International Practice Development Journal

Promuovere la pratica centrata sulla persona in terapia intensiva

• Promoting person-centred practice within acute care: the impact of culture and context on a facilitated practice development programme
• Original practice development and research
• Tanya McCance, Bernadette Gribben, Brendan McCormack, Elizabeth A Laird
• Volume 3, Issue 1, Article 2
• May 2013
• acute care, context, evaluation, person-centredness, practice development
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• Background: The promotion of person-centredness in practice has the capacity to make a critical difference to the care experience of patients and staff. While there is growing international evidence to suggest that emancipatory practice development programmes can develop person-centred cultures, understanding of how person-centredness is effectively operationalised in practice remains an underdeveloped area.
  Aim: The research aim was to explore how the culture and context of acute care practice settings impacts on the engagement of practitioners in a facilitated practice development programme.
  Methods: The methodology used was programme evaluation, using multi-methods including process evaluation, reflective accounts and focus group interviews. Data analysis was undertaken using a creative hermeneutic approach.
  Findings: The findings highlighted that the programme enabled a level of engagement that was characterised by positive ways of working, building relationships and maintaining momentum. This in turn impacted on the ability to embrace person-centred values in practice and reflected nurses’ confidence and competence. Person-centredness in practice was also impeded by conflicting priorities characterised by a sense of feeling pressurised, limited staffing and resources, and the challenges of an evolving context, particularly within the provision of services in acute hospitals.
  Conclusions: The findings are confirmatory and add to the existing evidence regarding the effectiveness of practice development as an approach that facilitates teams to explore their own practice. The findings, however, add to existing evidence by highlighting new insights that should be taken into account when delivering a facilitated practice development programme.These insights reflect the tussle between the impact of context and the development of cultures that support person-centredness in everyday practice.
  Implications for practice: There is a need to further explore the impact of the contradictions of espoused values of person-centredness on the experience of patients and staff and how further refined interventions can contribute towards workplace cultures that are healthful and that enable human flourishing for all.
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