Advanced practice nurses facilitating clinical translational research

In 2006, the Clinical and Translational Science Award (CTSA), initiated by the National Center for Research Resources, was launched, with the overall goal to improve human health through clinical translational research. The purpose of this study was to examine the association between the total visit length for standardized study visits requiring the services of either a physician colleague or a designated advanced practice nurse (APN) for a protocol conducted in a clinical research center (CRC) supported with CTSA funds.

Data collected for administrative purposes between June 2008 and September 2009 were used. This retrospective study compared the total visit length for the standardized study visits of a single study protocol requiring a gluteal fat biopsy procedure performed by either a physician colleague (an MD in this case) or a CRC-based APN employed by the CRC.

During the observed time period, 67 gluteal fat biopsy procedures were performed by one physician colleague, and 33 procedures were performed by one CRC-based APN. The mean total visit length of standardized study visits for research subjects treated by the physician colleague was 192.9 ± 65.8 minutes, whereas the mean total visit length of standardized study visits for research subjects treated by the APN was 154.8 ± 40.9 minutes (P = .003). Generalized least squares random effects regression model further evaluated the association between provider and visit length while controlling for age, gender, percent body fat and physical activity. The type of provider (P < .001) and gender (P < .05) were associated with length of visit.

The introduction of a CRC-based APN to perform advanced procedures demonstrates an efficient use of resources to meet the advanced clinical needs of specific research protocols. In this retrospective study, the ready availability of an APN (employed by the CRC) to perform gluteal fat biopsies during standardized study visits led to a decrease in total visit length, and thus a more rapid "turnover" of clinical research space compared to the use of a physician colleague. To best meet the needs of clinical researchers, CRCs should consider the employment of other clinicians to complement the research facilitation services provided by registered nurses. The addition of an APN to the CRC research facilitation team is novel and lends itself to the spirit of the clinical translational research initiative; additional studies evaluating the contribution of other licensed practitioners to improve research facilitation efficiency are needed.