Implementation of the evidence for the improvement of nursing care to the critical patient’s family: a Participatory Action Research

Abstract

BackgroundThere are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. However, there is no widespread application of such evidence in clinical practice. There has also been no analysis made of the evolution of patterns of knowing during the act of improving clinical practice. Therefore, the purpose of the study is to understand the change process aimed at improving care to critical patient’s families, and to explore the evolution of patterns of knowing that nurses use in this process.MethodsQualitative study with a Participatory Action Research method, in accordance with the Kemmis and McTaggart model. In this model, nurses can observe their practice, reflect upon it and compare it with scientific evidence, as well as define, deploy and evaluate improvement strategies adapted to the context. Simultaneously, the process of empowerment derived from the Participatory Action Research allows for the identification of patterns of knowing and their development over time. The research will take place in the Intensive Care Units of a tertiary hospital. The participants will be nurses who are part of the regular workforce of these units, with more than five years of experience in critical patients, and who are motivated to consider and critique their practice. Data collection will take place through participant observation, multi-level discussion group meetings and documentary analysis. A content analysis will be carried out, following a process of codification and categorisation, with the help of Nvivo10. The approval date and the beginning of the funding were December 2012 and 2013, respectively.DiscussionThe definition, introduction and evaluation of care strategies for family members will allow for their real and immediate implementation in practice. The study of the patterns of knowing in the Participatory Action Research will be part of the theoretical and practical feedback process of a professional discipline. Also, the identification of the construction and evolution of knowledge will provide decision elements to managers and academics when choosing strategies for increased quality.

Application of a flexible visitation system in critically ill patients: A randomized clinical trial

“…12 Regular visiting rules allow families affected by anxiety and patients in passive states to have only a half an hour a day for visits. This can easily result in suspicion and doubt by the families, 2 , 13 , 14 but a flexible visitation system, if the clinical situation allows, can fully inform families and satisfy both the patient and their family. This system also embodies the quality of the nursing concept of “taking patients as a member of our family.” In our study, the incidence of delirium in the experimental group was significantly reduced, while satisfaction was significantly increased.…”

The Utility of Participatory Action Research in the Nursing Field: A Scoping Review

“…Research Designs Using Participatory Principles. Of the 20 articles reviewed, seven used qualitative methods (Atkins et al, 2018;De-La-Cueva-Ariza et al, 2018;D. Goeman et al, 2016;D.…”

“…Of the 20 reviewed articles, six used PAR approaches to produce positive change in nursing practice documentation and also appeared suitable for effective outcome modification. In six studies, significant improvement was achievable by engaging staff and particularly leaders, in order to maintain focus and ensure sustainability (De-La-Cueva-Ariza et al, 2018;Faizi et al, 2017, Fletcher et al, 2015Hestevik et al, 2019;Liang et al, 2019;O'Reilly-de Brún et al, 2018). Three articles reported combining PAR with other appropriate practices to ensure better documentation, including nurse participation, compliance with documentation standards, managerial accountability, leadership style enhancement, and sustainable monitoring and control (Carroll, 2017;Salzmann-Erikson, 2017;Vafaei et al, 2018).…”

Aporte metodológico: Protocolo de acceso A la comunicación a distancia en personas hospitalizadas en tiempos de Covid-19

“…comunicación efectiva, el bienestar de la persona hospitalizada, la participación de las familias en los cuidados, disminuir el síndrome de desgaste profesional y los cuidados al final de la vida (Alonso-Ovies & Heras la Calle, 2019).Por otro lado, la hospitalización de una persona provoca una alteración en la estructura familiar, enfrentando estresores emocionales, cognitivos y sociales, generando sentimientos de conmoción, incertidumbre, desesperanza, negación, enojo, culpa, ansiedad y miedo a la muerte de un miembro de la familia, considerando la situación como traumática(De la Cueva Ariza, et al, 2018). Por esto, es imprescindible considerar a la familia como un agente activo dentro del proceso de hospitalización, afirmando que al facilitar su contribución a la recuperación de la persona hospitalizada se pueden obtener efectos positivos no tan solo para el sujeto, sino también para ellos mismos, y los profesionales de la salud, reduciendo el estrés emocional y facilitando la cercanía y comunicación de las partes implicadas (Heras La Calle, Cruz Martin, & Nin , 2017).En el contexto de Unidades de paciente crítico (upc) existen guías clínicas tales como las guías padis(Devlin, et al, 2018) usando al aBcdeF de Bundle como referencia, donde se considera el compromiso de la familia, incorporando en el plan de tratamiento sus necesidades e interrogantes como parte de un proceso de hospitalización y como un pilar que contribuye activamente en disminuir la ansiedad en la persona hospitalizada(Marra, Ely, Pandharipande, & Patel, 2017).…”