Transition from an open-plan to a two-cot neonatal intensive care unit: A participatory action research approach

Journal article


Broom, Margaret, Gardner, Anne, Kecskes, Zsuzsoka and Kildea, Sue 2017. Transition from an open-plan to a two-cot neonatal intensive care unit: A participatory action research approach. Journal of Clinical Nursing. 26 (13-14), pp. 1939 - 1948. https://doi.org/10.1111/jocn.13509
AuthorsBroom, Margaret, Gardner, Anne, Kecskes, Zsuzsoka and Kildea, Sue
Abstract

Aims and objectives To facilitate staff transition from an open-plan to a two-cot neonatal intensive care unit design.

Background In 2012, an Australian regional neonatal intensive care unit transitioned from an open-plan to a two-cot neonatal intensive care unit design. Research has reported single- and small-room neonatal intensive care unit design may negatively impact on the distances nurses walk, reducing the time they spend providing direct neonatal care. Studies have also reported nurses feel isolated and need additional support and education in such neonatal intensive care units. Staff highlighted their concerns regarding the impact of the new design on workflow and clinical practice.

Design A participatory action research approach.

Methods A participatory action group titled the Change and Networking Group collaborated with staff over a four-year period (2009–2013) to facilitate the transition. The Change and Networking Group used a collaborative, cyclical process of planning, gathering data, taking action and reviewing the results to plan the next action. Data sources included meeting and workshop minutes, newsletters, feedback boards, subgroup reports and a staff satisfaction survey.

Results The study findings include a description of (1) how the participatory action research cycles were used by the Change and Networking Group: providing examples of projects and strategies undertaken; and (2) evaluations of participatory action research methodology and Group by neonatal intensive care unit staff and Change and Networking members.

Conclusion This study has described the benefits of using participatory action research to facilitate staff transition from an open-plan to a two-cot neonatal intensive care unit design. Participatory action research methodology enabled the inclusion of staff to find solutions to design and clinical practice questions. Future research is required to assess the long-term effect of neonatal intensive care unit design on staff workload, maintaining and supporting a skilled workforce as well as the impact of a new neonatal intensive care unit design on the neonatal intensive care unit culture.

Relevance to clinical practice A supportive work environment for staff is critical in providing high-quality health care.

KeywordsIntensive Care; Neonatal; Participatory action research; Work environment; Clinical practice
Year2017
JournalJournal of Clinical Nursing
Journal citation26 (13-14), pp. 1939 - 1948
ISSN0962-1067
Digital Object Identifier (DOI)https://doi.org/10.1111/jocn.13509
Scopus EID2-s2.0-85017396757
Open accessOpen access
Page range1939 - 1948
Research GroupSchool of Nursing, Midwifery and Paramedicine
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Lee, Nigel J., Coxeter, P., Beckmann, M., Webster, J., Wright, V., Smith, T. and Kildea, Sue 2011. Study protocol: A randomised non-inferiority controlled trial of a single versus a four intradermal sterile water injection technique for relief of continuous lower back pain during labour. BMC Pregnancy and Childbirth. 11 (21), pp. 1 - 9. https://doi.org/10.1186/1471-2393-11-21
An account of significant events influencing Australian breastfeeding practice over the last 40 years
Thompson, Robyn, Kildea, Sue, Barclay, L. and Kruske, S. 2011. An account of significant events influencing Australian breastfeeding practice over the last 40 years. Women and Birth (print version). 24 (3), pp. 97 - 104. https://doi.org/10.1016/j.wombi.2010.08.005
Pragmatic indicators for remote Aboriginal maternal and infant health care: Why it matters and where to start
Kildea, Sue, Barclay, Lesley, Steenkamp, Malinda and Rumbold, Alice 2010. Pragmatic indicators for remote Aboriginal maternal and infant health care: Why it matters and where to start. Australian and New Zealand Journal of Public Health. 34 (1), pp. 55 - 58. https://doi.org/10.1111/j.1753-6405.2010.00545.x
Rural birth index for Australia?
Kildea, Sue and Stratagos, Susan 2010. Rural birth index for Australia? Australian Journal of Rural Health. 18 (2), pp. 85 - 86. https://doi.org/10.1111/j.1440-1584.2010.01130.x
A literature review supporting the proposed national Australian definition for Staphylococcus aureus bacteraemia
Mitchell, Brett, Gardner, Anne, Collignon, Peter, Stewart, Lee and Cruickshank, Marilyn 2010. A literature review supporting the proposed national Australian definition for Staphylococcus aureus bacteraemia. Healthcare Infection. 15 (4), pp. 105 - 113. https://doi.org/10.1071/HI10030
The work of nurse practitioners
Gardner, Glenn, Gardner, Anne, Middleton, Sandy, Della, Phillip, Kain, Victoria and Doubrovsky, Anna 2010. The work of nurse practitioners. Journal of Advanced Nursing. 66 (10), pp. 2160 - 2169. https://doi.org/10.1111/j.1365-2648.2010.05379.x
The first Australian nurse practitioner census: A protocol to guide standardized collection of information about an emergent professional group
Middleton, Sandy, Gardner, Glenn, Gardner, Anne, Della, Phillip, Gibb, Michelle and Millar, Lynne 2010. The first Australian nurse practitioner census: A protocol to guide standardized collection of information about an emergent professional group. International Journal of Nursing Practice. 16 (5), pp. 517 - 524. https://doi.org/10.1111/j.1440-172X.2010.01877.x
Barriers to increasing hospital birth rates in rural Shanxi province, China
Gao, Yu, Barclay, Lesley, Kildea, Sue, Hao, Min and Belton, Suzanne 2010. Barriers to increasing hospital birth rates in rural Shanxi province, China. Reproductive Health Matters. 18 (36), pp. 35 - 45. https://doi.org/10.1016/S0968-8080(10)36523-2
Development and validation of a novel approach to work sampling: A study of work practitioner work patterns
Gardner, Glenn, Gardner, Anne, Middleton, Sandy, Gibb, Michelle, Della, Phillip and Duffield, Christine 2010. Development and validation of a novel approach to work sampling: A study of work practitioner work patterns. Australian Journal of Advanced Nursing. 27 (4), pp. 4 - 12.
Clients' understanding of the role of nurse practitioners
Susan, Allnutt,, Allnutt, Nissa, McMaster, Rose, O'Connell, Jane, Middleton, Sandy, Hillege, Sharon, Della, Phillip, Gardner, Glenn and Gardner, Anne 2010. Clients' understanding of the role of nurse practitioners. Australian Health Review. 34 (1), pp. 59 - 65. https://doi.org/10.1071/AH09688
'Closing the gap': How maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women
Kildea, Sue, Kruske, Sue, Barclay, Lesley and Tracy, Sally 2010. 'Closing the gap': How maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women. Rural and Remote Health. 10 (3), pp. 1383 - 1402.
The status of Australian nurse practitioners: The first national census
Gardner, Anne, Della, Phillip R., Middleton, Sandy and Gardner, Glenn 2009. The status of Australian nurse practitioners: The first national census. Australian Health Review. 33 (4), pp. 679 - 689. https://doi.org/10.1071/AH090679
The role of the midwife in Australia: views of women and midwives
Homer, Caroline, Passant, Lyn, Brodie, Pat, Kildea, Sue, Leap, Nicky, Pincombe, Jan and Thorogood, Carol 2009. The role of the midwife in Australia: views of women and midwives. Midwifery. 25 (6), pp. 673 - 681. https://doi.org/10.1016/j.midw.2007.11.003
Pressure injury prevalence in a private health service: Risks and recommendations
Gardner, Anne, Millar, Lynne, Legg, Sandra, Gomez, Yvette, McGillion, Tony and Mulcahy, Aidan 2009. Pressure injury prevalence in a private health service: Risks and recommendations. Wound Practice & Research. 17 (3), pp. 134 - 145.
Absolutely fabulous - but are we? Carers' perspectives on satisfaction with a palliative homecare service
O'Connor, Lera, Gardner, Anne, Millar, Lynne and Bennett, Peter 2009. Absolutely fabulous - but are we? Carers' perspectives on satisfaction with a palliative homecare service. Collegian. 16 (4), pp. 201 - 209. https://doi.org/10.1016/j.colegn.2009.04.005
Implementing a journal club in a palliative care setting: A link in the chain of evidence-based practice
O'Connor, Lera, Bennett, Peter, Gardner, Anne, Hawkins, Mary and Wellman, David 2009. Implementing a journal club in a palliative care setting: A link in the chain of evidence-based practice. Collegian. 16 (3), pp. 147 - 152. https://doi.org/10.1016/j.colegn.2008.12.006
A literature review of central venous catheter dressings: Implications for haemodialysis in the tropics
McArdle, Joleen and Gardner, Anne 2009. A literature review of central venous catheter dressings: Implications for haemodialysis in the tropics. Infection, Disease and Health. 14 (4), pp. 139 - 146. https://doi.org/10.1071/HI09014
Excellence in regional stroke care: An evaluation of the implementation of a stroke care unit in regional Australia
McCann, Leanne, Groot, Patrick, Charnley, Chris and Gardner, Anne 2009. Excellence in regional stroke care: An evaluation of the implementation of a stroke care unit in regional Australia. Australian Journal of Rural Health. 17 (5), pp. 273 - 278. https://doi.org/10.1111/j.1440-1584.2009.01098.x
Writing ourselves into a web of obedience: A nursing policy analysis
Bail, Kasia, Cook, Robert, Gardner, Anne and Grealish, Laurie 2009. Writing ourselves into a web of obedience: A nursing policy analysis. International Journal of Nursing Studies. 46 (11), pp. 1457 - 1466. https://doi.org/10.1016/j.ijnurstu.2009.04.005
Potential scope and impact of a transboundary model of nurse practitioners in aged care
Bail, Kasia, Arbon, Paul, Eggert, Marlene, Gardner, Anne, Hogan, Sonia, Phillips, Christine, van Dieman, Nicole and Waddington, Gordon 2009. Potential scope and impact of a transboundary model of nurse practitioners in aged care. Australian Journal of Primary Health. 15 (3), pp. 232 - 237. https://doi.org/10.1071/PY09009
Patients' and nurses' perspectives on oxygen therapy: A qualitative study
Eastwood, Glenn, O'Connell, Beverley, Gardner, Anne and Considine, Julie 2009. Patients' and nurses' perspectives on oxygen therapy: A qualitative study. Journal of Advanced Nursing. 65 (3), pp. 634 - 641. https://doi.org/10.1111/j.1365-2648.2008.04933.x
Reporting a research project on the potential of aged care nurse practitioners in the Australian capital territory
Arbon, Paul, Bail, Kasia, Eggert, Marlene, Gardner, Anne, Hogan, Sonia, Phillips, Christine, van Dieman, Nicole and Waddington, Gordon 2009. Reporting a research project on the potential of aged care nurse practitioners in the Australian capital territory. Journal of Clinical Nursing. 18 (2), pp. 255 - 262. https://doi.org/10.1111/j.1365-2702.2008.02452.x
Selecting the right integration of research into practice strategy
Eastwood, Glenn, O'Connell, Beverley and Gardner, Anne 2008. Selecting the right integration of research into practice strategy. Journal of Nursing Care Quality. 23 (3), pp. 258 - 264. https://doi.org/10.1097/01.NCQ.0000324591.76590.e9
From competence to capability: A study of nurse practitioners in clinical practice
Gardner, Anne, Hase, Stewart, Gardner, Glenn, Dunn, Sandra and Carryer, Jenny 2008. From competence to capability: A study of nurse practitioners in clinical practice. Journal of Clinical Nursing. 17 (2), pp. 250 - 258. https://doi.org/10.1111/j.1365-2702.2006.01880.x
Making pregnancy safer in Australia: The importance of maternal death review
Kildea, Sue, Pollock, Wendy E. and Barclay, Lesley 2008. Making pregnancy safer in Australia: The importance of maternal death review. Australian and New Zealand Journal of Obstetrics and Gynaecology. 48 (2), pp. 130 - 136. https://doi.org/10.1111/j.1479-828X.2008.00846.x
Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: A randomised crossover trial
Eastwood, Glenn, O'Connell, Beverley, Gardner, Anne and Considine, Julie 2008. Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: A randomised crossover trial. Anaesthesia and Intensive Care. 36 (5), pp. 691 - 694.
Maternal deaths high for indigenous women
Kildea, Sue 2008. Maternal deaths high for indigenous women. Women and Birth. 21 (4), pp. 175 - 176. https://doi.org/10.1016/j.wombi.2008.06.002
The core role of the nurse practitioner: practice, professionalism and clinical leadership
Carryer, Jenny, Gardner, Glenn, Dunn, Sandra and Gardner, Anne 2007. The core role of the nurse practitioner: practice, professionalism and clinical leadership. Journal of Clinical Nursing. 16 (10), pp. 1818 - 1825. https://doi.org/10.1111/j.1365-2702.2007.01823.x
Living with chronic illness
Gardner, Glenn and Gardner, Anne 2007. Living with chronic illness. in: Solution focused nursing: rethinking practice United Kingdom: Palgrave Publishing. pp. 143 - 153
Dealing with data: optimising data consistency to demonstrate the value of nurse practitioner service
Gardner, Anne, Millar, Lynne and Driscoll, Andrea 2007. Dealing with data: optimising data consistency to demonstrate the value of nurse practitioner service. The Nurse Practitioner Series (9780980412901). 2 (1), pp. 19 - 25.
Intravascular catheter bloodstream infections: An effective and sustained hospital-wide prevention program over 8 years
Collignon, Peter J., eimanis, Dianne E., Beckingham, Wendy D., Roberts, Jan L. and Gardner, Anne 2007. Intravascular catheter bloodstream infections: An effective and sustained hospital-wide prevention program over 8 years. Medical Journal of Australia. 187 (10), pp. 551 - 554.
Maternal mortality and psychiatric morbidity in the perinatal period: Challenges and opportunities for prevention in the Australian setting
Austin, Marie-Paule, Kildea, Sue and Sullivan, Elizabeth 2007. Maternal mortality and psychiatric morbidity in the perinatal period: Challenges and opportunities for prevention in the Australian setting. Medical Journal of Australia. 186 (7), pp. 364 - 367.
The development of national competency standards for the midwife in Australia
Homer, Caroline, Passant, Lyn, Kildea, Sue, Pincombe, Jan, Thorogood, Carol, Leap, Nicky and Brodie, Pat 2007. The development of national competency standards for the midwife in Australia. Midwifery. 23 (4), pp. 350 - 360. https://doi.org/10.1016/j.midw.2006.03.008
The capability of nurse practitioners may be diminished by controlling protocols
Carryer, Jenny, Gardner, Glenn, Dunn, Sandra and Gardner, Anne 2007. The capability of nurse practitioners may be diminished by controlling protocols. Australian Health Review. 31 (1), pp. 108 - 115. https://doi.org/10.1071/AH070108
Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings
O'Connell, Beverley, Gardner, Anne, Takase, Miyuki, Hawkins, Mary, Ostaszkiewicz, Joan, Ski, Chantal and Josipovic, Patricia 2007. Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings. International Journal of Nursing Practice. 13 (3), pp. 182 - 192. https://doi.org/10.1111/j.1440-172X.2007.00624.x
Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory
O'Keefe, Elissa, Gardner, Anne, Currie, Marian, Garland, Suzanne, Tabrizi, Sepehr and Bowden, Francis 2006. Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory. Sexual Health. 3 (2), pp. 91 - 94. https://doi.org/10.1071/SH05047
Maternity emergency care: Short course in maternity emergencies for remote area health staff with no midwifery qualifications
Kildea, Sue, Kruske, Sue and Bowell, Libby 2006. Maternity emergency care: Short course in maternity emergencies for remote area health staff with no midwifery qualifications. Australian Journal of Rural Health. 14 (3), pp. 111 - 115. https://doi.org/10.1111/j.1440-1584.2006.00785.x
Competency and capability: imperative for nurse practitioner education
Gardner, Glenn, Carryer, Jenny, Dunn, Sandra and Gardner, Anne 2006. Competency and capability: imperative for nurse practitioner education. Australian Journal of Advanced Nursing. 24 (1), pp. 8 - 14.
Using a monitored sip test to assess risk of aspiration in postoperative patients
Osborne, Sonya, Gardner, Glenn, Gardner, Anne, Franklin, Susan, Tuohy, Elizabeth and Fisher, Alex 2006. Using a monitored sip test to assess risk of aspiration in postoperative patients. AORN Journal. 83 (4), pp. 908 - 928. https://doi.org/10.1016/S0001-2092(06)60010-0
Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians
Kruske, Sue, Kildea, Sue and Barclay, Lesley 2006. Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians. Women and Birth. 19 (3), pp. 73 - 77. https://doi.org/10.1016/j.wombi.2006.07.001
Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice
Feeley, Kathy and Gardner, Anne 2006. Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice. Australian Critical Care. 19 (2), pp. 73 - 77. https://doi.org/10.1016/S1036-7314(06)80012-3
How ophthalmic day surgery patients convalesce at home: an exploration of the salient issues
Ryan, Fiona, O'Connell, Beverley and Gardner, Anne 2006. How ophthalmic day surgery patients convalesce at home: an exploration of the salient issues. Day Surgery Australia. 5 (3), pp. 11 - 16.
Maternity care in the bush: Using the internet to provide educational resources to isolated practitioners
Kildea, Sue, Barclay, Lesley and Brodie, Pat 2006. Maternity care in the bush: Using the internet to provide educational resources to isolated practitioners. Rural and Remote Health. 6 (3), pp. 1 - 12.
AARN and CRANA: Peak rural and remote nursing bodies welcome Medicare item for maternity care
Kildea, Sue and Armstrong, Wendy 2006. AARN and CRANA: Peak rural and remote nursing bodies welcome Medicare item for maternity care. Australian Journal of Rural Health. 14 (2), pp. 91 - 92.
Risky business: Contested knowledge over safe birthing services for Aboriginal women
Kildea, Sue 2006. Risky business: Contested knowledge over safe birthing services for Aboriginal women. Health Sociology Review. 15 (4), pp. 387 - 396.
Pressure injury: an exploration of the relationship between risk factors and interface pressure
Gardner, Anne, Dunk, Ann Marie, Eggert, Marlene, Gardner, Glenn and Wellman, David 2006. Pressure injury: an exploration of the relationship between risk factors and interface pressure. Wound Practice & Research. 14 (4), pp. 140 - 149.
Nurse Practitioner competency standards: Findings from collaborative Australian and New Zealand research
Gardner, Glenn, Carryer, Jenny, Gardner, Anne and Dunn, Sandra 2006. Nurse Practitioner competency standards: Findings from collaborative Australian and New Zealand research. International Journal of Nursing Studies. 43 (5), pp. 601 - 610. https://doi.org/10.1016/j.ijnurstu.2005.09.002
A trial of nurse practitioner scope of practice
Gardner, Anne and Gardner, Glenn 2005. A trial of nurse practitioner scope of practice. Journal of Advanced Nursing. 49 (2), pp. 135 - 145. https://doi.org/10.1111/j.1365-2648.2004.03273.x
Best practice in stabilisation of oral endotracheal tubes: a systematic review
Gardner, Anne, Hughes, Dot, Cook, Robert, Henson, Rachael, Osborne, Sonya and Gardner, Glenn 2005. Best practice in stabilisation of oral endotracheal tubes: a systematic review. Australian Critical Care. 18 (4), pp. 158 - 165. https://doi.org/10.1016/S1036-7314(05)80029-3
Parenting a preterm infant: Experiences in a regional neonatal health services programme
Rowe, Jennifer, Gardner, Glenn and Gardner, Anne 2005. Parenting a preterm infant: Experiences in a regional neonatal health services programme. Neonatal, Paediatric and Child Health Nursing. 8 (1), pp. 17 - 23.
A broader understanding of indigenous health
Kildea, Sue 2004. A broader understanding of indigenous health. Women and Birth. 14 (4), pp. 24 - 24.