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Case study: Taking a seat at the research table

An interview with Dr Jacqui Prieto, Associate Clinical Professor, Infection Prevention and NIHR 70@70 Senior Nurse Research Leader, Health Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust.

Captivated by nursing and research

I wanted to be a nurse from a very young age. This unwavering aspiration shaped my future career path. Back in 1984, as course work for my GCE ‘O’ Level in Sociology, I got my first taste of research on nursing. I interviewed three registered nurses about their careers and, based on their responses, created a questionnaire survey, which I sent to a larger group of nurses. I analysed the results and wrote up my first study of nurses’ experiences of nursing as a career, before even embarking on my own. I didn’t realise then how relevant this would be for me today as a nurse who combines clinical practice and research.

At the start of my own career in 1986 I studied for a BSc Honours degree in Nursing with RGN, which I loved because it combined the practice and academic elements of nursing. It was during this time that microbiology and infection prevention grabbed my attention.

In my final year I undertook an empirical research study to compare bacterial growth beneath two types of dressing commonly used for intravenous cannulae. At that time, it wasn’t standard practice to use a sterile dressing and my findings revealed the difference this made to minimising bacterial growth and reducing the risk of infection. I was now hooked on research.

At the time of studying for my degree there was much less recognition than there is today of the value of combining nursing practice with academia. There were assumptions that practical nursing and research just didn't go together. And yet without both how can we advance our profession and improve patient care?

I am also in awe of the amazing research that’s happening in response to COVID-19.

Impact of nursing research and clinical academic careers

There were no formal pathways to combine nursing practice and research when I first started nursing. I simply followed my interests and took opportunities that appealed to me. Having specialised in infection control I applied for a research fellowship to do a PhD while continuing to work as a clinical nurse specialist. This was my first experience of combining nursing practice and research.

My research was a detailed case study to investigate how the implementation of infection control precautions could be improved when nursing patients in single room isolation with an infectious condition.

This was highly applied research that involved the entire ward team of nurses and healthcare assistants. Showing them how much of a difference research can make to their
practice was exciting. It allowed them to see how they could overcome the practical problems they encountered when implementing infection prevention principles in practice.

I have since secured regional and national funding to further my career as a clinician academic, the most recent being a five-year NIHR Senior Clinical Lectureship in 2013-18. This allowed me to embed my role within the NHS, to drive clinically focused research on infection prevention and lead improvements in the implementation of evidence-based practice.

Currently my programme of research and improvement work focuses primarily on reducing catheter-associated urinary tract infection, a leading cause of healthcare-associated infection.

I returned to full-time clinical practice for three months in my role as part of the infection prevention team to help during the COVID-19 pandemic.

Strengthening the nursing and midwifery contribution to research through the 70@70 programme

In March this year, I returned to full-time clinical practice for three months in my role as part of the infection prevention team to help during the COVID-19 pandemic. It’s been a powerful reminder of the importance of evidence and the difficulties we face when this is lacking. As a novel virus, SARS-CoV-2 is presenting an immense challenge.

Whilst there are sound scientific rationales underpinning the infection prevention principles we apply in routine clinical practice, the threat posed by this virus in the context of a global pandemic has unnerved medical professionals and the public alike. I feel incredibly proud of how quickly nurses, medics and allied health professionals across the hospital where I work have come together to restructure and adapt to what is happening.

It isn’t just issues with the virus and how we treat it that we’re having to overcome, but how we communicate with patients through layers of PPE, how we are there for each other during extraordinary times of pressure and spending extra time with patients in the absence of their relatives being allowed to see them.

I am also in awe of the amazing research that’s happening in response to COVID-19. New trials to help find a vaccine, find effective treatments and test new ways of working have demonstrated the agility and huge capability of our research community.

This includes those who work hard behind the scenes to make research happen, particularly nurses working in research delivery. Being part of the 70@70 programme has helped me to encourage other nurses and midwives to get involved in research and engage with those who deliver research in different areas of practice. As nurses we’re not great at shouting about what we do, but programmes like 70@70, and the pandemic, are thrusting us into a research arena where we need, and deserve, to stay.

I like to think of nurses as the oil that keeps the wheels running in research and in healthcare. We’re great at spotting gaps and problems on the ground and often know how we can solve them. This means we have much to contribute to the generation of new research, its successful delivery and future innovations in care.

We need more programmes like 70@70 to help us stay at the research table, gain acknowledgement for our roles in all stages of the research process and to continue strengthening our voice and influence.

We have much to contribute to the generation of new research, its successful delivery and future innovations in care.