Developing nursing practice to meet the needs of persons admitted to acute care with Chronic Obstructive Pulmonary Disease (COPD) : an action research study

Acute care nurses represent a large component of the healthcare workforce and are in a prime position to effect better care provision to persons with chronic disease in an acute setting. Many authors highlight the role of nurses in the delivery of care to persons with Chronic Obstructive Pulmonary Disease (COPD) and subsequently urge them to take a proactive role in COPD disease management. In recent times there has been a rise in community or primary health care innovation in care for persons with COPD, and a subsequent improvement of understanding of nursing roles in that area. Nurses in acute care have attracted scant attention in the COPD literature and their role remains characterized by descriptions of task focused support for persons who experience acute exacerbations of the disease. There is a paucity of research which articulates the current situation of nursing care provision for people admitted to hospitals with COPD and how improvements in such care might occur. Specifically, there is a lack of research which includes those acute care nurses-in investigation and improvement of their own practice as it relates to care of persons with COPD. This study addresses the concern of understanding and improving COPD care within hospitals from the perspective of acute care nurses. Nurses from an acute care setting came together to collaboratively work in an action research group, at first to enhance their understandings of the issues that impacted on care provision and then to work toward improving the care received by people with COPD nursed on their ward. The findings suggest that utilizing and action research framework approach is effective in engaging acute care nurses in understanding and improving their practice. However they also highlight the difficulties of undertaking collaborative research in a complex, changing acute care environment and the need to ensure support for such activities from a management perspective. The study adds to what is known of COPD care provision by contributing to understandings of acute care experiences and provision from the perspective of nurses caring for this group of patients. In addition the study demonstrates that is it possible for acute care nurses to be empowered to change practice and to improve care to persons with COPD.