Action Research in Healthcare: judging value

and impactDr Annetta Smith

17. 2.11

Overview

• Summary of action research characteristics

• Overview of two action research projects1. Transfer of pain knowledge from a continuing

education course into practice

2. Development of case management models in community nursing practice

• Judging value and impact

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Action Research Characteristics

Main tenets of inquiry: focus on practice improvement and the premise that practitioners responsible for practice should be involved in that improvement.

• Participatory character

• Investigation into social practices

• Contribution to practice change

• Development of theory

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Value and impact ?

Participatory character

1. Collaborative endeavour between researchers and participants

2. Shared interests advanced through a process of dialogue and co-operation

3. Participants locate their inquiry in their social world - and in doing so may involve others in aspects of the research

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Investigation into social practices

• Access to practical theories (Kemmis 1993)

• Participants investigate their practice, the context in which practice occurs, formulate accounts of their situation and devise appropriate plans (informed action) which reflect their practice situation

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Contribution to practice change

• Expressed as the commitment to improve practice

• Participants are encouraged to search for solutions to problems and then apply these within their practice settings

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Development of theory

• Practical knowledge– What practitioners do in practice / how

practitioners apply theory in practice

• Propositional knowledge– The conditions under which practical actions

are carried out

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Project 1 An action research inquiry exploring the transfer of pain knowledge from a continuing education course into practice

• Research aims:– To explore the transfer of pain knowledge from a

continuing education course into practice.– To investigate the impact that nurses’

participation in action research has on their ability to improve aspects of their pain practice.

• Research question:– How does engagement in action research affect

nurses’ capacity to influence pain assessment and management practices?

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Project 1 – value and impact

• Participatory character“We ended up on the same wave length because of what we had done together. We struggled together, helped each other out…and we have built a rapport. We can help each other in a non-judgemental way.”

Investigation into social practice “On a busy ward it is really hard I think to assess

someone’s pain properly unless you spend time with them…it’s a bit of a lottery sometimes.”

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Project 1 – value and impact

• Contribution to practice change “I thought I was going to be able to help get the

message across and I am doing that in a small way…you have to share your knowledge”.

• Development of theoryPractical knowledge – e.g. negotiations for changing practice when transferring theatre patients

Propositional knowledge- e.g. need for collective, interdisciplinary, organisational effort to change practice.

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Project 2: Case Management in Community Nursing – Model Development

Research Aim• To contribute to the development

of a case model approach to support

Community Nursing practice.

Research Questions• Which aspects of case management models do nurses

identify as contributing to the effectiveness of Community Nursing?

• What is required to promote the integration of case management into the Community Nursing service?

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Phases of Inquiry: Based on action research principles community nurses a) reviewed and analysed their current practice and b) identified and evaluated approaches to case management that could be tested in practice

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Reflection

Project 2 – value and impact

• Participatory character“One of the most successful features of case management would be the building of relationships –like this”

• Investigation into social practice“But there’s countless patients who come home, who are already at home when it is the GP that phones or the nurse because there is now a crisis”

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Project 2 – value and impact

• Contribution to practice changeValue of reflective discourse

Research recommendations to funders – education requirements and organisational change

• Development of theoryPractical knowledge – e.g. Using SPARRA data

Propositional knowledge- e.g. need for shared understandings of philosophy of care, underpinning principles, roles and responsibilities.

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Final thoughts: Value and impact

• If action research has a focus on practice improvement with the premise that practitioners responsible for practice should be involved in that improvement, it may be useful to have a framework to help evaluate the extent to which these goals have been achieved.

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