‘From Conception to Delivery’: A Journey Towards a Trust‐Wide Strategy to Develop a Culture of Patient‐Centredness

Down, Jill

doi:10.1002/9780470698884.ch12

Cited by 5 publications

(3 citation statements)

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“…For nursing practice, the notion of an 'underdeveloped community' would seem to have some currency (Titchen & McGinley 2003, Down 2004, Manley 2004) and indeed the magnet initiative reflects organizations' deliberate attempts to create environments that actively support innovation and enable local autonomy (Aiken et al 1994). The genesis of the practice development movement (Garbett & McCormack 2002) was widespread dissatisfaction with the quality of care patients received and a growing sense that technological Table 3 Twelve elements of the innovation journey Initiation period 1.…”

Section: Do Recent Innovations In Nursing Reflect Any Of These Elements?mentioning

confidence: 99%

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The need for systems change: reflections on knowledge translation and organizational change

Kitson

2008

Journal of Advanced Nursing

180

173

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Title. The need for systems change: reflections on knowledge translation and organizational change. Background. Despite over 40 years’ work on general systems theory, informed by critical social science, there is a mismatch between the theories used to explain and influence clinical practice in nursing and the way in which transferring new knowledge into practice is articulated. Data sources. The analysis and emerging propositions were based on a critique of seminal texts published in English up to 2008 covering critical social science, action science, diffusion of innovations, practice development and the management of innovations. Discussion. There is an implicit adherence to the world view that healthcare systems operate like machines, and much of the science generated around knowledge translation research tends to be logico‐deductive. This is in direct contrast to the prevailing arguments of general systems theorists, who view the system more as an organism. Five propositions are posited: knowledge translation is a necessary but not sufficient mechanism to transform systems; the ‘system‐as‐machine’ metaphor is profoundly unhelpful to knowledge translation; the healthcare system is best viewed as a complex entity; successful innovation is a function of the level of local autonomy experienced by individuals, teams and the unit involved; innovation is most effective when it involves key stakeholders. Conclusion. The purposeful integration of systems theory with knowledge translation theories and models may enable the application of research and new knowledge to practice to be speeded up.

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Section: Do Recent Innovations In Nursing Reflect Any Of These Elements?mentioning

confidence: 99%

“…For nursing practice, the notion of an ‘underdeveloped community’ would seem to have some currency (Titchen & McGinley 2003, Down 2004, Manley 2004) and indeed the magnet initiative reflects organizations’ deliberate attempts to create environments that actively support innovation and enable local autonomy (Aiken et al. 1994).…”

Section: Data Sourcesmentioning

confidence: 99%

The need for systems change: reflections on knowledge translation and organizational change

Kitson

2008

Journal of Advanced Nursing

180

173

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“…Caring is a core aspect of the professional work that nurses provide and caregiving is 217 identified by nurses as the major professional nursing value (Killeen and Saewert, 2007). In line with a report issued following the Health Professions Education Summit which identifies five core competencies of nursing practice, care is the first of those since its provision is patient-centred (see ‗patient-centeredness culture' in Down, 2004; also see Chitty, 2011;Fagerberg and Kihlgren, 2001). In this way, the value of caring is closely linked to the value of altruism as a -patient-focused, individualized, and humanistic‖ approach to care (Fagerberg, 2004: 285).…”

Section: Discussionmentioning

confidence: 90%

Investigating nurses' professional identity construction in two health settings in New Zealand

Lazzaro-Salazar¹

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<p>The increasing nursing shortage experienced in healthcare institutions alongsidethe communicative issuesrelated to multiculturalnursing teams have placed nurses at the centre of the stage in a growing body of healthcare-related research. In this context, the values, beliefs and conceptualizations which characterize a nurse‘s professional identity play a significant role in organizational life since they guide nurses‘ decisions on the kind of clinical practices they adopt and influence their work performance. However, there islittle empirical evidence on how nurses discursivelyconstruct their professional identity.To date most sociolinguistic research on professional identity in healthcare environments has focused on the power asymmetries characterising doctor-patient, doctor-nurse and nurse-patient discourse, largely disregarding nurse-nurse interaction. Thus, moving away from the traditional approach taken to this area of enquiry, this thesis considershow nurses from an array of ethnic backgrounds construct their professional identity throughdiscursive practices as they interact with other nurses in workplace meetings. The data for this study involve nurses and nurse managers in a ward of a public healthcare institution andata private healthcare institution in New Zealand. The data consist of audio and video recordings of four roster and five handover meetings from the hospital and four clinical and four staff meetings from the clinic, collected by employing Interactional Sociolinguistics as a methodological approach which provides anethnographic lensand afocus on context and culture. To investigate professional identity construction, the analysis takes a theoretical stance which draws on social constructionismand social identity theoryand exploresprofessional identity as it emerges within the boundaries of local interaction and practices. Nurses‘ professional identity formation is consideredin three interactional contexts, namely, voicing and responding to complaints, displaying professional expertise, and negotiating professional values. Findings demonstratethat nurses index multiple group membership alignments as a way to ̳indirectly‘ voice direct complaints and to respond to them in community-appropriate ways as they build in-group solidarity and rapport, and observe interactants‘ face needs.In addition, considerations ofthe use of question-answer adjacency pairs, medical jargon and rationality of case presentation show how expertise construction belongs in a dynamic continuum which is actively transited by nurses as they construct themselves and others as more or less expert on differentaspects of professional practice. Consideringnurses‘ expert claims astemporary, nurses are shown to construct multiple self and other subject positions at the local and wider community levels in order to achieve different interactional goals.This thesis also shows how, when evaluating professional practice, nurses negotiate their professional values at both local and wider community levels by indexing multiple group alignments and displaying expertise that positively construct their professional stance,and by using persuasion techniques that ascribe preferred professional images with the aim of standardising professional practices. Overall, theresearch highlights the partial nature of identity construction as other-initiatedclaims cause nurses to re-consider their stance in order to orienttowards a preferred professional image of themselves, makingsituationally motivated selections of their discursive resources to craft their identity claims.</p>

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2010

Person‐Centred Nursing

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‘From Conception to Delivery’: A Journey Towards a Trust‐Wide Strategy to Develop a Culture of Patient‐Centredness

Cited by 5 publications

References 10 publications

The need for systems change: reflections on knowledge translation and organizational change

The need for systems change: reflections on knowledge translation and organizational change

Investigating nurses' professional identity construction in two health settings in New Zealand

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