Intermediate care for older people: Using action research to develop reflective nursing practice in a rehabilitation setting

Abstract

The importance of developing intermediate care options for older people is gaining increasing prominence in the UK with the promotion of new health and social care partnerships. Consequent changes in practice and values are demanded from staff. An action research approach provides a process of generating information linked to dialogues which facilitate such changes. This article draws on a case study of nursing staff working with older people in a newly‐defined rehabilitation setting in a Welsh community hospital. The action research cycle reported, focused on a series of collaborative interventions aimed at bringing about such changes in thinking and practice from a ‘doing for’ to an ‘enabling’ rehabilitative style of nursing. Three questionnaires and a round of group interviews were successively undertaken with a group of 49 staff, with planning and discussion sessions taking place between each data collection round. The process highlighted differing assumptions between different grades of nursing staff and between nurses and therapists about the nature of the rehabilitative process and how far it could be integrated with nursing care. The article discusses how the action research process supported a shared change in perspective that progress needed to be made to work in an integrated rehabilitative way. Participative approaches, such as action research, should be drawn on if the positive and cost‐effective benefits of rehabilitation for older people are to be more actively realised

Media reports of abuse in adult residential care: implications for staff and practice

“…Lehmann et al (2004) argued that "collaborative inquiry is a powerful tool to develop reflective capacity among health workers", and Moffatt et al (2005) outlined a process for community practice research as a reflective process. Walker & Poland (2000) reported on an action research cycle that provided a process of generating information which facilitated positive and cost-effective changes to practice. The research reported in this paper was not instigated 'from above' and was developed and led by a health care assistant who had been taught research skills.…”

Staying stronger longer

“…In group interviews, care staff in a rehabilitation unit of a Welsh community hospital admitted that they often found themselves 'doing for' patients because it was quicker than waiting for residents to dress themselves, for example. Staff said it was frustrating not having more time to spend with residents and having to rush through routine tasks in order to leave time for rehabilitation (Walker & Poland, 2000).…”