Implementing Clinical Research in the High Acuity Setting of the Emergency Department

Holli A. DeVon, Frances L. Patmon, Anne G. Rosenfeld, Michelle M. Fennessy, Daphene Francis

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction: Clinical research in the emergency department provides supporting evidence needed for the development of practice guidelines, such as door-to-needle and door-to-balloon times for treatment of acute coronary syndromes, and is vital to improvements in patient outcomes. The purpose of this article is to describe barriers and lessons learned in launching a multisite clinical research study of symptoms of acute coronary syndromes in the emergency department. Methods: Participants included ED and research staff in 4 busy emergency departments in 3 states. At each step of the study launch, the principal investigator at the clinical site identified barriers that either were anticipated or experienced and discussed them with the site staff and study principal investigator to validate the issue as a barrier. Orientation sessions and ongoing communication between clinicians, research staff, and the research study team provided opportunity for adjustment of study protocols. Results: Barriers were lack of staff engagement in research, difficulty identifying eligible patients, perception of interference in clinical care, variability in research staff education and training, patient refusals, nurses' perceptions of lack of time, undifferentiated patients, and time-sensitive quality improvement indicators necessitating acceleration in care. Discussion: Important strategies to overcome barriers were developed, including identification and support of unit champions in emergency nursing and medicine; minor protocol modifications to improve enrollment goals; development of specific written expectations, roles, research protocols, and algorithms; and sharing successes among sites.

Original languageEnglish (US)
Pages (from-to)6-12
Number of pages7
JournalJournal of Emergency Nursing
Issue number1
StatePublished - Jan 2013


  • Acute coronary syndrome
  • Clinical research
  • Emergency department
  • Nursing research
  • Research methods
  • Research protocols

ASJC Scopus subject areas

  • Emergency


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