Action research studies in the intensive care setting: A systematic review

Soh, Kim Lam; Davidson, Patricia M.; Leslie, Gavin; Rahman, Aisai Bin Abdul

doi:10.1016/j.ijnurstu.2010.09.014

Cited by 38 publications

(55 citation statements)

References 37 publications

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“…This pattern reflects the comments made in Chapter 2 from the systematic reviews by Soh et al 87 and by Munn-Giddings et al…”

Section: Participatory and Action Researchsupporting

confidence: 75%

“…Several reviews have examined action research but have found that the impacts on patient care and health outcomes are often not covered. For example, Soh et al 87 reviewed action research studies in intensive care settings but of the 21 studies included only one described improved health-care outcomes. 88 Munn-Giddings et al 89 reviewed studies of action research in nursing published between 2000 and 2005.…”

Section: Action Research and Participatory Action Researchmentioning

confidence: 99%

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Engagement in research: an innovative three-stage review of the benefits for health-care performance

Hanney

Boaz

Jones

et al. 2013

Health Services and Delivery Research

106

160

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BackgroundThere is a widely held assumption that research engagement improves health-care performance at various levels, but little direct empirical evidence.ObjectivesTo conduct a theoretically and empirically grounded synthesis to map and explore plausible mechanisms through which research engagement might improve health services performance. A review of the effects on patients of their health-care practitioner's or institution's participation in clinical trials was published after submission of the proposal for this review. It identified only 13 relevant papers and, overall, suggested that the evidence that research engagement improves health-care performance was less strong than some thought. We aimed to meet the need for a wider review.MethodsAn hourglass review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves health care; and (3) a wider (but less systematic) review of papers identified during the two earlier stages. Studies were included inthe focused review if the concept of ‘engagementinresearch’ was an input and some measure of ‘performance’ an output. The search strategy covered the period 1990 to March 2012. MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and other relevant databases were searched. A total of 10,239 papers were identified through the database searches, and 159 from other sources. A further relevance and quality check on 473 papers was undertaken, and identified 33 papers for inclusion in the review. A standard meta-analysis was not possible on the heterogeneous mix of papers in the focused review. Therefore an explanatory matrix was developed to help characterise the circumstances in which research engagement might improve health-care performance and the mechanisms that might be at work, identifying two main dimensions along which to categorise the studies:the degree of intentionalityandthe scope of the impact.ResultsOf the 33 papers in the focused review, 28 were positive (of which six were positive/mixed) in relation to the question of whether or not research engagement improves health-care performance. Five papers were negative (of which two were negative/mixed). Seven out of 28 positive papers reported some improvement in health outcomes. For the rest, the improved care took the form of improved processes of care. Nine positive papers were at a clinician level and 19 at an institutional level. The wider review demonstrated, for example, how collaborative and action research can encourage some progress along the pathway from research engagement towards improved health-care performance. There is also evidence that organisations in which the research function is fully integrated into the organisational structure out-perform other organisations that pay less formal heed to research and its outputs. The focused and wider reviews identified the diversity in the mechanisms through which research engagement might improve health care: there are many circumstances and mechanisms at work, more than one mechanism is often operative, and the evidence available for each one is limited.LimitationsTo address the complexities of this evidence synthesis of research we needed to spend significant time mapping the literature, and narrowed the research question to make it feasible. We excluded many potentially relevant papers (though we partially addressed this by conducting a wider additional synthesis). Studies assessing the impact made on clinician behaviour by small, locally conducted pieces of research could be difficult to interpret without full knowledge of the context.ConclusionsDrawing on the focused and wider reviews, it is suggested that when clinicians and health-care organisations engage in research there is the likelihood of a positive impact on health-care performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved health-care performance. Further explorations are required of research networks and schemes to promote the engagement of clinicians and managers in research. Detailed observational research focusing on research engagement within organisations would build up an understanding of mechanisms.Study registrationPROSPERO: CRD42012001990.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…This pattern reflects the comments made in Chapter 2 from the systematic reviews by Soh et al 87 and by Munn-Giddings et al…”

Section: Participatory and Action Researchsupporting

confidence: 75%

Section: Action Research and Participatory Action Researchmentioning

confidence: 99%

Engagement in research: an innovative three-stage review of the benefits for health-care performance

Hanney

Boaz

Jones

et al. 2013

Health Services and Delivery Research

106

160

View full text Add to dashboard Cite

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“…In the first phase, the participatory dimension of the practice development probably contributed to satisfaction and was an incentive to reorganizing the traditional ICU to a dedicated ICU ward for CCI patients. It has been argued that such an approach empowers staff and therefore gives a greater feeling of autonomy [30], an important factor for ICU nurses' job satisfaction [20]. In the first phase, working with teams to increase their knowledge about the CCI and developing new knowledge was successful in developing practice and may have impacted team satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Staff satisfaction between 2 models of care for the chronically critically ill

Roulin

Boulch

Merlani

2012

Journal of Critical Care

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“…This collaborative relationship is an essential component of action research enabling sustainable change, both to patient care and the work environment [23], as shown in the Heart Beads program and emphasised in other programs utilising this approach [14, 15, 17, 19, 20]. …”

Section: Discussionmentioning

confidence: 99%

“…Action research allows knowledge development which can be applied back to the practice area from which it was created [19]. An advantage of an action research approach is the collaborative relationship between the researchers, staff, patients, and families in the clinical setting that can enable sustainable changes to patient care and the work environment [23]. …”

Section: Introductionmentioning

confidence: 99%

Appreciation of a Child’s Journey: Implementation of a Cardiac Action Research Project

Dengler

Wilson²,

Redshaw³

et al. 2012

Nursing Research and Practice

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The aim of this paper is to provide an overview of the phases of the action research process involved in developing, implementing, and evaluating the Heart Beads program. The aim of the project is to enrich the hospital experience of children with cardiac conditions. Heart Beads involves children receiving unique beads specific to each cardiac treatment, procedure or event in recognition of their experiences, and endurance. An action research approach, involving a partnership between clinicians and researchers and emphasising the involvement of patients and their families, was used to guide the Heart Beads program. The project followed the five phases of action research: identification, investigation, program development, implementation, and evaluation. Heart Beads began as a small project which continues to grow in popularity and significance with children at a tertiary paediatric hospital in Sydney, Australia. The program is now being implemented nationwide with the vision that all Australian children hospitalised with cardiac conditions can benefit from Heart Beads.

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Action research studies in the intensive care setting: A systematic review

Cited by 38 publications

References 37 publications

Engagement in research: an innovative three-stage review of the benefits for health-care performance

Engagement in research: an innovative three-stage review of the benefits for health-care performance

Staff satisfaction between 2 models of care for the chronically critically ill

Appreciation of a Child’s Journey: Implementation of a Cardiac Action Research Project

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