Building Skill-Building Into Nursing Practice

Action Research Project -- Cardiac Rhythm Interpretation The purpose of this paper is to discuss the possible outcomes of the proposed solution to the project. In particular, the discussion will focus on outcomes that might occur if the solution is not effective in the manner intended. The preparation for the project has focused on pre- and post-tests of the use of ECG flashcards. The literature has shaped the conceptualization of desirable outcomes for the project and enabled the project to assume the structure of an action research project (Lewin, 1951).

The project has been guided and defined by the dynamics inherent in change processes, which are supported by change theory and the literature on transfer of training (Bridges, 2003). The action research problem, which was identified during the practicum experience, is the need for ongoing education of CLC nurses on cardiac rhythm interpretation (Finkelman & Kenner, 2010).

The significance of the problem became apparent through the review of the pre-test, which consisted of flashcard review of rhythm strips, and through the training outcomes for both new and well-seasoned nurses who experienced difficulty with correct rhythm interpretations during their just-in-time training sessions. The situation that CLC nurses are experiencing is not unique. The research confirms that nurses often do not receive adequate training and experience in reading cardiac rhythms (Weatherburn, et al., 2009).

Indeed, the hospital at which the practicum experience took place has not established competencies for staff to complete in order to show that they are competent on interpreting cardiac rhythms. The primary outcome of the action research project is to develop a competency exercise on rhythm interpretation for staff to complete one to two times each year (Kearney-Nunnery, 2008).

Establishment of fully developed competency exercises will offer a path to skill improvement and expertise within the nursing staff at the hospital, and will support the ongoing efforts to provide evidence-based, high quality and safe patient care (Collins, et al., 2007; Melnyk & Fineout-Overholt, 2005). Articulation of the project has pivoted on the successful integration of change theory, nurse training literature, and action research processes. The steps of a nursing practice change process and the phases of an action research project are nearly a point-to-point match.

Both are designed to support nursing staff to adopt a new practice or refine an existing practice in a manner that contributes to substantial outcomes. The steps generally outlined in change theories include the following: 1) Identifying the problem or concern along with factors that influence the need for change; 2) collecting information to better understand the need and possible solutions; 3) identifying barriers to change and the facilitators for change; 4) identifying solutions for the problem or concern; 5) deciding the.