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Commentary: The conundrum of clinical trials and standard of care in sub-Saharan Africa – the research nurse perspective

The reviewed study describes the delivery and conduct of two clinical trials in Uganda, and considers the challenges of this, both for the recruitment and follow-up of patients and also amidst the clinical pressures. These issues are relevant to the UK, and most likely globally, as all healthcare systems are under pressure to deliver care and research with less capacity and fewer resources, making successful trial delivery increasingly challenging. The reviewed paper contributes to the literature, which does not have a lot of publications looking at the role of research nurses in the successful delivery and conduct of research. It is fascinating to read from a perspective that is international and yet so relevant to everyday research practice in the UK. Research nurses are vital to the successful delivery of research and I believe that studies would not be delivered to the same standard, efficiency and quality without research nurse involvement. The author describes some of the research nurse roles, including ensuring fully informed consent, and the vital role of patient education in ensuring maintenance of consent throughout the study. One area of increasing interest to practitioners, and anyone involved in healthcare, is the evidence suggesting that patients have better outcomes in hospitals where research is conducted. The author alludes to this when commenting on the need to translate the high standards of care participants receive when part of a research study and to integrate this into all clinical care. It would be worthy of fuller discussion as this is where the benefits of research really have an impact on clinical care. The author describes the disparity of care between research and routine hospital care, and the balance of delivering the research alongside colleagues under pressure to deliver care. This occurs in the UK too, and it is really important for research nurses not only to be aware of their own targets and pressures, but to be cognisant of those that their colleagues face, and to assist in times of pressure rather than walk away as their funding is strictly for research activity. This does occur and is