Participatory action research and action learning: changing clinical practice in nursing handover and communication

Abstract

Combining participatory action research (PAR) and action learning (AL) is an effective mechanism for healthcare practitioners who wish to change clinical practice: The outcome of a study on nursing handover and multi-disciplinary communication. Traditionally verbal handovers are lengthy and time consuming resulting in nurses spending an unacceptable time away from patient care. They lack structure and the information presented is often repetitive, incomplete, inadequate, or incorrect and therefore does not always present sufficient information to plan appropriate patient care. The primary purpose of this study was to review the effectiveness of the traditional nursing handover (in one clinical unit) with the aim of developing and implementing evidence-based strategies that would improve practice. In addition, this study aims to highlight the appropriateness and effectiveness of using PAR and AL within ePD. The results of the project indicated early adoption by nursing and medical staff of a database tool developed to assist handover. This improved multi-disciplinary communication, increased staff satisfaction, focussed staff on discharge planning and problem solving as well as reducing the time spent in handover. There remained however, areas for improvement and these were identified in order to begin the next rotation of the PAR cycle. This study suggests that by combining PAR with AL clinicians not only succeeded in changing handover practice but were then able to take what they learned and use it to further develop projects within the unit. It is therefore important to consider carefully the process by which knowledge utilisation takes place in order to ensure that learning is an intended outcome rather than an unexpected consequence of participation.