ResearchEstablishing a practice-based research network of advanced practice registered nurses in southern New England*
Section snippets
Ingredients of a network
In speaking about the development of a PBRN, Green and Lutz1 list the “ingredients” of a good research network as a zealot with a purpose, a sponsoring group, a funding source, an administrative structure, a set of unified symbols, a system of governance, and a multimethod system of communication. A brief discussion on how APRNet developed these basic components follows.
Zealot and purpose
A worthy project such as an APRN research network requires recognized spokespersons in primary care research who are well regarded in both the nursing and medical fields for the importance and integrity of their work. They need to be relatively established in an academic setting that recognizes and supports their research and allows them ready access to other leaders in their field, both nationally and internationally. They must be willing to make the time to start such a project and must have
Sponsorship
Once the project has a zealous leader, it requires a group of experts in appropriate fields to guide and support it through its planning stage. Members can be from the community that will be served by the network, from existing organizations or institutions with an interest or experience in primary care research, or from any number of other sources. Members should contribute expertise and experience from areas that the network must address (eg, data management, Health Insurance Portability and
Funding
Initial funding for any research network is difficult at best. Generally the network has no track record other than the reputation of its director and the members of its planning committee. Unless a professional or parent organization, such as the American Academy of Family Physicians, takes a network under its financial wing, the network must be creative and assertive in finding funding for the first few difficult years when the focus is more on organization than on research. Initial funding
Network administration
There are two elements that are critical for the early success and responsiveness of a network's administration. First is an administrative team with managerial experience in running research studies and with business experience for activities such as developing budgets and creating a communications system. The network manager should be full-time and housed in an office dedicated to the network's administrative functions. For the purposes of the APRN network, hiring a network manager with a
Symbols
Both the network director and manager realized the importance of the network as a “perceived reality” as it struggled to shape and define itself in the early months. A graphics design team at Yale University's Reprographics and Imaging Department was consulted to design a logo for the network on the basis of the nickname that the project had acquired in the planning stages—APRN Net. As the design team explained, the basic design principles that guided them were simplicity in form, complexity in
Governance
From the start, the Planning Committee created subcommittees to address the various issues and tasks relevant to the network's development. Among the tasks was the recruitment of APRN members; from these members the Planning Committee hoped to create a volunteer Advisory Board. It also planned to establish a Community Advisory Board from nominations of the Member Advisory Board.
Recruitment
The network needed a minimum of 25 members to meet its AHRQ grant objective for enrollment. In February 2001, the network staff designed a letter of consent explaining the goals and objectives of APRNet and drafted a membership questionnaire—a 4-page document containing questions on practitioner, practice, and patient demographics (available by request from the authors). YSN's Human Subjects Research Review Committee reviewed the packet containing information and data solicitation and approved
Communication
It was decided to follow some basic rules gleaned from the experience and advice of other primary care PBRNs regarding network communication. First, keep messages timely and repeat them more than once if a response from members is expected. Second, make it easy to access or relay information and questions; provide a 24-hour answering machine or service for network members; and, if possible, offer a toll-free number for the network office. Third, ensure ongoing communication; keep members
APRNet accomplishments
First and foremost, APRNet exists. This reflects an outstanding and continuing commitment from the founding universities—YSN, Boston College School of Nursing, University of Connecticut, University of Massachusetts at Amherst and Worcester, and University of Rhode Island. Without the forward thinking of these institutions' administrators, APRNet would not be a reality. One study has been completed—a survey of the membership that elicited information not only about members but also about their
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2003, Journal of Biomedical InformaticsA Review of 50 Years of International Literature on the External Environment of Building Practice-Based Research Networks (PBRNs)
2022, Journal of the American Board of Family MedicineA review of 50-years of international literature on the internal environment of building practice-based research networks (PBRNs)
2021, Journal of the American Board of Family MedicinePerceived outcomes of research and audit activities of clinical specialists in Ireland
2015, Clinical Nurse Specialist
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Reprint requests: Margaret Grey, DrPH, FAAN, CPNP, 100 Church St South, Yale University School of Nursing, New Haven, CT 06519.