Implementing evidence in an onco-haematology nursing unit: a process of change using participatory action research
Article first published online: 1 MAR 2013
© 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute
International Journal of Evidence-Based Healthcare
Volume 11, Issue 1, pages 46–55, March 2013
How to Cite
Abad-Corpa, E., Delgado-Hito, P., Cabrero-García, J., Meseguer-Liza, C., Zárate-Riscal, C. L., Carrillo-Alcaraz, A., Martínez-Corbalán, J. T. and Caravaca-Hernández, A. (2013), Implementing evidence in an onco-haematology nursing unit: a process of change using participatory action research. International Journal of Evidence-Based Healthcare, 11: 46–55. doi: 10.1111/1744-1609.12006
This article was part of the doctoral thesis by Eva Abad-Corpa.
This paper forms part of the fieldwork of the project entitled ‘An Analysis of the Effectiveness of the Implementation of an Evidence-Based-Nursing Model Using Participatory Action Research in a Hematology/Oncology Department', financed by the Health Research Fund (PI05/1330, Health Ministry) after a peer reviewed funding process.
- Issue published online: 1 MAR 2013
- Article first published online: 1 MAR 2013
- Health Research Fund. Grant Number: PI05/1330
- change theory;
- evidence implementation;
- oncology care;
- participatory action research;
- qualitative research
To implement evidence in a nursing unit and to gain a better understanding of the experience of change within a participatory action research.
Study design of a participatory action research type was use from the constructivist paradigm. The analytical-methodological decisions were inspired by Checkland Flexible Systems for evidence implementation in the nursing unit. The study was carried out between March and November 2007 in the isolation unit section for onco-haematological patients in a tertiary level general university hospital in Spain. Accidental sampling was carried out with the participation of six nurses. Data were collected using five group meetings and individual reflections in participants' dairies. The participant observation technique was also carried out by researchers. Data analysis was carried out by content analysis. The rigorous criteria were used: credibility, confirmability, dependence, transferability and reflexivity.
A lack of use of evidence in clinical practice is the main problem. The factors involved were identified (training, values, beliefs, resources and professional autonomy). Their daily practice (complexity in taking decisions, variability, lack of professional autonomy and safety) was compared with an ideal situation (using evidence it will be possible to normalise practice and to work more effectively in teams by increasing safety and professional recognition). It was decided to create five working areas about several clinical topics (mucositis, pain, anxiety, satisfaction, nutritional assessment, nauseas and vomiting, pressure ulcers and catheter-related problems) and seven changes in clinical practice were agreed upon together with 11 implementation strategies. Some reflections were made about the features of the study: the changes produced; the strategies used and how to improve them; the nursing ‘subculture’; attitudes towards innovation; and the commitment as participants in the study and as healthcare professionals.
The findings throw light on the process of change in the healthcare sector. The results are useful to modify nursing practice based on evidence.