Building effective engagement for implementation with i-PARIHS: a collaborative enquiry into paediatric pain care in the emergency department
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107597419. Available under License Creative Commons Attribution 4.0. |
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Description
Background: Pain is a central and distressing experience for children in the emergency department (ED). Despite the harmful effects of pain, ED care often falls short of providing timely and effective pain relief. Knowledge translation research targeting systems of care holds potential to transform paediatric pain care. This article reports on the first stages of an implementation project aimed at embedding effective and sustainable practice change in an Australian children’s hospital ED. Methods: The integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework underpinned a cooperative process of engagement to establish a practitioner-led, interprofessional research collaborative. The Kids Pain Collaborative (KPC) aimed to co-design innovation in paediatric ED pain care, facilitating an extensive reconnaissance of research evidence, clinician and family experiences, and local evaluation data. This critical appraisal of the context and culture of pain management generated foci for innovation and facilitation of implementation action cycles. Results: Engaging in a complex process of facilitated critical reflection, the KPC unpacked deeply embedded assumptions and organisational practices for pain care that worked against what they wanted to achieve as a team. A culture of rules-based pain management and command and control leadership produced self-defeating practices and ultimately breakdowns in pain care. By raising a critical awareness of context, and building consensus on the evidence for change, the KPC has established a whole of ED shared vision for prioritising pain care. Conclusions: In-depth key stakeholder collaboration and appraisal of context is the first step in innovation of practice change. The KPC provided a space for collaborative enquiry where ED clinicians and researchers could develop context-specific innovation and implementation strategy. We provide an example of the prospective application of i-PARIHS in transforming ED pain care, using a collaborative and participatory approach that has successfully enabled high levels of departmental engagement, motivation and ownership of KPC implementation as the facilitation journey unfolds.
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ID Code: | 229282 | ||||||
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Item Type: | Contribution to Journal (Journal Article) | ||||||
Refereed: | Yes | ||||||
ORCID iD: |
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Additional Information: | Funding Information: This project has been funded by a Queensland Health Nursing and Midwifery Implementation Research Fellowship and the Centaur Memorial Fund for Nurses Postgraduate Scholarship. | ||||||
Measurements or Duration: | 15 pages | ||||||
Keywords: | Context, Culture, Emergency department, Facilitation, i-PARIHS, Implementation, Paediatric, Pain management | ||||||
DOI: | 10.1186/s12913-022-07740-w | ||||||
ISSN: | 1472-6963 | ||||||
Pure ID: | 107597419 | ||||||
Divisions: | Current > Research Centres > Centre for Healthcare Transformation Current > QUT Faculties and Divisions > Faculty of Health Current > Schools > School of Nursing |
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Funding Information: | This project has been funded by a Queensland Health Nursing and Midwifery Implementation Research Fellowship and the Centaur Memorial Fund for Nurses Postgraduate Scholarship. | ||||||
Copyright Owner: | 2022 The Author(s) | ||||||
Copyright Statement: | This work is covered by copyright. Unless the document is being made available under a Creative Commons Licence, you must assume that re-use is limited to personal use and that permission from the copyright owner must be obtained for all other uses. If the document is available under a Creative Commons License (or other specified license) then refer to the Licence for details of permitted re-use. It is a condition of access that users recognise and abide by the legal requirements associated with these rights. If you believe that this work infringes copyright please provide details by email to qut.copyright@qut.edu.au | ||||||
Deposited On: | 05 Apr 2022 00:38 | ||||||
Last Modified: | 15 Jul 2024 05:44 |
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