Search

Aim: To evaluate an emancipatory Practice Development approach for strengthening nursing surveillance on a single medical‐surgical ward. Background: Registered nurses keep patients safe in acute care settings through the complex process of nursing surveillance. Our interest was understanding how frontline teams can build safety cultures that enable proactive nursing surveillance in acute care wards. Design: A year‐long emancipatory Practice Development project. Methods: A collaborative relationship was established around a shared interest of nursing surveillance capacity and researcher embedded on a medical‐surgical ward. Critical analysis of workplace observations and reflection with staff generated key sites for collective action. Ward engagement was supported by creative Practice Development methods including holistic facilitation, critical reflection and action learning. An action learning set was established with a group of clinical nurses, facilitating practitioner‐led change initiatives which strengthened nursing surveillance and workplace learning. Evaluation supported an iterative approach, building on what worked in an acute care context. Immersive researcher evaluation, drawing on multiple data sources, generated an analysis of how ward nursing surveillance capacity can be strengthened. COREQ criteria guided reporting. Results: The ward moved through a turbulent and transformative process of resistance and retreat towards a new learning culture where nursing surveillance was visible and valued. Staff developed and sustained innovations including the 'My MET Call series', a 'Shared GCS initiative', an enhanced 'Team Safety Huddle', and staff‐led Practice Development workshops. These new practices affirmed nurses' agency, asserted nurses' clinical knowledge, positioned nurses to participate in team decision‐making and humanised care. Conclusion: Working collaboratively with frontline staff enabled bottom‐up sustainable innovation to strengthen nursing surveillance capacity where it mattered most, at the point of care. Relevance to clinical practice: Emancipatory Practice Development enables the profound impact of small‐scale, microsystem level practice transformation. It is an accessible methodology for clinical teams to develop effective workplace cultures. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the impact of an educational programme focused on social behaviours and relationships on organisational learning culture in the residential aged care context. Background The number of aged care homes will continue to rise as the frail older elderly live longer, requiring more formal care and support. As with other small- to medium-sized health services, aged care homes are faced with the challenge of continuous development of the workforce and depend upon registered nurses to lead staff development. Design A mixed-method evaluation research design was used to determine the impact of an educational programme focused on social aspects of learning on organisational learning culture. Methods One hundred and fifty-nine (pre) and 143 (post) participants from three aged care homes completed the Clinical Learning Organisational Culture survey, and three participant-researcher registered nurse clinical educators provided regular journal entries for review. Results While each site received the same educational programme over a six-month period, the change in organisational learning culture at each site was notably different. Two aged care homes had significant improvements in affiliation, one in accomplishment and one in recognition. The educators' journals differed in the types of learning observed and interventions undertaken, with Eucalyptus focused on organisational change, Grevillea focused on group (student) change and the Wattle focused on individual or situational change. Conclusion Clinical educator activities appear to have a significant effect on organisational learning culture, with a focus on the organisational level having the greatest positive effect on learning culture and on individual or situational level having a limited effect. Relevance to clinical practice Clinical educator facilitation that is focused on organisational rather than individual interests may offer a key to improving organisational learning culture. [ABSTRACT FROM AUTHOR]