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PubMed2005

The effects of appreciative inquiry interviews on staff in the U.K. National Health Service.

PURPOSE: To obtain preliminary data on the short- and medium-term effects and personal acceptability of appreciative inquiry (AI) in staff development in health care. DESIGN/METHODOLOGY/APPROACH: AI is a non-problem-solving management approach focusing on developing current successes into the future through reflection at individual and group level. Individual one-hour interviews were undertaken with nursing staff on a national paediatric liver in-patient ward. They were asked to recount stories based on their experiences of successful delivery of health care, with active listening, followed by reflection on the process. A total of 32 staff members took part with only two refusals. Data were written and analysed by an open coding method. Follow up was obtained two years later using a written, open question method. FINDINGS: The process was emotional-but well received. Staff described quality in interpersonal interactions, preventing errors and engaging their personal values in their work. No improvement in recruitment or retention was shown but a high level of sickness absence fell significantly during the period of the project. Two years later, significant positive effects were recalled and attributed to the interviews by many respondents. AI appears a cost-effective way of connecting professionals' motivation toward quality in their work with strategic intentions. RESEARCH LIMITATIONS/IMPLICATIONS: The interviewer was a medical consultant and ward manager, implying either that the interviews could have worked as a form of managerial supervision or improvements could be a Hawthorne effect. Other unknown influences were likely to be occurring on the ward during the study period. PRACTICAL IMPLICATIONS: Short AI interventions on an individual basis can change sickness absence, at least while the interventions are continuing. It is an important tool for staff motivation with the potential for connecting strategic with micro-operational levels. AI is an approach to NHS management with wide application including appraisal, personal development and mentoring. It can be a positive introduction to reflective practice. ORIGINALITY/VALUE: AI is gaining recognition for its value in staff and service development in health care. The paper shows service and personal effects, cost-effectiveness and illustrates how to use AI for these purposes.

Attitude of Health Personnel↗

PubMed2006

An acute hospital ward, densely populated with students during a 12-week clinical study period.

This article presents some thoughts and ideas about a different way to organize clinical studies for nursing students. The model involved a large group (12 to 15) of third-year nursing students taking their 12-week clinical study period on the same acute geriatric hospital ward. Difficulties with finding enough clinical study venues, together with a belief in peer learning and situated learning as important for learning, were the main reasons for trying out a model with many students doing clinical studies on the same ward. The model has been used twice, and evaluations showed that students believed the clinical study period had given them the opportunity to develop their nursing competence. Most of the students experienced cooperation with other students as self-developing. Staff experienced this model as a positive influence on students' professional development and as stimulating for the professionalism of the ward.

Attitude of Health Personnel↗

PubMed1993

Service management.

Superior service is the outcome of a dedicated planning methodology. Medical groups that plan and manage for patients' service needs will achieve market differentiation, enjoy enhanced levels of staff development and motivation and improve long-term financial performance. Medical groups that ignore the importance of service excellence will find themselves trailing those groups that provide superior service to their patients.

Consumer Behavior↗

PubMed1986

Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

Hospital Bed Capacity, 300 to 499↗

PubMedDate not supplied

A consortium approach to intravenous certification.

Providing education for intravenous therapy without offering redundant courses is a concern for staff development educators. The consortium approach maximizes resources, provides a standard and consistent level of intravenous training, and provides a cost-effective remedy. Problems, solutions, and benefits to students, educators, and hospitals are described in this article. Emergent issues are also discussed.

Certification↗

PubMedDate not supplied

A new clinical educator role: bridging the education-practice gap.

A new clinical educator role implemented at Georgetown University Hospital is described in this article. Nurses in this role assume dual responsibilities for nursing staff development and clinical supervision of baccalaureate nursing students. These clinical educators have joint appointments in the Department of Nursing and the School of Nursing. This role helps to bridge the education-practice gap and encourages a more efficient use of nursing resources.

Education, Nursing, Baccalaureate↗

PubMedDate not supplied

Developing self-learning packages.

In the current health care economy, staff development educators are searching for viable, cost-effective methods of delivering instruction. Self-learning packages are one such method. A step-by-step method for developing self-learning packages is presented along with a comparative analysis of costs with the use of self-learning packages versus a traditional classroom program.

Cost-Benefit Analysis↗

PubMedDate not supplied

Preceptorship: a model to empower nurses in rural health settings.

Continuing education and staff development help nurses meet new needs and demands caused by rapid changes in society, demography, technology, politicoeconomic structure, and disease patterns. Rural nurses have a unique, generalist role within their practice but are disadvantaged in accessing professional development because of geographical and professional isolation. A preceptorship program was developed to empower individual nurses in rural health units in South Australia. This program equipped them with the knowledge, skills, and attitudes necessary to make changes in their health units. At the same time, it enabled participants to act as mentors to colleagues in collaborative partnerships designed to meet the complex health needs of their rural clients.

Curriculum↗

PubMed1990

ASHP national survey of hospital-based pharmaceutical services--1990.

The results of a national mail survey of pharmaceutical services in community hospitals conducted by ASHP during May through July 1990 are reported and compared with the results of earlier ASHP surveys. A sample of community hospitals (short-term, nonfederal) was selected randomly from the population of community hospitals registered by the American Hospital Association. Questionnaires were mailed to each director of pharmacy. The adjusted gross sample size was 881. The net response rate was 66% (582 usable replies). The average number of hours of pharmacy operation per week reported by the respondents was 96. Complete unit dose drug distribution was offered by 89% of the respondents (up from 74% in 1987). About 70% offered complete, comprehensive i.v. admixture programs (essentially unchanged from 1987). Most of the hospitals (70%) had centralized pharmaceutical services. A computerized pharmacy system was present in 64% of the departments, and 75% had at least one microcomputer. More than 90% reported participation in adverse drug reaction and drug-use evaluation programs. Some 80% participated in drug therapy monitoring. Almost half of the respondents regularly provided written documentation of pharmacist interventions in patients' medical records. Approximately one third provided patient education or counseling, and one third provided drug management of medical emergencies. A well-controlled formulary system was in place in 58% of the hospitals; therapeutic interchange was practiced by 49%. A total of 98% of the respondents participated in group purchasing, and 96% used a prime vendor. Half of the departments served as training sites for pharmacy students. Less than half had a staff development program, but about two thirds supported continuing-education activities for pharmacists. The 1990 survey revealed a continuation of the changes in many hospital-based pharmaceutical services documented in earlier surveys and identified static areas that merit the attention of pharmacy leaders.

Centralized Hospital Services↗

PubMedDate not supplied

The "Party Planner": a novel approach to teaching complex material to all levels of the healthcare team.

One of the challenges facing staff development educators today is addressing the needs of a new healthcare team with widely differing education and experience. We developed a novel approach--the Party Planner--to teach a diverse healthcare team about a rather complicated practice model. The Party Planner addresses issues that are central in the current healthcare environment--using resources, balancing cost and quality, eliminating non-value added routines, and achieving critical outcomes.

Communication↗

PubMed2004

An unwanted visitor. Aggressive infection control strategies are needed to shorten the hospital visit of the easily spread norovirus.

Norovirus is the name for a group of Norwalk-like viruses that cause acute gastroenteritis of rapid onset. A recent outbreak at a tertiary care facility in Alberta provided an opportunityfor staff and management to review their outbreak protocol and improve their infection prevention and control procedures. The outbreak caused illness in 32 of 73 exposed patients as well as 42 staff members. None of the infected patients or staff developed complications. The source of norovirus contamination was probably associated with a symptomatic food services staff member serving food cafeteria style in a satellite patient dining room. Food service procedures and serving techniques were reviewed; although no breaks in technique were identified, correct food handling procedures were reviewed with staff. Subsequent patient and staff cases were probably related to the cross contamination of environmental surfaces and patient care equipment. The director of nursing and the infection control practitioner led the investigation and management of the outbreak. An Outbreak Management Committee was also formed to reinforce routine infection prevention practices and implement infection control strategies. Communication strategies for staff, patients and visitors were quickly devised and implemented. Gaps in the outbreak protocol were identified and resolved promptly Four permanent changes were made: the use of alcohol hand rinse in designated locations; the development of a comprehensive e-mail to facilitate site-wide communication; the development of teamwork checklists and accountabilities; and the establishment of criteria for use in outbreak situations to proactively determine essential and non-essential therapies and treatments.

Alberta↗

PubMed2005

An exploration of the caring attributes and perceptions of work place change among gerontological nursing staff in England, Scotland and China (Hong Kong).

This study investigates caring attributes and perceptions of work place change among qualified and unqualified nursing staff working with older people in three countries. A Modified Caring Attributes Questionnaire and Perception of Workplace Change Schedule were administered to 737 staff. Caring attributes scores were highest for nurses working in long stay settings, and lowest in nurses aged 25-29 years. Nurses in Hong Kong appear better educated than UK counterparts. Staff development seemed more common in long stay settings. Results suggest workplace changes limiting care quality were more pronounced in Scotland. Reported job satisfaction and moral were lowest in the UK group.

Acute Disease↗

PubMedDate not supplied

A mock trial at nursing grand rounds.

In staff development, varying methods of presentation can often make or break the learning process. A mock trial can help to increase nurses' awareness of the legal system and decrease the likelihood of a nurse being named in a medical negligence case. The mock trial presented at Texas Children's Hospital demonstrated what should and should not be documented and the importance of practicing within nursing standards of practice and hospital policies.

Education, Nursing, Continuing↗

PubMed1988

"Thinking aloud" as a strategy to improve clinical decision making.

Although "thinking aloud" has been used as a research method to collect data about nurses' knowledge and cognitive processes, it has not been used widely for instruction. We suggest that thinking aloud can be an effective teaching strategy for staff development. Two techniques are described for incorporating thinking aloud into dialogue among experienced nurses and into mentoring activities between experts and novices. An excerpt from a transcript of one nurse's thinking aloud while making a triage decision is presented to illustrate the types of knowledge and cognitive processes that can be elicited and revealed by using this strategy. Potential educational benefits are identified, along with suggestions for implementing thinking aloud as an instructional method.

Decision Making↗

PubMedDate not supplied

Critical care education. A consortium approach.

Staff development specialists are being forced to look at more economical models to present traditional educational programs. In this article, the author describes a creative approach taken by a nurse educators' consortium in northern New Jersey to collaboratively organize and present a basic critical care course. Benefits to learners as well as educators are identified. Cost analysis of this program versus that of a more traditional approach demonstrates the savings for each of the participating hospitals.

Critical Care↗

PubMedDate not supplied

The new grad: a success story.

The new graduate nurse is a fragile commodity to the healthcare system and should be handled carefully to create a smooth transition to competent staff nurse. A primary role of the staff development nurse is to plan an orientation program that not only provides direction for success but is also flexible enough to meet the individual nurse's needs when problems arise. Second, having an understanding of the significance of the coach-orientee relationship is equally important in ensuring a successful orientation.

Adaptation, Psychological↗

PubMedDate not supplied

Making the most of learning needs assessments.

Identifying learning needs of nurses is an important role of the staff development educator. However, few educators have specific training in the preparation and evaluation of a learning needs assessment. This article describes the assumptions, benefits, and potential barriers when planning a needs assessment survey. Specific strategies to maximize the benefits of the survey are shared. Competent nurses are the cornerstone of professional nursing care, and identifying and responding to learning needs through a needs assessment is a critical step in assuring competence.

Clinical Competence↗

PubMedDate not supplied

New graduate orientation in the rural community hospital.

Retention rates for 1-year new graduate nurses had fallen to 30% at the author's institution. Upon reviewing feedback, a lack of a new graduate orientation program was determined to be a significant factor. The challenge presented to staff development was to develop a program that would increase 1-year retention rates of new graduate nurses without incurring overtime costs or significant additional expenses. The result was a successful 8-week orientation program using multiple teaching methods. New graduates rated their own progress through the use of a self-assessment questionnaire. One-year retention rates for new graduate nurses increased to 77% after the program was implemented.

Hospitals, Community↗