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The Need for Institutional Review Boards (IRBs) and Their Impact on Research Studies

     Institutional Review Boards (IRBs) play a vital role in the modern research landscape, particularly in healthcare settings where studies involve human participants. These ethics committees serve as essential gatekeepers, ensuring that research maintains high ethical standards while protecting participants from potential harm. My clinical experience working alongside nurse researchers has shown me firsthand how crucial these oversight bodies are to maintaining public trust in the research enterprise. The primary function of IRBs stems from historical ethical failures in research. The infamous Tuskegee Syphilis Study, where researchers withheld treatment from African American men with syphilis without their knowledge, and the horrific Nazi medical experiments during World War II demonstrated the dire consequences of unchecked research. These events led to the development of ethical frameworks like the Nuremberg Code and the Declaration of Helsinki, which eventually evolved into our current IRB system ‌(Barrow et al., 2022). Today, IRBs ensure that researchers obtain proper informed consent, maintain participant privacy, minimize risks, and equitably distribute research benefits.

      IRBs can significantly impact research studies in various ways. One example involves modifying participant recruitment methods. In a study by White et al. (2021), researchers examining pregnancy and birth experiences initially proposed recruiting vulnerable postpartum women through direct solicitation in hospital settings. The IRB identified potential constraint issues and required revisions to the recruitment protocol, mandating that initial contact occur through healthcare providers who had no stake in the research. This modification protected vulnerable participants from feeling pressured to participate but extended the recruitment timeline by several months. Another example of IRB impact relates to risk mitigation strategies. Stokes et al. (2017) conducted a study examining trauma-informed nursing interventions for patients with severe mental illness. The original protocol included detailed questioning about traumatic experiences without adequate psychological support mechanisms. The IRB required substantial revisions, including the addition of on-site mental health professionals during interviews, development of distress protocols, and follow-up mental health resources. While these changes enhanced participant protection, they increased study costs and necessitated additional personnel training.

     IRBs can also shape data collection procedures to protect participant privacy. In my own clinical setting, I observed a nursing quality improvement project examining medication errors that initially proposed collecting identifiable information about staff members involved in errors. The IRB required removing all staff data and implementing stronger data security measures to prevent potential professional repercussions for staff. This modification protected participants but limited some analytical opportunities regarding individual-level factors contributing to errors. The structure and function of IRBs continue to evolve alongside emerging research methodologies and technologies. Modern IRBs must navigate complex issues like genetic data privacy, social media-based recruitment, and international collaborative research (Somia Abdul Same’e & Antony Sheela Anmary, 2024). While sometimes perceived as administrative hurdles, IRBs ultimately strengthen research quality and protect both participants and researchers by ensuring ethical compliance.

References

Barrow, J. M., Khandhar, P. B., & Brannan, G. D. (2022). Research Ethics. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459281/

Somia Abdul Same’e, & Antony Sheela Anmary. (2024). Navigating the Ethical Complexities. Advances in Information Quality and Management, 139–158. https://doi.org/10.4018/978-1-6684-8526-2.ch009

Stokes, Y., Jacob, J.-D., Gifford, W., Squires, J., & Vandyk, A. (2017). Exploring nurses’ knowledge and experiences related to trauma-informed care. Global Qualitative Nursing Research, 4(4). https://doi.org/10.1177/2333393617734510

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White, A., Grady, C., Little, M., Sullivan, K., Clark, K., Ngwu, M., & Lyerly, A. D. (2021). IRB Decision‐Making about Minimal Risk Research with Pregnant Participants. Ethics & Human Research, 43(5), 2–17. https://doi.org/10.1002/eahr.500100

  

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Barriers to Advanced Practice Nursing

There are many barriers that slow the progression of advanced practice nursing in healthcare. In this discussion, I will focus on the affects of the financial burden of affording higher education, restrictions on the scope of practice, and role conflict within interprofessional teams. It will address the impact that these barriers have on the growth of advanced practice nursing, as well as strategies that can be used to help advanced practice nurses (APRNs) navigate and overcome them.

Financial Burden of Affording Higher Education

While programs like The Affordable Healthcare Act’s Graduate Nurse Education Demonstration aim to offset the costs of clinical training for APRNs, many candidates still face difficulty financing their advanced degrees (Porat-Dahlerbruch et al., 2022). This slows the progress of advanced practice nursing by limiting access from nurses who are financially disadvantaged due to income, number of dependents, or established debt. Possible solutions to overcoming the lack of financial support for education include considering working full-time while completing the advanced degree, seeking scholarships and grants from honor societies and other organizations, applying for financial aid through federal student aid, and exploring military benefits (Khawly & Blore, 2025).

Restrictions on the Scope of Practice

The roles, responsibilities and autonomy for APRNs vary from state to state.  While 27 US states and territories allow full practice authority, others only allow reduced or restricted practice regulations (Boehning & Punsalan, 2023). This factor causes healthcare disparities within our nation by inhibiting access to high-quality, affordable, and preventative healthcare in many underserved areas (Boehning & Punsalan, 2023). This barrier can be overcome by advocating for state and federal-level policy changes allowing full practice authority for APRNs across the board.

Role Conflict within Interprofessional Teams

APRNs are trained to provide care by utilizing evidence-based practice and standardizing high-quality and affordable patient care for the American public (Boehning & Punsalan, 2023). The persistent misunderstanding of the APRN role has limited effective collaboration within the interprofessional team establishing role conflict. One distinguishing characteristic of APRNs is their proactivity in patient care. This feature is displayed within the advanced nursing practice via comprehensive patient education and lifestyle counseling, holistic patient care, and disease prevention (NPHub, 2024a). Establishing an advanced practice nursing leadership structure within healthcare organizations could help overcome this barrier within the interprofessional team by evaluating, maintaining, and promoting the APRN role. (Henderson et al., 2024).

Conclusion

           In conclusion, financial constraints, limitations on practice authority, and interprofessional role conflict hinder the progression and advancement of advanced practice nursing. Addressing these inhibitions would require policy reforms, financial support programs, and enhanced collaboration within the interprofessional network. APRNs can continue to evolve and improve patient outcomes with ongoing advocacy and systemic change. 

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