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Background: Multisite studies offer larger, more diverse samples to successfully capture populations and clinical practices of interest at the point of care. However, investigators face challenges with site recruitment and sampling, differences in clinical practices across sites, and data integrity. Addressing these issues a priori can improve the rigor and reproducibility of the research. Objective: This article aims to describe a cascading approach tomultisite research. An exemplar is provided of a study using this approach, which aimed to evaluate the prevalence of pain and the pain management practices provided to critically ill children in pediatric intensive care units in the United States. Methods: The cascading approach includes two or more pilot study procedures with a progressively increasing number of sites prior to a full-scale study. Following each pilot, study procedures are evaluated; feedback was obtained from site personnel and content experts; procedures were revised accordingly; approvals were obtained; sites were trained; and the revised procedures are repeated with a larger, more diverse number of sites. Results: In the exemplar provided, improvements in the efficiency and integrity of data collection were noted for the full-scale study following the pilots. All sites that completed the agreements and approvals for study participation were retained for the duration of the two pilots and full-scale study. Discussion: Borrowing fromprinciples of process improvement, the cascading approach allows knowledge to be gained regarding site differences and informs the revision of study procedures while potentially maximizing efficiency and data integrity, minimizing site burden, and maintaining site engagement for multisite studies. [ABSTRACT FROM AUTHOR]

Practical training for nursing professional development specialists in the facilitation of clinical simulations was implemented using a six-step curriculum development framework. General and targeted needs assessments were conducted. Methods used to apply needs assessment findings into the course design and delivery and the participant's responses via program evaluations are described. The process used to develop this training may be applied by other nursing professional development departments to prepare educators in the delivery of simulated-based learning experiences. [ABSTRACT FROM AUTHOR]