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Clinical Research Nursing and Advanced Practice Helen Pidd and Gail Holmes.

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Presentation on theme: "Clinical Research Nursing and Advanced Practice Helen Pidd and Gail Holmes."— Presentation transcript:

1 Clinical Research Nursing and Advanced Practice Helen Pidd and Gail Holmes

2 Overview of presentation National Context What is Advanced Practice? Manchester Context – why and how MSc in Advanced Practice Health and Social care – an overview


4 Wheres the starting point? Benefits of the Job The conduct of research to international standards Travelling to investigator meetings and conferences nationally and internationally Eating at good restaurants to discuss the research project/s and to network No shift work Drawbacks of the Job Drowning in a sea of research jargon Frequently working in isolation Other nurses view the CRN as a data collector Short term contracts Sometimes have to arrange holidays around studies in progress

5 Historically Worked in isolation from their professional colleagues Convenient whilst raising a family, not having to work weekends and evenings Mere data collectors Short term contracts Lack of line management support Invisible to trust personnel systems Extended and specialised role

6 Cork Dublin Galway Aberdeen Inverness Dundee Hull York Brighton Peninsula Cardiff Leeds Liverpool Sheffield Nottingham Leicester Birmingham Oxford Bristol London Royal Brompton Barts Southampton Biomedical Research Units Bristol Nottingham Birmingham Manchester Cambridge Southampton Newcastle London McMichael Centre UCLH Somers GOSH Guys & St Thomas Hull York Manchester Childrens Sheffield Sheffield Childrens Birmingham Childrens Oxford Peninsula Brighton Surrey Aberdeen Edinburgh Glasgow Inverness Tayside Dundee Belfast Dublin Galway Cork Cardiff Clinical Research Facilities Aberdeen Dundee Glasgow Edinburgh Newcastle Manchester Liverpool Cambridge Oxford London Great Ormond St Guys & St Thomas Imperial Moorfields Royal Marsden UCL Biomedical Research Centres Edinburgh Glasgow Belfast Newcastle Leeds Manchester Liverpool Sheffield Leicester Birmingham Cambridge Oxford London Barts ICR Imperial KCL UCL Southampton Experimental Cancer Medicine Centres Edinburgh Glasgow Belfast Newcastle Leeds Manchester Liverpool Sheffield Leicester Birmingham Cambridge Oxford London Surrey Southampton

7 NIHR Dementias & Neurodegenerative Diseases Research Network NIHR Diabetes Research Network NIHR Medicines for Children Research Network NIHR Mental Health Research Network NIHR Comprehensive Clinical Research Network NIHR Stroke Research Network NIHR Primary Care Research Network NIHR National Cancer Research Network NIHR Clinical Research Networks

8 NIHR Comprehensive Research Network

9 Clinical Research Nurses Newcastle year n % Increase over 3 years

10 Similar Picture Across the Country NURSES Cambridge148 Sheffield 173 Manchester 168 Norfolk & Norwich 56 Newcastle 180 Birmingham 87 (Trust) Scotland 411 AHP/STUDY COORDINATORS Cambridge26 Sheffield21 Manchester13 Norfolk & Norwich 8 NUMBERS INCREASING YEAR ON YEAR 2012/13 10,000

11 Changes since 2001 National:- including Developing the Best Research Professionals (Finch) 2007, Competency document – version 2, Training – GCP, Informed Consent, new roles emerging Networks:- Induction Portfolios, local training, information sharing - UKCRF Network – Trust:- Lead Nurse Appointments, Local Training

12 Opportunities Academic Management Clinical


14 Advanced Practitioner The definition used widely by the DOH outlines that an advanced practitioner is a clinically autonomous practitioner, defines the scope of practice of others and continuously develops clinical practice within a defined field. Experienced non-medical registered professional who has developed his or her knowledge to a very high standard in a specific and often high level of practice. This high standard is such that not only is the individual the expert in the base domain:-but can also accept the full responsibilities for providing those services hitherto supplied by others, in defined circumstances. (J. Sargent 2003)

15 Core Characteristics of Advanced Practice Work across organisations and different agencies Provide advanced levels of practice, knowledge and skills Clinical focus - Clinically autonomous. Empowered to make high-level decisions. Be self directed, manage risk, have high levels of communication skills and be a member of a wider clinical/ service team. In many cases the person will have their own patient/client caseload with decision making responsibilities In many cases manage medications including assessment, review and prescribing. Undertake a physical examination and history taking, diagnosis and plan care and treatment.

16 Advanced Practice in Manchester Modernising workforce European working time directive Patient centred seamless care PARTNERSHIP 2004 Strategic Health Authority 13 Acute and Mental health Trusts University of Bolton (primary care) University of Salford (acute)

17 Advanced Practice in Manchester Greater Manchester SHA initiative – Delivering the Workforce Advanced and Assistant Practitioners Need identified by Trust, application to GMSHE Trainee roles commissioned and funded through GMSHA Supported by an education programme

18 Application Process Rigorous process Trust and WTCRF commitment to the role Detailed proposal form submitted to SHA Decision to support application sits with SHA

19 The Proposal Executive sign off Role description Reason for developing role Needs analysis Skills and competencies Facilitation of WBL Identification of mentor/assessor/line manager Safety, effectiveness. governance Funding arrangements and sustainability Organisational track record

20 The Role - Overview To develop advanced knowledge and skills in the identified theme areas and assist both new and established investigators to efficiently carry out their studies and enable them to achieve study targets by providing continuity of service. In partnership with the Clinical team manager provide clinical leadership to the team of nurses, focusing on enhanced practice development To develop nurse led research and support the development of clinical academic roles.

21 The Role - Expectations Lead on participant care for the duration of a study, including assessment for inclusion in a study, medical history taking, medical examinations, management of drug infusions, prescribing and reviewing and refining participant care throughout the study Provide medical cover for identified cardiovascular and paediatric studies Undertake informed consent for Clinical Trials of Investigational Medicinal Products

22 Demonstrate enhanced clinical skills including arterial bloods, biopsies, management of central lines, minor surgical procedures, ultrasound in the vascular system, management of anaphylaxis, pulse wave analysis, analysis and decisions relating to test results Lead on the development of nurse led research and enhanced clinical practice Provide advice and guidance to PIs on study efficacy and safety Participate in the development and testing of new devices and approaches to health care for patient benefit

23 MSc - Programme 2 years (part time) 45 weeks per year (3 semesters). 2 learning days per week. Thursdays taught day. Thursdays and some Fridays sem 1 and 2 Attendance at University greatly reduced year 2. - WBL Second day student choice for clinical/work based needs. 90 days per year clinical application.

24 University of Salford, MSc Advanced practice (Health and Social Care Pathway) Programme Overview Semester 1 Semester 2 Semester 3 Credits Credits Year 1 Principles of Advanced Practice (30) Application of Life Sciences (30) Contextualising Advanced practice (30) 90 Portfolio Individual Learning Pathway Tripartite Agreement core and bespoke skills Organisational pathway analysis Year 2 Research Methods (30) AP1: Practitioner competence (30) AP2: Clinical Reasoning (30) 90

25 Portfolio of Evidence Year 1 Job description Individual Learning Pathway Clinical Skills Learning Agreement Bespoke Skills identified and agreed Objective and subjective evidence for sub elements of the Elements of Advanced Practice Achievement of skills at level 2 on Taxonomy of Achievement Organisational pathway analysis 360 degree feedback

26 Portfolio of Evidence Year 2 Cases (formative and summative) Triangulated evidence for many sub-element of Elements of Advanced Practice Completed skills log (core and bespoke) at level 2 and 3 40 case assessments Completion of Individual Learning Pathway 180 credits at level M

27 Programme Support Mentors –Stay with student for 2 years –Understand programme and learning requirements –Advocate in Trust on behalf of student Assessors –Objective judgement on performance throughout 2 years –May delegate some work to supervisors of appropriate standing

28 Programme Support Trust Mentor Line Manager Assessors Supervisors University Personal Tutor Academic Supervisor Programme lead Student Life Learning Facilitator

29 Where are we now Successful SHA application – 2 posts Successfully recruited through internal secondment – band 7 in training, 8a once qualified Steering group in place 2 trainees commenced Sept 2011


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