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The Impact of Progress Toward a Clinical Development Unit in Cardiology
Amanda Henderson
Nursing Director, Education, Nursing Practice Development Unit, Princess Alexandra Hospital and District Health Service, Woolloongabba; Adjunct Associate Professor, Griffith University, Nathan QLD
Mary Boyde
Clinical Lecturer, Princess Alexandra Hospital / University of Queensland, Woolloongabba QLD
Sarah Winch
Nursing Director, Research, Princess Alexandra Hospital, Woolloongabba QLD
Abstract
Health care organisations are continually implementing quality initiatives to develop staff to enhance the provision of patient care. However, the impact of such initiatives often fail to be assessed which can jeopardise provision for their systematic support.
This paper reviews staff perceptions of how progress toward a Clinical Development Unit has influenced their practice in Cardiology. The process began in August 2003 when the unit philosophy included the use of best evidence into practice. Key initiatives integral to the development of a CDU were: facilitated engagement with clinical evidence, assisted through a structured education program for all staff; and opportunities for involvement in patient centred research. This evaluation sought descriptive information from staff as sustainability of such units is reliant on positive attitudes. Feedback was obtained from a convenience sample of staff who participated in three focus groups conducted over two months, 29 staff in total.
Prevailing themes that emerged indicated the development of a positive ward culture. Four dominant themes emerged: the development of a culture of evidence into practice; a continuous learning environment; awareness of the contribution of research; and a ‘re’-focus on patient care. While structures and processes were in place to support learning and practices based in evidence that staff viewed favourably, there was little indication of individual staff members being ‘pro-active’ and being initiators of seeking evidence to make changes to practice.
Keywords
clinical development, learning, research, evidence, cardiology
References
Atsalos C and Greenwood J (2001) The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia, Journal of Advanced Nursing 34(3): 408-416.
Avis M, Bond M and Arthur A (1997) Questioning patient satisfaction: an empirical investigation in two outpatient clinics, Social Science & Medicine 44(1): 85-92.
Boyde M, Jen C, Henderson A and Winch S (2005) A clinical development unit in cardiology: The way forward, International Journal of Nursing Practice 11: 134-139.
Graham I, Fielding C, Rooke D and Keen S (2006) Practice Development ‘without walls' and the quandary of corporate practice, Journal of Clinical Nursing 15: 980-988.
Greenhaulgh T, Robert G, MacFarlane F, Bate P and Kyriakidou O (2004) Diffusion of innovations in service organizations: Systematic review and recommendations, The Milbank Quarterly 82(4): 581-629.
Greenwood J (1997) Should nursing development units be accredited? Collegian 4(1): 6-11.
Greenwood J (1999) Clinical Development Units (Nursing): the Western Sydney approach, Journal of Advanced Nursing 29(3): 674-679.
Greenwood J (2000) Clinical Development units (nursing): Issues surrounding their establishment and survival, International Journal of Nursing Practice 6: 338-344.
Greenwood J and Parsons M (2002) The evaluation of a clinical development unit leadership preparation program by focus group interview - Part 1: positive aspects, Nurse Education Today 22: 527-533.
Henderson A, Winch S, Holzhauser K and deVries S (2006) The motivation of health professionals to explore research evidence in their practice: an intervention study, Journal of Clinical Nursing 15(12): 1559-1564.
McCormack B, Manley K and Garbett R (2004) Practice Development in Nursing, Blackwell Publishing, Oxford.
Manley K and McCormack B (2003) Practice development: purpose, methodology, facilitation and evaluation, Nursing in Critical Care 8(1): 22-29.
Miles MB and Huberman AM (1994) Qualitative data analysis: An expanded sourcebook 2nd edn, Thousand Oaks, CA: Sage Publications.
National Health and Medical Research Council (2003) When does quality assurance in health care require independent ethical review? Advice to institutions, human research ethics committees and health professionals, Canberra, Australia.
Parkin C and Bullock I (2005) Evidence-based health care: development and audit of a clinical standard for research and its impact on an NHS trust, Journal of Clinical Nursing 14(4): 418-425.
Rycroft- Malone J, Harvey G, Seers K, Kitson A, McCormack B and Titchen A (2004) An exploration of factors that influence the implementation of evidence into practice, Journal of Clinical Nursing 13: 913-924.
Upton D and Upton P (2005) Professional Issues: Nurses' attitudes to evidence-based practice: impact of a national policy, British Journal of Nursing 14(5): 284-8.
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