Search

BackgroundMarie Curie currently has 18 Practice Development Facilitators (PDFs) across the UK working in both hospice and community. The PDF role transitioned from the traditional Practice Educator role in August 2015, where the focus is now on facilitating learning and development opportunities rather than mandatory training. In partnership with Queen Margaret University the Practice Development Team have developed their knowledge and understanding of practice development methodologies and the impact this can have on developing person-centred cultures.AimsUse creative practice development methodologies to bring about culture change where current staff engage with possible recruits and feedback into the recruitment process.To ensure that potential new recruits fully understand the role on which they were embarking and experience these methods in practice during interview.To improve retention of new staff to this role.MethodsThe methods used were based on the Practice Development Workbook (Dewing, McCormack, & Titchen, 2014). The interview was conducted in three parts; the first two exercises are group activities. Using creativity to understand their journey to here; a values exercise to explore their values as well as Marie Curie’s and then a short individual interview.ResultsIt has been challenging at times as the interview process is around three hours rather than the traditional style of interview of at least one hour. Feedback received from individuals who have completed this process have been highly evaluated.ConclusionTo build authentic and meaningful relationships and cultures it is important to identify individual values and beliefs (Wilson, 2011). Establishing person-centred cultures requires a sustained commitment from individuals and organisations. The focus on staff and service users is vital to ensuring compassionate care and a flourishing culture.

BackgroundAppreciative Inquiry (AI) is a way of looking at organisational change which focuses on identifying and doing more of what is already working, rather than looking for problems and trying to fix them. AI may be used to facilitate workforce engagement, and promote organisational learning and positive organisational change in the health care context (Trajkovski et al., 2013). Pressure ulcers were seen as a way of exploring the use of AI and its potential impact in culture change.AimsTo provide a safe space and facilitate engagement with teams when exploring case studiesTo explore learning from the case studies and how this was being shared/disseminatedTo develop a culture of honesty, openness and trust ensuring Duty of Candour.MethodsGrade 2 pressure ulcers were flagged on our reporting systems and the Director of Nursing was notified. The team was then extended an invitation to present this case study to the Director and her team to explore this scenario and any learning that has come from it.ResultsCurrently a work in progress and we are in the process of evaluating this work.ConclusionA culture of engagement is more likely to predict performance than any other variables including competence (Alimo-Metcalfe & Bradley, 2010). Through discussion and exploration we are able to expand upon learning and explore decision making. Disseminated learning allows for more openness and transparency amongst the team. There is a shift from the perception of a ‘blame culture’ to one of collaboration, inclusiveness and participation. Including staff who delivered the front-line care in these scenarios and discussions further enriches the process.

BackgroundCulture is not about individuals but about the social contexts that influence the way people behave and the social norms that are accepted and expected (Manley et al., 2011). Culture is widely understood as ‘how things are done around here’ (Drennan, 1992). Anthony (1994) argues that corporate culture reflects what is espoused, what the organisation wants to portray rather than the actual culture that is experienced. Nursing practice is significantly impacted by the constantly evolving societal, environmental and organisational context in which nurses work (Keyko, 2014; McCormack et al., 2013). The dominant NHS approach in recent years has been described as ‘pace-setter’ (King’s Fund, 2012), a command and control culture with little delegation or collaboration, which is primarily driven by top down targets (Riley, 2014). The present health care environment is paternalistic (Newton, 2000) and predominantly task orientated which can lead to fundamental care falling short (Shannon & Peelo-Kilroe, 2012; Francis, 2010). Emancipatory practice development is the product of critical social theory (Shaw, 2013; Fairbrother et al., 2015), action orientated (McCormack et al., 1999) and transformational. It relies on the development and maintenance of critical and progressive clinical practice cultures which drive change and growth in health care practice (Manley et al., 2013; Fairbrother et al., 2015).AimsUnderstand the perception of cultureEngage staff with their beliefs of self and culture.MethodsUsing creative emancipatory practice development methodologies to explore questions about culture in a less confrontational way.ConclusionPractice development and person-centred care aim to establish workplace cultures that enable everyone to flourish (Manley et al., 2014). Working collaboratively and enabling staff to contribute to the future success of the organisation provides them with a voice and creating shared governance contributes to an atmosphere of respect for staff (Boyer, 2005).

BackgroundThe term ‘Link Nurse’ refers to nurses who are prepared to acts as links between specialist services and the staff/patients of the clinical areas where they work. Link Nurses are not specialist nurses but are nurses with a keen interest in the area. We have developed link nurse programmes for both infection control and tissue viability. The Link Nurse role is seen as a means of improving the quality of care delivered to patients through the development and education of the staff who provide 24 hour ongoing care at a direct level (Friedewald, 2009). The Link Nurse role within Marie Curie is particularly relevant to areas as we are a disperse organization with nine hospices and ten regions in which we deliver end of life care. Ensuring the consistency of key messages and development opportunities is essential to patients and their families/loved ones receiving the best possible care at end of life.Aims• To develop registered nurses skills in leadership and development of others as is expected from their professional code of conduct (NMC, 2015)• To increase their knowledge in a specialist area so that they can provide and disseminate key information in relation to that topic• To offer individualised development dependent on the individuals need• To be a resource in the local area in which they are working.MethodsRegistered Nurses identified with an interest in either infection control or tissue viability have undertaken quarterly development days, which have been led by the specialist infection control lead nurse and external tissue viability lead.ResultsWe are currently looking at the evaluation of these development programmes.ConclusionThe Link Nurse programmes are developing momentum and we see each nurse acting as a role model and visible advocate for their specialist interest (RCN, 2012). Communication and networking is vital to further development and understanding of these roles and the many benefits they bring including supporting audit and surveillance of key issues.

BackgroundFor patients approaching end of life, the majority have a preference to be cared for and to die at home (de Roo et al., 2014). Community palliative care makes a key contribution towards this goal. With the increased demand on these services, there will be an increase in the number of registered nurses and health care support workers needed to meet these needs. As an organisation we need to support this through initiatives to aid the recruitment, retention, job satisfaction and performance of staff working in this setting. There is a lack of previous research on the impact of transition to palliative community care on the member of staff. As far as the research team is aware, this is the first study to explore the role of the nurse preceptor in palliative care with both registered nurses and health care assistants.AimsTo develop an understanding of the nurse preceptor role in community palliative care to explore the experience of the nurse preceptor in community palliative care to identify the barriers and rewards of undertaking this role.MethodAll nurses (n=12) undertaking the preceptor role were approached an invited to participate in the research study. 7 preceptors participated over two scheduled focus group sessions, two withdrew from preceptorship prior to the focus groups. At the end of the focus group interviews the participants were debriefed.ResultsFour key themes were identified: supporting the individual, promoting clinical readiness, confidence building, and advocacy and the preceptor.ConclusionPreparation of new staff into the role of a community palliative health care worker is essential to development, support and integration of the individual into the new working environment as well as the organisation. Lone working is a requirement within our community palliative care services and was identified as a major concern in focus groups as well as the potential impacts and scope for development in relation to this.