An action research approach to the development of a clinical pathway for women requiring Caesarean sections
Gwen Moody
CNC Infant Feeding and Postnatal Education, Westmead Hospital, NSW
Yoong Yin Choong
Senior Nurse Educator, Westmead Hospital, NSW
Jennifer Greenwood
Professor of Nursing, Western Sydney Area Health Service, University of Western Sydney, Nepean NSW
PP: 195 - 205
Abstract
An action research framework was utilised to introduce a clinical pathway for women undergoing Caesarean section in the Maternity Unit at Westmead Hospital in 1998-1999. This style of research allowed the development of the clinical pathway for women having a Caesarean section to be progressively modified to adapt it to suit the needs of the multidisciplinary team and the clinical environment.
The clinical pathway itself became a document that facilitated the education of the women, improving their preparation for discharge, aided the orientation and skill development of new staff and improved the continuity of care by enhancing the multidisciplinary approach to the women's care. It also identified the need for continuing staff education throughout the implementation and evaluation phases.
Keywords
action research; clinical pathway; critical pathway
References
Australian Midwives Association, Rowley, M, Giles, W. (1990) Continuity of Care: An Evaluation.
Bigos, K, Graybeal, K. (1993) Critical pathway development: the Overlake model, Nursing Management 24(4): 42-45.
Crummer, M. B, Carter, V. (1993) Clinical pathways: the pivotal tool, The Journal of Cardiovascular Nursing 7(4): 30-37.
Falconer, J.A. Et al, (1993) The clinical path method in stroke rehabilitation: lessons from and experiment in cost containment and outcome improvement, Quality Review Bulletin 1: 8 -16.
Fern, E. F. (1982) The use of focus groups for idea generation: the effects of group size, acquaintanceship, and moderator on response quantity and quality, Journal of Marketing Research 19: 1-13.
Goode, C. J. (1993) Developing a CareMapTM for patients with a Caesarean section: a multidisciplinary process, Journal of Perinatology and Neonatology Nursing 7(2): 40-49.
Goodwin, D. R. (1992) Clinical pathways in home healthcare, Journal of Advanced Nursing 22(2): 35-40.
Greenwood, J. (1984) Nursing Research: a position paper. Journal of Advanced Nursing 9: 77-82.
Greenwood, J. (1994) Action research and action researchers: same introductory considerations. Contemporary Nurse 3(2): 84-91. http://www.contemporarynurse.com/archives/vol/3/issue/2/
Holter, D. R. Schwartz-Barcott, D. (1993) Action research: what is it? How has it been used and how can it be use in nursing? Journal of Advanced Nursing 18: 298-304.
Kemmis, S & McTaggart, R. (Eds) (1988) The Action Research Planner (3rd Ed.). Deakin University Press, Geelong, Victoria.
Kingsland, S, Smith, P, McKinley, S. (1994) Introduction of managed care plans in a cardiac surgery unit. Contemporary Nurse 3(4): 189-194. http://www.contemporarynurse.com/archives/vol/3/issue/4/
Krueger, R.A. (1994) Focus Groups: A Practical Guide For Applied Research. Sage Publications, Thousand Islands, California.
Laxade, S. Hale, C.A. (1993) Managed care 1: an opportunity for nursing. British Journal of Nursing 4(5): 290-294.
Lumley J. (1990) Having a baby in Victoria: final report of the ministerial review of birthing services in Victoria, Health Department Victoria, Melbourne.
Maternity Alliance (1993) Critical pathways, Parmer, M, Bower, K.A., Falk. C. D Parramatta, 1994.
McCaugherty, D. (1991) The theory - practice gap in nurse education: its causes and possible solutions. Findings from an action research study. Journal of Advanced Nursing 16: 1055-1061.
Morgan, D. L. (1988) Focus Groups as Qualitative Research. Sage Publications, Newbury Park.
Mutryn, C. S. (1993) Psychological impact of Caesarean section on the family: a literature review, Social Sciences in Medicine 37: 1271-1281.
Nugent, K. E. (1993) The clinical nurse specialist as case manager in a collaborative practice model: bridging the gap between quality and cost of care, Clinical Specialist 6:2, 1992, pp.106-109.
Page, L. (1993) Changing Childbirth, MIDIRS Midwifery Digest 3(4).
Petryshen, P. R, Petryshen, P. M. (1992) The case management model: an innovative approach to the delivery of patient care, Journal of Advanced Nursing 17: 1188-1194.
Westmead Hospital, Hosprint, (1995) Westmead Hospital Manual of Standing Instructions and Procedures - Obstetrics, Gynaecology, Neonatal Intensive Care, Section 5.
Windle, P. E. (1992) Critical pathways: an integrated documentation tool, Nursing Management 25(9): 80A-80P.
WHO (1993) Expert Committee on Maternal and Child Health, WHO: Geneva.
Zander, K. (1992) Physicians, caremaps and collaboration, The New Definition, 7:1, pp.1-4.

eContent Home




