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Practice Development

At a nursing forum at the RCH on the 12th July 2007, nurses in attendance described practice development as:

• a desire to improve care for children and families at the RCH.

Practice Development approaches range along a continuum from technical to emancipatory.

Technical practice development focuses on getting practitioners to apply technical knowledge as a means for improving outcomes for patients. There is an assumption that equipped with technical knowledge and skill there will be development of practice. It is assumed culture or context exert no influence, therefore there is no concern for the environment in which the practice takes place.

At the other end of the spectrum, emancipatory practice development not only pays attention to the individual/group's practice but focuses on the context and culture in which the practice occurs. Concern is for both the process and outcome of developing practice.

Practice Development initiatives at the RCH

Within the context of the Nursing Development Program, a three year program designed to prepare nurses contemporary practice, a number of initiatives are under way.

Facilitation program

The facilitation program is designed to support the development of skills in those working with nurses to explore and develop practice. Following a successful pilot progam in early 2008 the facilitation program ran three times over the year. For more information regarding the facilitation program and to book a space please contact Shirley Burke.

Nursing Leadership Development Program

A series of workshops and leadership development opportunities are available. Please contact Shirley Burke, Nursing Executive or Human Resources to discuss options for developing and advancing your leadership skills. .

Clinical Supervision

A program of Clinical Supervision is currently being piloted in two clinical areas. If you would like more information regarding this program please contact Shirley Burke.

Person Centred Nursing Index (PCNI)

The PCNI is a 115 item survey designed to explore domains of practice and caring. The PCNI has been distributed systematically, with all areas completing the survey by the end of 2008. The intent is to repeat the PCNI in 2009 and again in 2010. The practice development team, are providing supportive roles as external facilitators, engaging nurses within clinical areas as co researchers and internal facilitators, who are then supported in distributing the PCNI within their teams in the way felt most appropriate for that environment.

The intention is to analyse and feed back the results in a timely fashion utilising collaborative and participative approaches. Methods utilised to feed back results vary, determined by internal facilitators in collaboration with external facilitators. Nurses are then supported to use the data from the PCNI, along with complimentary data from sources such as observations of practice, tracking, and patient and staff stories (see below), to develop action plans to evolve workplace cultures of effectiveness.

For further details regarding the PCNI please contact Bronwyn Carter.

Observations of Practice

The Practice Development Team is actively involved in supporting nurses in clinical areas to undertake observations of practice as a means of collecting data to reflect on what is working well and areas that require improvement. A variety of tools are being used to support the observations, including the Workplace Culture Critical Analysis Tool (WCCAT) and 24 hour tracking in conjunction with the Clinical Redesign Team. To discuss ways in which observations of practice might be undertaken, please contact Shirley Burke or Sally Hanson.

Patient, Family and Staff Stories

Protocols are currently being developed for the collection of patient, family and staff stories. The collection and analysis of these stories will add another layer of complexity to the data available for nurses to explore and evolve their practice. For further details regarding patient stories please contact Shari Stewart. For further details regarding family and staff stories please contact Sally Hanson or Danielle Mee.

Creating a Shared Vision

Many units have been involved in creating a shared vision through a values clarification exercise. This work helps to inform the vision for desired future ways of working, identifying core values that will inform that vision and make it a reality. If you would like to discuss ways in which you might support your team in developing a shared vision, please contact Sally Hanson or Shirley Burke.

Model Ward

In conjunction with Clinical Redesign, and following building on the 24 hour tracking exercise, the Practice Development Team has been working with nurses across two units to explore and develop practice. The key initiatives to evolve from this project have been location and availability of resources, nursing handover and team nursing. Early outcomes were presented at the Transforming Nursing Practice conference in September 2008. For more information regarding the Model Ward Project please contact Sally Hanson or Danielle Mee from the Practice Development team, or James Downie from Clinical Redesign