Lessons Learned From a Practice‐Based, Multisite Intervention Study With Nurse Participants

• Published in: Journal of nursing scholarship Vol. 49; no. 2; pp. 194 - 201
• Main Authors: Friese, Christopher R., Mendelsohn‐Victor, Kari, Ginex, Pamela, McMahon, Carol M., Fauer, Alex J., McCullagh, Marjorie C.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2017
• Subjects: Ambulatory Care; Budgets; Cancer therapies; Challenges; Clinical trials; Computer based; Continuing education; Education; Educational materials; Employees; environmental health; Feedback; Grants; Guideline Adherence - statistics & numerical data; Health Care Surveys; Health sciences; Human subjects; Humans; Information technology; Infrastructure; Internet; Intervention; intervention research; Leadership; Neoplasms - nursing; Nurses; Nursing; Nursing schools; Nursing Staff - psychology; Oncology; Pediatrics; Personal protective equipment; Personal Protective Equipment - statistics & numerical data; Recruitment; Safety; Site visits; Studies; survey methodology; Technology; work environment; Ann Arbor Michigan; United States > US; work environment; intervention research; Education; environmental health; survey methodology
• DOI: 10.1111/jnu.12279
• ISSN: 1527-6546

Purpose To identify challenges and solutions to the efficient conduct of a multisite, practice‐based randomized controlled trial to improve nurses’ adherence to personal protective equipment use in ambulatory oncology settings. Design The Drug Exposure Feedback and Education for Nurses’ Safety (DEFENS) study is a clustered, randomized, controlled trial. Participating sites are randomized to Web‐based feedback on hazardous drug exposures in the sites plus tailored messages to address barriers versus a control intervention of a Web‐based continuing education video. Approach The study principal investigator, the study coordinator, and two site leaders identified challenges to study implementation and potential solutions, plus potential methods to prevent logistical challenges in future studies. Findings Noteworthy challenges included variation in human subjects’ protection policies, grants and contracts budgeting, infrastructure for nursing‐led research, and information technology variation. Successful strategies included scheduled Web conferences, site‐based study champions, site visits by the principal investigator, and centrally based document preparation. Strategies to improve efficiency in future studies include early and continued engagement with contract personnel in sites, and proposed changes to the common rule concerning human subjects. The DEFENS study successfully recruited 393 nurses across 12 sites. To date, 369 have completed surveys and 174 nurses have viewed educational materials. Conclusions Multisite studies of nursing personnel are rare and challenging to the existing infrastructure. These barriers can be overcome with strong engagement and planning. Clinical Relevance Leadership engagement, onsite staff support, and continuous communication can facilitate successful recruitment to a workplace‐based randomized, controlled behavioral trial.