Action research improved general prerequisites for evidence-based practice

Area of Science:

• Healthcare Management
• Nursing Research
• Clinical Implementation Science

Background:

• Implementing clinical pathways is crucial for improving patient care in intensive care units (ICUs).
• Action research offers a methodology to explore and facilitate implementation processes within healthcare settings.
• The Promoting Action on Research Implementation in Health Services (PARIHS) framework guides the assessment of prerequisites for evidence-based practice (EBP).

Purpose of the Study:

• To evaluate if action research methodology enhances the general prerequisites for evidence-based practice (EBP) in an ICU.
• To explore the implementation process of a clinical pathway for patients on mechanical ventilation.
• To assess changes in healthcare professionals' perceptions regarding EBP components.

Main Methods:

• A questionnaire study conducted within a Swedish ICU as part of an action research project.
• Inclusion of registered nurses, assistant nurses, and anesthesiologists at baseline (n=50) and follow-up (n=44).
• Utilized the Evaluation Before Implementation Questionnaire and the Attitudes towards Guidelines Scale for data collection.

Main Results:

• General prerequisites for EBP significantly improved post-implementation.
• Staff reported increased discussions on patient experiences, research utilization, context, and facilitation.
• No significant changes were observed in the discussion of clinical experiences or attitudes towards guidelines.

Conclusions:

• Action research, when used to implement clinical pathways, can positively influence several prerequisites for EBP in ICUs.
• The methodology appears to stimulate mechanisms that enhance specific EBP components, though not all.
• Further research may be needed to optimize the impact of action research on all PARIHS-defined prerequisites for EBP.