Nursing What is a Protocol Nurse? The Protocol Nurse works with the investigative team in developing and implementing clinical protocols on the GCRC. Each protocol nurse is experienced in their area of specialty as well as in clinical research. This unique blend of expertise provides the investigative team with the clinical skill and expert knowledge needed to develop, implement and execute clinical protocols. Protocol Nurse (Continued) To further aid in our clinical expertise, all GCRC nurses work within clinical cluster groups such as neurology, psychiatry, neurobioimaging, cardiology, critical care, endocrinology, infectious disease, pediatrics and oncology. In addition, the nurse provides the compassion and human caring necessary to ensure the well being of our subjects. Nursing Responsibilities Development and implementation of the protocol in collaboration with the study team and GCRC staff, including: Collaborates with study team to develop research data collection tools. Assist with physician order implementation. Conducts regular evaluation of protocol progress with PI, study staff, GCRC staff. Conducts Nursing assessments. Nursing Responsibilities (Continued) Educates GCRC staff on protocolspecific procedures. Designs a plan of care that ensures: subject safety  maintenance of subject’s health state  prompt identification and treatment of adverse events  Implementation of the discharge plan.  Nursing Responsibilities (Continued) Monitors subjects’ physiological and psychological status during the study. Oversees accuracy of lab slips and specimen labels. Administers study medication and procedures and observes and records subjects’ response. Nursing Responsibilities (Continued) Participates in preparation of study findings for presentation and publication. Participates in research protocol review with membership on Partners HRC committees and MGH Patient Care Services Collaborative Governance committees. Common Nursing Procedures Performs clinical assessment of the subject. Implements emergency preparedness. Performs venipuncture or IV placement for administration of medication. Continually assesses subjects’ response. Completes EKG and physiological monitoring. Conducts study-specific procedures and equipment usage as appropriate. Common Nursing Procedures (Continued) Teaches protocol requirements, reviews study visit, injection teaching, urine collection, medication administration, etc. Processes laboratory samples in the absence of lab tech staff. Develop protocol-specific scheduling templates. Study Staff Requirements Confirm study visit date and time with the research subject. Arrive at the scheduled time. Submit approved doctors’ orders two business days before scheduled visit. Delivers protocol-specific equipment and supplies, including medications and protocolspecific aliquots and tubes. Pick up specimens in a timely fashion. Study Staff Requirements Notification of cancellation:  Call the front desk at 6-3294 or 60807 (BIC) ASAP.  Cancel visits through the “Request for Appointment” program, which will update the Turbo Scheduler. PATIENT IDENTIFICATION AREA MASSACHUSETTS GENERAL HOSPITAL GENERAL CLINICAL RESEARCH CENTER OUTPATIENT HEALTH HISTORY GCRC USE ONLY PROTOCOL #______________ CONSENT SIGNED EXPIRES_________________ Welcome to the General Clinical Research Center. Please take a few minutes to give us some general information on your health. This information is confidential and will enable us to assist you during the study. Name:_______________________________ Hospital ID#(if known)_______________Today’s date_______________ Date of Birth__________ Sex: Male Female Marital Status: Single Married Divorced Widowed Other Address:__________________________________________Telephone: Home____________Work:_______________ Emergency Contact and Phone Number_________________________ Employed: Yes No Retired Disabled Insurance Yes No Last exam by Primary Care Physician_____________________Name____________________ Do you smoke cigarettes? Yes Packs per day?____ No How many alcoholic drinks do you consume a week?____ Are you on other research studies? Yes No What kind?____________________Where?_____________________ What study are you here for today?__________________________ __Study Physician__________________________ What have you been hospitalized for in the past?_________________________________________________________ What surgeries have you had in the past?_______________________________________________________________ MEDICATIONS List medications you are currently taking (Continue medications on reverse side if necessary) ALLERGIES To medications, foods or other substances SYMPTOMS Check ( ) symptoms you currently have or have had in the past year. GENERAL GASTROINTESTINAL EYE, EAR, NOSE, THROAT  Chills  Appetite poor  Bleeding gums  Depression  Bloating  Blurred vision  Dizziness  Bowel changes  Crossed eyes  Fainting  Constipation  Difficulty swallowing  Fever  Diarrhea  Double vision  Forgetfulness  Excessive hunger  Earache  Headache  Gas  Eye discharge  Loss of sleep  Hemorrhoids  Hay fever  Loss of weight  Heartburn  Hoarseness  Nervousness  Indigestion  Loss of hearing Numbness Nausea    Nosebleeds  Sweats  Rectal bleeding  Persistent cough MUSCLE/JOINT/BONE  Stomach pain  Ringing in ears Pain, weakness, numbness or  Vomiting  Sinus problems previous fractures/breaks in:  Vomiting blood  Vision - Flashes  Arms Hips CARDIOVASCULAR  Vision - Halos  Back Legs SKIN  Chest pain  Feet Neck  High blood pressure  Bruise easily  Hands Shoulders  Irregular Heart Beat  Hives GENITO-URINARY  Low Blood Pressure  Itching  Blood in urine  Poor circulation  Change in moles  Frequent urination  Rapid Heart beat  Rash Lack of bladder control   Swelling of ankles  Scars  Painful urination Varicose Veins   Sore that won’t heal MEN only  Breast lump  Erection difficulties  Lump in testicles  Penis Discharge  Sore on Penis  Other_____________ WOMEN only  Abnormal pap smear  Bleeding between periods  Breast lump  Extreme menstrual pain  Hot flashes  Nipple discharge  Painful intercourse  Vaginal discharge  Vaginal dryness  Other_____________ Date of last menstrual period________________ Date of last pap smear________________ Have you had a mammogram?_________ Are you pregnant?______ Number of children_____ *** CONTINUE FILLING OUT FORM ON OTHER SIDE *** Contact Us! Maureen E. Schnider, Interim Nurse Manager    Phone 617 726-3201 Fax 617 724-3497 E-mail mschnider@partners.org MGH White 13   Phone (617) 726-3294 Fax (617) 726-7563 Biomedical Imaging Core (BIC) CNY building 149 2nd floor   Phone (617) 726-0807 Fax (617) 724-3101 Go Back to GCRC Orientation