title: Nurse-led action research project for expanding nurses' role in patient education in Iran: Process, structure, and outcomes.
abstract: BACKGROUND
  Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses' role in patient education in Iran.
  
  
  METHODS
  This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis.
  
  
  RESULTS
  A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a "core research support team," "two steering committees," and community representatives of clients and professionals as "feedback groups." A seven-stage process, named the "Nurse Educators: Al-Zahra Role Expansion Action Research" (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components.
  
  
  CONCLUSIONS
  A nurse-led ad hoc structure with academic-clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses' educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system policy makers in a wider range of practice.
authors.affiliation: Department of Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Khorasani
authors.affiliation: Department of Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rassouli
authors.affiliation: Department of Paediatric Nursing, Nursing and Midwifery Faculty, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Soroor
authors.initials: S
authors.lastname: Parvizy
authors.affiliation: Department of Nursing Management, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mansoureh
authors.initials: M
authors.lastname: Zagheri-Tafreshi
authors.affiliation: Health Education Office, Al-Zahra Teaching Hospital, Medical University of Isfahan, Isfahan, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Nasr-Esfahani
keywords: Capacity building; Iran; nurses; patient education; professional role