherine PhD, RN-BC, RNC-OB, NEA-BC, FAAN

Abstract

ABSTRACT: This month's column highlights the value contribution of advanced practice registered nurses (APRNs) to research and the importance of chief nursing officer development of health system infrastructure to engage APRNs in research.

 

Article Content

Advanced practice registered nurses (APRNs) are in high demand, delivering accessible, high-quality care.1 According to the US News and World Report, nurse practitioners (NPs), one of the 4 categories of APRNs, are listed as the #1 healthcare job in the United States.2 Although many APRNs are engaged in direct patient care, many are seeking to expand their career portfolio and branch into areas of education, advocacy, leadership, and research. One might wonder why research is considered, but APRNs are both interested and sought after to engage in research. Their education, experience, ability to elevate clinical interests, and unique perspective are valuable qualities in the development of high-level research, dissemination, and translation to patient care.

 

Chief nursing officers (CNOs) provide the infrastructure and promote the culture to advance professional practice, including the quest to use the best evidence and conduct research. Common barriers to practice-based research include support for the time necessary to complete a project and the mentorship to conduct a project. Chief nursing officers must remove barriers to promote practice based on evidence and the generation of new knowledge; CNOs must also be role models of behaviors that support a culture of evidence-based practice (EBP) and research.3 Structures that support EBP and research vary on the basis of facility size and relationships with collaborating stakeholders. For example, at Vanderbilt University Medical Center (VUMC), the Office of EBP and Nursing Research coordinates EBP and research activities for nurses at all levels of practice by facilitating relationships with the school of nursing and the broader research enterprise. The EBP and Nursing Research office's director is a member of the executive CNOs' senior leadership team and is directly aligned with other nursing departments, including VUMC's Office of Advanced Practice Nursing. The office is the front door for APRNs who are prepared to conduct research projects but do not know where to start.

 

In the Montgomery et al observational study,4 infrastructure was indicated as a key variable to building a successful and effective program for APRNs. Chief nursing officers remain central to the development and implementation of programs focused on the engagement of nurses in research and translation into EBP, but to effectively integrate APRNs, advocating for and building capacity for research is paramount.4 Although APRNs, particularly those who have completed doctoral programs, have education and training to conduct research, they are often engaged in time consuming clinical practice and patient care. Creating capacity for research, they can bring expertise in practice and patient care, bring unique and valuable perspective, and ultimately direct implementation to EBP. Engagement in research activities offers opportunity for professional growth and development, a key contributor to career satisfaction.

 

Opportunities for research are abundant, especially throughout the ongoing COVID-19 pandemic. However, investing time and attention and addressing the learning curve for research have been extremely challenging. As CNOs implement frameworks for research, opportunities to engage should be prominent. For example, as we were entering the pandemic, our infectious diseases department began rigorous work developing and launching a vaccine study. The lead infectious diseases physician, Dr Buddy Creech, reached out to ask if there were APRNs interested in allotting time and work effort toward the study. This was an exciting opportunity, and when asked to share more about his interest in APRN involvement, he stated, "They (APRNs) play critical roles in research. In vaccine clinical trials, assessment of safety is paramount; therefore, having the training needed to assess clinical events after vaccination rigorously is essential. APRNs also provide the ability to serve as subinvestigators on clinical trials, assessing eligibility and conducting physical examinations."5

 

During the ensuing days, a few interested APRNs were available to work on the vaccine study. The experience was invaluable. Anne Gallion, one of these NPs, emailed the following experience: "It was an honor to work on the Moderna COVID-19 vaccine trial as a subinvestigator and one of many APRNs on the vaccine research team. Despite the challenges inherent in the fight against a new pandemic, I view it as some of the most important and rewarding work I have ever done. As a NP, I can attest that advanced practice nurses have played a central role in the COVID-19 vaccine trials. In my role on the team, I was able to leverage my clinical and leadership skills as a NP in many ways, including that of assessing the eligibility of study subjects, completing physical exams, and in the continued monitoring of subjects throughout the study. We often hear of the great contributions of our physician-scientist colleagues in research, but the reality is that NPs have also made great contributions to this groundbreaking science. Our team with APRNs produced high-quality data and helped move the needle towards the COVID-19 vaccines. Although there are many challenges brought on by the pandemic, I think it has highlighted both the incredible skills of the APRN and the broad impact that we can have through our ever-evolving roles, from frontline patient care and health system leadership to cutting-edge research."6

 

High-functioning nursing organizations and CNOs incorporate programs to encourage and facilitate research for nursing at all levels. Including and augmenting APRNs into the structure can enhance both programs and research outcomes. The ever-increasing body of APRNs are but 1 facet of the great whole of nursing, but the experience and perspective of the role can have a tremendous impact in advancing nursing science and patient care.

 

Acknowledgments

The authors would like to acknowledge Anna H. Gallion, DNP, APRN, FNP-BC, and Clarence Buddy Creech II, MD, MPH, for their contributions to this article.

 

References

 

1. Best health care jobs. US News and World Report. https://money.usnews.com/careers/best-jobs/rankings/best-healthcare-jobs. Accessed December 1, 2021. [Context Link]

 

2. More than 325,000 nurse practitioners (NPs) in the United States. American Association of Nurse Practitioners (AANP). https://www.aanp.org/news-feed/more-than-325-000-nurse-practitioners-nps-license. Accessed December 1, 2021. [Context Link]

 

3. Gallagher-Ford L, Connor L. Transforming healthcare to evidence-based healthcare: a failure of leadership. JONA. 2020;50(5):248-250. [Context Link]

 

4. Montgomery KE, Ward J, Raybin JL, Balian C, Gilger EA, Smith C. Building capacity through integration of advanced practice nurses in research. Nurs Outlook. 2021;69:1030-1038. [Context Link]

 

5. Email interview with Clarence Buddy Creech II, MD, MPH, Professor of Pediatrics, Director, Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, (mailto:Buddy.creech@vumc.org). [Context Link]

 

6. Email interview with Anna H. Gallion, DNP, APRN, FNP-BC, Nurse Practitioner, Hospital Medicine, Vanderbilt University Medical Center and Instructor for Instructor of Nursing, Vanderbilt University School of Nursing, (mailto:Anna.gallion@vumc.org). [Context Link]