Implementing a Nursing Research, Education, and Practice Program: A Participatory Action Reseach

Tuesday, 31 October 2017: 8:20 AM

Jacinth L. M. Lindo, PhD, MPH, MSN
The UWI School of Nursing, University of the West Indies, Mona, Kingston, Jamaica
Rosain N. Stennett, MPH
The UWI School of Nursing, Mona, The University of the West Indies, Kingston, Jamaica
Veronica H. Waugh-Brown, MPH, FNP
The University of the West Indies School of Nursing, The University of the West Indies, Kingston, Jamaica

Background: The need for research capacity building among nurses in the Caribbean is significant as the lack of adequate mentorship among nursing faculty remains problematic. This affects the conduct of research in practice environments, the delivery of nursing research courses, research mentorship for nurses and the advancement of nursing faculty in many universities (Edwards, Webber, Mill, Kahwa & Roelofs, 2009; Moore, Crozier & Kite, 2012). Mentorship of junior researchers by senior researchers is an important strategy in curtailing low rates of nurse-led research in LMIC such as Jamaica (Edwards, et al. 2009).

Student/faculty collaborative projects have been effective in increasing students’ research interest and the growth of the profession (Kessler & Alverson 2014). Through this collaborative process students sees the applicability of research theory and faculty members were able to enhance their own research skills (Kennel, Burns & Horn, 2009; Kessler & Alversom, 2014).

Objective: This study sought to enhance the learning experience of final year nursing students in a research course by allowing them to participate in elements of the research process, including data collection, data analysis and the research dissemination process. The study also provided mentorship to nursing faculty in the conduct and pedagogy of research. Finally, a practice issue which required research inquiry was identified and explored and the research findings disseminated

Methods:

Pre-step

A research proposal was designed to address quality of nursing documentation and included faculty from four schools of nursing using participatory action research. This topic was collaboratively identified by clinical staff and faculty.

The team approach used facilitated the timely IRB and institutional approval; permission from the health regions and Ministry of Health Jamaica to conduct an audit of a multi-level stratified sample of 245 client’s records from three Jamaican public hospital; evaluating nurses’ documentation of client assessment, nursing standards and discharge planning and teaching.

Action Phase

Students registered in the Research Methods course delivered on four campuses attended 2-day documentation data collection training workshop. Each student audited 2-3 clients records based on hospital visited for clinical experience. Students were required to analyze data at the level of hospital by conducting descriptive and inferential statistics. Poster and oral presentations of the findings were presented in a mock research conference to which nursing leadership was invited.

Aggregated data collected from each school was analyzed by faculty members and a manuscript submitted for peer reviewed publication.

Evaluation

Weekly reflections and observations recorded by project leader and research assistant and four focus group discussions which facilitated feedback from students, faculty and clinical staff helped to evaluate the project. Additionally, the staging of a mini research symposium facilitated dissemination and completed the evaluation process along with course assessments.

Findings: Feedback from students, faculty and the clinical sites was overwhelmingly positive. Students demonstrated adequate data collection skills, voiced awareness of the importance of theoretical and ethical principles of research and were enthused about the high clinical relevance of the study. Variations in the level of research competences among faculty were noted. Faculty welcomed the opportunity to observe and participate in the process of drafting and implementing the study and felt supported by mentors.

Clinical staff participated in discussions about documentation and presented possible solutions.

Implications for practice: Increased research interest and research self-efficacy among students may increase the likelihood of the pursuit of post-graduate studies. Faculty had an opportunity to work on drafting a manuscript for peer review publication and experienced increased research self-efficacy; this will ultimately strengthen the propensity for evidence based practice. The additional benefit of strengthened relationships with clinical partners and future research opportunities spawned by the collaborative effort was a major outcome of the study. Developing nurse researchers is an important element for generating new evidence which is highly relevant for evidence based practice. Given the dearth of published nursing research evidence from the Caribbean, dissemination of this body of work is invaluable to the nursing profession. For example; a national assessment of the quality of nursing documentation could be used to gage the quality of care being delivered by nurses and drive the process of strengthening the healthcare delivery by identifying training needs of nurses.

Conclusions: This participatory action research project yielded positive learning outcomes for students and allowed faculty to gain experience in the conduct of research. Students and faculty alike, developed / improved self-efficacy and obtained a sense of accomplishment. The study was highly beneficial to the clinical sites through the dissemination of the study results which highlighted weaknesses in nursing documentation and provided opportunities for improvement.

Faculty members successfully participated in the publication process. Clinical site administrators at one institution asked the team to replicate the study after the implementation of a documentation education intervention among nursing staff. This approach to learning should be considered for the delivery of other research courses given the associated mutual benefits.