Changing nursing practice through reflection on the Roper, Logan and Tierney model: the enhancement approach to action research


  • Loretta M Bellman MPhil BSc(Hons) RGN RCNT CertEd RNT

    1. Lecturer/Advisor in Nursing, Institute of Advanced Nursing Education, Royal College of Nursing, 20 Cavendish Square, London W1M 0AB, England
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To the clinical practitioner both nursing models and nursing research may currently be viewed as distant and élitist In the current political climate neither may be highly valued by practitioners or managers Yet, by facilitating group reflection on the nursing model identified in the ward philosophy and adopting the enhancement approach to action research, surgical nurses were empowered to effect change and, consequently, to enhance the quality of patient care in their ward The study was undertaken in two phases over a 15-month period and utilized a multi-method approach In phase 1 triangulation of the data enabled the practitioners/co-researchers to identify and reflect on patients ‘psychological needs within the independence/dependence continuum of the Roper et al (1990) model Phase 2 involved a collaborative approach to the planning, implementation and evaluation of innovations which resulted from reflection on practice Nurse-doctor relationships including anaesthetist non-compliance were, though, a controversial issue Collaborative practice was undermined by the co-researchers' ambivalence concerning feedback from the medical staff Overall, however, the individual contribution of each co-researcher was recognized and valued They had both choice and control which enabled them to develop personally and professionally Group reflection was seen as an essential feedback strategy during the change process