Support Provided by LGBTI Police Liaison Services: An Analysis of a Survey of LGBTIQ People in Australia

Lesbian, gay, bisexual, transgender, and intersex (LGBTI) police liaison programs were established around Australia from the late 1980s onwards to ameliorate discriminatory relationships between LGBTIQ people and police. With specialized training to better understand LGBTIQ issues, police liaison officers can provide support to LGBTIQ people as victims, offenders, or witnesses. Interestingly, very few LGBTIQ people seek support from these officers, even though many know they exist. This paper reports the results of a survey of a sample of LGBTIQ community members across two Australian states (Queensland and New South Wales) that explored why LGBTIQ people seek support from LGBTI police liaison officers. An online questionnaire asked LGBTIQ people about their perceptions of, and experiences with, police generally, and LGBTI police liaison officers specifically. Similar to past research, our analysis primarily found high levels of awareness of liaison officers, but very few participants accessed them. Further, and concerningly, the participants were generally reluctant to seek them out for support. Key implications of our findings for policy and practice development in police and LGBTIQ community services are discussed.

Integrated knowledge translation in nursing homes: exploring the experiences of practice development nurses

Background Practice Development Nurses (PDNs) in Norwegian nursing homes (NHs) hold a specific responsibility for knowledge translation in this increasingly complex healthcare setting. They were involved as end users in an integrated knowledge translation (IKT) study, developing, testing and evaluating the IMPAKT (IMPlementation of Action to Knowledge Translation) intervention. PDNs participated in an educational programme tailored to their own defined needs. In a second intervention component, the PDNs applied their new skills with facilitation, in implementing the National Early Warning Score (NEWS2) in their respective NHs. The aim of this study was to explore 1) the PDNs’ experiences of participating in an IKT educational intervention, and 2) how they applied the learning in planning, tailoring and initial implementation of the NEWS2. Methods This is a qualitative exploratory study based on a phenomenological hermeneutical method. Study participants were PDNs working in the nine NHs in the intervention group of the IMPAKT trial. We conducted nine in-depth interviews and eight non-participatory observational sessions of the intervention delivery. Results The PDNs expressed that the educational programme met their needs and enhanced their understanding about leading knowledge translation (KT). They reported a move from operating in a “big black box of implementation” to a professional and structured mode of KT. The gamechanger was a shift from KT as the PDNs’ individual responsibility to KT as an organizational matter. The PDNs reported enhanced competencies in KT and in their ability to involve and collaborate with others in their facility. Organizational contextual factors challenged their KT efforts and implementation of the NEWS2. Conclusions This study demonstrates that an IKT approach has the potential to advance and improve staff competencies and NH readiness for KT. However, individual motivations and competencies were challenged within an organizational culture which was less receptive to this new leadership role and level of KT activity.

Editorial: The power of collaboration

Since Covid-19 appeared almost two years ago, strategic leaders and academics have offered their wisdom to leaders ‘in the field’ in terms of what worked for them during previous crises. Learning from others’ experiences may be helpful, but the unprecedented nature of the context in which we are living and working has called for innovation, creativity and collaboration, to ‘work things out’. A theme of positivity runs through literature, encouraging leaders to foster hope through being available, listening, responding and showing compassion at a time when there seemed little reason to be positive. Over the difficult period of the pandemic, though, there have been so many stories of close collaborations, person-centred ways of being, helpfulness and kindness, and collaboration is a central theme in this issue of the IPDJ. Over recent months, we have reviewed and refined the aim and scope of the journal, alongside our key stakeholders at the Foundation of Nursing Studies, the International Practice Development Collaborative (IPDC) and the Person-centred Practice International Community of Practice (PCP-ICoP).

Development and evaluation of a new model for person-centred goal setting using practice development and appreciative inquiry approaches in a rehabilitation unit

Background: This article explores the use of a mixed-methods participatory approach to bring about transformative change to goal setting in an 18-bed, subacute rehabilitation unit in New South Wales. Aim: To use a blended approach underpinned by practice development and appreciative inquiry approaches, to develop and evaluate a model of person-centred goal setting for rehabilitation clients. Methods: Evaluative methods were co-designed and co-agreed by members of the rehabilitation team, based on what the team hoped to achieve in terms of establishing goals for clients in their care and what this meant to clients and each other. Data sources included team discussions, semi-structured interviews with individual team members and clients, a survey and stories using emotional touchpoints. Interpretation of the data involved content analysis for generation of themes and the use of Statistical Package for Social Science software for analysis of the survey. Results: Nine themes emerged. Clients highlighted: barriers to goal achievement; incorporation of goals into daily care; goal achievement; and a sense of purpose. The rehabilitation team highlighted: becoming person-centred; their role in goal setting; and barriers to establishing goals. The survey responses showed the team used person-centred approaches to achieve person-centred goals. Conclusion: Changes to goal setting allowed staff to feel person-centred in their care delivery and gave them the satisfaction of knowing they were doing something meaningful for those in their care. There was strong agreement that a unified team approach to goal setting was key to client satisfaction and achievement of the goals. Clients felt valued and included in making decisions surrounding their care. Implications for practice: • Using the practice development principle of developing collaborative partnerships among healthcare teams leads to greater involvement of clients in their care • Involving clients in goal setting leads to greater success and improved client satisfaction • Appreciative inquiry and practice development approaches are effective in developing partnerships between team members • Staff who treat clients with dignity and respect improve participation in goal setting by the clients • Creating a space in which the emotional needs of clients can be heard and acted on is crucial for success in goal achievement • Appreciative inquiry generates a greater appreciation and understanding of how to deliver person-centred care

PLATO: a practice development approach to reconsidering student learning partnerships

Background: This article explores the use of a practice development approach to support nursing students’ engagement in learning partnerships in clinical practice settings. Aim: To reflect, using the model proposed by Rolfe and colleagues (2001), on the development of ‘PLATO’ – an educational tool to help nursing students explore their role in building learning partnerships in clinical settings. Conclusion: A practice development approach to clinical learning partnerships can support an effective learning culture. As a result, nursing students can gain greater empowerment and take increased responsibility for their learning. Implications for practice: • Facilitating learning partnerships with students is important for achieving person-centred care • Partnership working provides opportunities for true collaboration and for learning with and from our students • Developing collaborative spaces can facilitate nursing students to reflect in and on their practice

Facilitating person-centred leadership support during the Covid-19 crisis

Background: The Covid-19 crisis has created new and difficult working conditions for all frontline healthcare staff and leaders. Ward managers in particular have faced significant challenges. The practice development initiative described in this article began at a hospital in Denmark immediately after the country’s first Covid-19 wave. The hospital has person-centredness as its vision for care and research. Aim: The purpose of this article is to offer a reflection on the ways in which our research and its findings enabled us to learn from the experiences of ward managers so as to support them and strengthen their network during a difficult time, using principles of practice development. Conclusion and implications for practice: The evidence produced in the project was found to be relevant to leadership practice by the ward managers and led to a strengthened position at a time of crisis. This implies that: • It is possible to establish collaborative and useful evidence for clinical practice under difficult circumstances • By using principles of practice development it is possible to facilitate constructive dialogues between ward managers and executive managers • At a time of a major crisis, the role of ward managers should not be underestimated

Evaluating the use of narrative pedagogy in person-centred care and human factors in perioperative practice education

Background: There is an international effort to develop understanding from human factors theory and implement this in healthcare to improve person-centred care and patient safety. Aim: This project aimed to evaluate the use of narrative pedagogy to teach human factors to perioperative personnel in the workplace. Methods: Using the action research model, an interactive learning session based on lessons from serious incidents was developed and delivered to perioperative staff in an NHS Trust within a practice development programme. Data were collected in the form of questionnaires and peer reviews to evaluate the learning session, and thematically analysed. Findings: The use of narrative pedagogy to explore human factors theory empowered participants to speak up, and this influenced the workplace safety culture. Conclusion: Narrative pedagogy reconnects healthcare employees with compassionate approaches to person-centred care, and this provides powerful motivation to improve the safety culture. Further studies should focus on different applications of narrative pedagogy in workplace learning, and creative approaches to teaching human factors. Implications for practice: • Narrative pedagogy can be a conduit to develop person-centred practice • Engaging staff through interactive practice development sessions can encourage expansive learning about human factors and their application in practice • Narrative pedagogy motivates healthcare staff to improve the safety culture in practice

Book Review: International Practice Development in Health and Social Care (2nd Edition)

I was asked to review this book in my role as a clinical educator and novice practice developer. My introduction to practice development and person-centred practice came through the 2019 Inspire Improvement Fellowship, run by the Foundation of Nursing Studies, and through my work as a practice teacher for student specialist practitioner district nurses at Queen Margaret University, Edinburgh. My initial thoughts were how relatable this book is to me in practice. It is up to date, with references to Covid-19 and the WHO’s Year of the Nurse and Midwife 2020. The first part explores the theory of practice development and this follows through to later chapters where readers will find the application of theoretical ideas in practice. Practice development is explored at micro, meso and macro levels, supported by the book’s progression from smaller, ward-based projects to large system-based interventions. The evolution of practice development is also evident, moving from its origins within nursing to multidisciplinary and interagency approaches and contexts. I found it useful that chapters flowed through themes, with the final chapters focusing on leadership, workplace cultures and wellbeing, which are currently hot topics in the ever-changing landscape of health and social care. A wide range of references is helpfully used throughout to encourage more in-depth analysis and further reading.

Utilising Practice Development and the PARIHS Framework to Implement the Liverpool Care Pathway

<p>The LCP is an evidence-based integrated care pathway that provides guidance to generic health care professionals to deliver best practice end-of-life care. My role as the LCP Project Coordinator in a District Health Board in New Zealand is central to the exploration of this process of implementing practice change. Working with clinicians to advance effective care and management of patients during the process of dying in an acute hospital setting requires not only knowledge and understanding of the clinical pathway and evidence supporting best practice, but also careful working with cultural and contextual change. This paper descriptively addresses the bases of both components, and provides a case example of the development. Working with health care professionals to bring about practice change is complex and challenging. Successful implementation of evidence in practice is dependant not only on the strength and nature of the evidence, but also the context and models of facilitation. Practice development (PD) methodology informs the realities and complexities of practice change and of achieving sustainable development. The 'Promoting Action in Research Implementation in Health Services' (PARIHS) framework identifies the interplay and interdependence of factors that resonate with the reality of the complexity of practice change in relation to the evidence and best practice for particular clinical contexts. Highlighting PD processes and the relevance of the PARIHS framework alongside real-time practice change will continue to stimulate recognition of change and development complexities and bring consideration of these as robust methods for working between the theory and implementation of evidence in practice.</p>