Jennifer Dempsey, Clinical Nurse Consultant, Medicine, Gosford Hospital, Holden Street, Gosford 2250, NSW Australia. E-mail:

It is with appreciation that I read the commentary supplied by Hill and colleagues that supports the study and the ideas advanced in the article. The impact of the multidisciplinary approach to care is acknowledged however nurses supply the bulk of direct care to the patient hence the attention given to this professional group. Hill and colleagues also note the potential for action research to empower staff and influence attitudes. This is achieved through a process of reflection on practice and a systematic approach to action for change. This potential has been realised with this same set of nurses who have recently completed an action research (Practice Development) project that arose from the original study. It is anticipated that the results of this study will be available in the near future and will also contribute to this important area of patient care and safety.