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Aims and objectives To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting. Background Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach. Design Qualitative, descriptive research design. Methods Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed. Results Four emergent themes described the influence of motivation on individuals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives. Conclusion Implementing practice change is more than just providing technical knowledge and includes changing individuals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team. Relevance to clinical practice Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital.

Aims and objectives To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting. Background Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach. Design Qualitative, descriptive research design. Methods Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed. Results Four emergent themes described the influence of motivation on individuals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives. Conclusion Implementing practice change is more than just providing technical knowledge and includes changing individuals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team. Relevance to clinical practice Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital.

AIMS AND OBJECTIVES: To explore the experiences and perceptions of hospital staff caring for dying patients in a dedicated patient/family room (named Lotus Room). BACKGROUND: Dying in hospital is a common outcome for people across the world. However, noise and activity in acute environments present barriers to quality end-of-life care. This is of concern because care provided to dying patients has been shown to affect both the patients and the bereaved families. DESIGN: A qualitative descriptive approach was used. METHODS: Semi-structured interviews were conducted with 17 multidisciplinary staff and seven families provided information through an investigator-developed instrument. RESULTS: Qualitative data analysis generated three categories describing: Dying in an hospital; The Lotus Room; and the Outcomes for patients and families. The Lotus Room was seen as a large, private and, ultimately, safe space for patients and families within the public hospital environment. Family feedback supported staff perspectives that the Lotus Room facilitated family presence and communication. CONCLUSIONS: The privacy afforded by the Lotus Room within this acute hospital provided benefits for the dying patients and grieving families. Improved outcomes included a peaceful death for patients, which may have assisted the family with their bereavement. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence of how the physical environment can address well-established barriers to quality end-of-life care in acute hospitals.

AIMS AND OBJECTIVES: To explore the experiences and perceptions of hospital staff caring for dying patients in a dedicated patient/family room (named Lotus Room). BACKGROUND: Dying in hospital is a common outcome for people across the world. However, noise and activity in acute environments present barriers to quality end-of-life care. This is of concern because care provided to dying patients has been shown to affect both the patients and the bereaved families. DESIGN: A qualitative descriptive approach was used. METHODS: Semi-structured interviews were conducted with 17 multidisciplinary staff and seven families provided information through an investigator-developed instrument. RESULTS: Qualitative data analysis generated three categories describing: Dying in an hospital; The Lotus Room; and the Outcomes for patients and families. The Lotus Room was seen as a large, private and, ultimately, safe space for patients and families within the public hospital environment. Family feedback supported staff perspectives that the Lotus Room facilitated family presence and communication. CONCLUSIONS: The privacy afforded by the Lotus Room within this acute hospital provided benefits for the dying patients and grieving families. Improved outcomes included a peaceful death for patients, which may have assisted the family with their bereavement. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence of how the physical environment can address well-established barriers to quality end-of-life care in acute hospitals.