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PURPOSE: The purpose of this study was to assess the associations between demographic, professional and other personal nurse characteristics, social support factors and comfort in conducting research with nurses' level of active participation in clinical research. DESIGN: A prospective, cross-sectional, correlational design was used. METHODS: Clinical nurses working in a multihospital healthcare system were recruited by email to complete an anonymous survey that used multiple valid and reliable scales to assess demographic and professional work characteristics, curiosity, grit, locus of control, perceived social support (for research activities), comfort in conducting research, and level of being research-active. Univariate and multivariable analyses were completed. RESULTS: Of 310 participants, 274 (88.4%) were female and mean (SD) age was 42.9 (13.1) years. After condensing 11 levels of research activity to four categories, 179 (57.7%) were not research-active, and 91 (29.4%), 26 (8.3%) and 14 (4.5%) were engaged at low, moderate, and high levels, respectively. Of 78 factors, 69 (88.5%) were associated with being research-active in univariate analyses. In multivariable analysis that adjusted for age, personal experience as a patient, years as a nurse and hours in direct patient care, professionalism characteristics, higher curiosity, internal locus of control, grit perseverance, support of a nurse scientist and nurse friends, and comfort in conducting research remained associated with higher levels of being research-active (all p < 0.01). CONCLUSION: Research-active nurses were more likely to be engaged professionally in hospital-based activities beyond their work roles and displayed higher levels of positive psychological characteristics and mentorship that supported research capacity. CLINICAL RELEVANCE: Research-active nurses were more likely to have internal factors and external resources that promoted higher levels of being research-active. A strong professional governance model may enhance clinical nurses research activities.

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PURPOSE: The aims of this study were to examine interrater agreement of delirium between clinical nurses and a clinical nurse specialist, determine delirium subtype prevalence, and examine associated patient, procedure, and hospital factors. DESIGN: A descriptive cross-sectional design and a convenience sample of nurses and patients on progressive care units were used in this study. METHODS: Clinical nurse specialist data were collected on a case report form, and clinician and patient data were obtained from electronic databases. Interrater agreement of delirium prevalence was assessed by κ statistic, and logistic regression models were used to determine patient factors associated with delirium. RESULTS: Of 216 patients, 23 had delirium; clinical nurses identified fewer cases than the clinical nurse specialist: 1.8% versus 10.7%; κ agreement, 0.27 (0.06, 0.49). By delirium subtype, hypoactive delirium was more frequent (n = 10). Factors associated with delirium were history of cerebrovascular disease (odds ratio [95% confidence interval], 2.8 [1.01-7.7]; P = .044), history of mitral valve disease (odds ratio [95% confidence interval], 0.31 [0.09-0.90]; P = .041), and longer perfusion time (odds ratio [95% confidence interval], 1.7 [1.1-2.7]; P = .016). One factor was associated with hypoactive delirium, longer perfusion time (odds ratio [95% confidence interval], 2.2 [1.3-4.2]; P = .008). CONCLUSIONS: Because clinician-clinical nurse specialist delirium agreement was low and hypoactive delirium was common, clinical interventions are needed.

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PURPOSE: The aim of this study was to quantify clinical nurse specialist (CNS) work and determine if competencies are associated with personal characteristics, priorities, and quality outcomes. BACKGROUND: The work of a CNS is difficult to quantify. Nurse leaders need quantifiable data to understand the impact of CNS work. DESIGN: A prospective, single-center, correlational study with a convenience sample was conducted. SETTING AND SAMPLE: The study was conducted in a 1200-bed quaternary care medical center in Northeast Ohio, using CNSs. METHODS: The investigator-developed Role Tracker Tool (software) and a CNS questionnaire were used to collect baseline and monthly data for 5 months. Characteristics of the CNSs were summarized using descriptive statistics. Correlational statistics were used to measure associations. After mutually exclusive groups were created, tests for differences were completed using a Welch 2-sample t test and analysis of variance. Regression models were used to determine if relationships existed over time between competencies, priority ranking of competencies, and nursing characteristics. FINDINGS: Among 14 CNSs, mean (SD) age was 45 (10.11) years; mean (SD) CNS experience was 5.57 (7.87) years. Of 6 competencies, CNSs ranked quality as most important, followed by clinical work. Research ranked low. Mean (SD) time spent in hours/8.5-hour workday over 5 months was highest for clinical work, at 1.9 (1) hours, and lowest for professional self-development, at 0.4 (0.4) hours. Time spent on specific competencies varied by specialty, years as a CNS and at current employer, and comfort in competencies and spheres after controlling for nurse characteristics and monthly trends. Of 9 quality initiative focuses, mean (SD) time in hours/8.5-hour workday was highest for heart failure, with 0.7(0.8) hours. Time spent on quality initiatives was not associated with changes in quality improvement outcomes. Clinical nurse specialist competency priorities, quality initiative focuses, and quality outcomes varied over time. IMPLICATIONS: The work of CNSs can be captured and analyzed to enhance understanding of unique and varied CNS contributions in the healthcare matrix.

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