Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review

Abstract

A B S T R A C T Background:As is often reported in the literature exploring the research-practice gap, applying the principles of evidence-based practice is easier said than done. Action research is a methodology with an explicit intent of linking the worlds of research and practice. This review attempts to answer the question: What is known about implementing evidence-based practice in nursing through action research?Approach: A total of 21 action research studies have been used to answer this question. To prevent possible confusion over terminology, we used a conceptual framework that distinguishes various influencing factors in terms of four target groups (ranging from the individual end user to society as a whole) at whom the strategy is aimed and various strategies (ranging from individual feedback to contracting care providers) related to the same four target groups.Findings: Studies often failed to name the implementation strategies applied, necessitating deduction from the text by the reader. In most of the studies the implementation strategy was directed at a combination of target groups. Many of the projects reviewed reported positive contextual outcomes, "knowledge improvement" among nurses, and to a lesser degree, improved "performance." Patient outcomes were the least reported outcome measure.Conclusion: With an element of caution, this review concludes that the implementation of evidencebased practice using action research is a promising approach. Caution is needed because of the lack of detailed descriptions of implementation strategies, and their intensity and frequency prevents us from drawing firm conclusions. These are important considerations for any action researcher intending to implement EBP using this approach.

Scientific rigour and innovations in participatory action research investigating workplace learning in continuing interprofessional education

“…Insofar as investigators may use, for instance, workplace learning in CIPE but neglect to spell it out in their publications, they inhibit knowledge sharing and the transferability of their findings. This failure is thus as significant a methodological shortcoming as conducting PAR cyclical process blindly (Badger, 2000;Hope & Waterman, 2003;Munten et al, 2010;Waterman et al, 2001).…”

“…It is also astonishing to discover that many authors do not describe the conduct of their PAR cyclical process (Hope & Waterman, 2003;Munten et al, 2010). PAR co-participants apparently proceed as best they can to decide on the conduct, frequency and length of their meetings with often hit-and-miss and suboptimal results (Hope & Waterman, 2003;Munten et al, 2010).…”

“…Another critique about rigour in PAR has been underscored by a number of authors regarding the inconsistency between some investigators' methodology and philosophy (Holter & Schwartz-Barcott, 1993;McTaggart, 1991;Munten et al, 2010;Waterman et al, 2001). In their literature review, Munn-Giddings, McVicar, and Smith (2008) found that most of the methods employed in action research including PAR are participant observation, interviews and questionnaires.…”

“…PAR co-participants apparently proceed as best they can to decide on the conduct, frequency and length of their meetings with often hit-and-miss and suboptimal results (Hope & Waterman, 2003;Munten et al, 2010). Insofar as investigators may use, for instance, workplace learning in CIPE but neglect to spell it out in their publications, they inhibit knowledge sharing and the transferability of their findings.…”

The New Era of Nursing Research

“…For the clinical settings, ten Ham [1] integrate reviewed 35 documents regarding the characteristics of benefit levers' for evidences-based nursing practices and indicated that three standards of individual, organizational, and contextual trait were merged into the different types, strategies, position, attitude, and support of leadership for the purpose of changing by the reinforcing structures. However, Munten [2] integrated reviewed 21 action studies to identify the lack of implementation strategies in terms of the intensity and frequency so that the authors could not provide evidences-based protocols for nursing research using action designed; additionally, the majority of research projects were focus on improving the knowledge of nurses, but their performances and the patients' outcomes. Therefore, Wright [3] integrate reviewed 18 articles following 85 unique resources regarding the productive ward of releasing time to care for the patients and identified seven themes were focused on the direct care time of the patient and staff experience emphasizing on the major issues of patient safety and financial impact as well as the team cooperation and support of leadership playing the success and barriers of determinants.…”