Abstract

Background: As nurses, midwives and allied health professionals deliver the majority of direct patient care, they are well placed to lead research and generate evidence to inform practice.

Aims: To consider how best to implement the findings of The Whitehouse Report, to reflect on the development of a nursing, midwifery and allied health professions research and evaluation service at a UK NHS foundation trust, and to understand the mechanisms that contribute to change.

Methods: Using the principles of change theory we developed four theories of change, underpinned by a logic model, to consider the sequence of events and the expected results. The impact of the new service on workforce capacity and capability and the mechanisms of change were considered retrospectively over a two-year period between 2019 and 2021. Surveys, interviews, field notes and data regarding a number of projects were collected and reviewed.

Results: Research, quality improvement and service evaluation activity have increased across all nursing, midwifery and allied health professions at our hospital trust. Six underpinning core values and seven practical mechanisms to implement these values were identified as successful drivers of change for the service.

Discussion: The intentional development of a network of teams, individuals and patients was fundamental to building capacity, capability and confidence among staff. Enablers to the increase in research activity included using role modeling, inspiration and perseverance to make visible the value of nurses, midwives and allied health professionals in leading research-based care. Preconceived ideas of who ‘should’ do research challenged the positive culture of critical inquiry for the benefit of patients, service improvements and celebration of existing work. Strategies to support research activities across the professions require vision, time, infrastructure and buy-in at micro, meso and macro levels, as well as a sustained effort from those directly involved.

Conclusions: It would be beneficial to encourage bespoke approaches to help staff translate ideas into practice-based projects as part of capacity, capability and confidence building for research across the clinical workforce. Audit, quality improvement and evaluation activities can lead directly to an increase in research engagement, involvement and leadership among nurses, midwives and allied health professionals, as well as supporting recruitment and retention. Future research could explore whether this approach would be replicable and effective in other healthcare organisations or systems.

Implications for practice:

• Shared values are essential to forge progress in research activities led by nurses, midwives and allied health professionals
• The use of audit, quality improvement and service evaluation approaches are effective in increasing research activity within organisations
• A number of approaches to growing the capacity, capability and confidence of staff should be considered within the organisational context. One approach does not fit all
• Research-active organisations have better outcomes for patients, whether or not the patients are part of a trial. Increasing the capacity and capability of staff means more research is likely to be undertaken through a nursing, midwifery and allied health professional’s lens

This article by Claire L. Whitehouse, Jacky Copping, Paul Morris, Darylile Guledew, Beverly Chilson, Rene Gray, Kirsty Cater and Helen Hall is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.