Plugging a hole and lightening the burden: A process evaluation of a practice education team

Aim: To investigate the perceptions of clinical and senior managers about the role of Practice Educators employed in one acute hospital in the UK. Background: Producing nurses who are fit for practice, purpose and academic award is a key issue for nurse education partnership providers in the UK. Various new models for practice learning support structures and new roles within health care institutions have been established. To sustain funding and policy support for these models, there is a need for evaluation research. Design: A process evaluation methodology was employed to determine the current value of a practice education team and to provide information to guide future direction. Methods: Data were collected through semi-structured telephone interviews using a previously designed schedule. All senior nurse managers (N=5) and a purposive sample of clinical managers (n=13) who had personal experience of and perceptions about the role of practice educators provided the data. Interview notes were transcribed, coded and a thematic framework devised to present the results. Results: A number of key themes emerged including: qualities needed for being a successful practice educator; visibility and presence of practice educators; providing a link with the university; ‘plugging a hole’ in supporting learning needs; providing relief to practitioners in dealing with ‘the burden of students’; alleviating the ‘plight of students’; and effects on student attrition. Conclusions: Findings provided evidence for the continued funding of the practice educator role with improvements to be made in dealing with stakeholder expectations and outcomes. Relevance to clinical practice: In the UK, there still remain concerns about the fitness for practice of newly registered nurses, prompting a recent national consultation by the professional regulating body. Despite fiscal pressures, recommendations for further strengthening of all systems that will support the quality of practice learning may continue to sustain practice learning support roles

Developing an Australian framework for scope of practice decisions by nurses and midwives – lessons for cross-border standards developments

Aims and objectives: Lessons for cross-border standard development learned in the consultation to create the Australian National Framework for the Development of Decision-Making Tools for Nursing and Midwifery (National DMF). Background: Although existing tools are broadly consistent, no cross-border or internationally accepted version exists of scope of practice decision-making guides. Development of a national framework in Australia's federated political system required commitment to wide consultation and consensus. Concurrent moves towards national registration stimulated timely completion of the work. Contextual factors such as differentiation of the profession of midwifery from nursing and varying understanding of scope of practice concepts in eight Australian jurisdictions were challenges. Design: A consultative policy development framework was used. Methods: Thematic analysis of written responses to a draft document and of focus group feedback informed the production of the National DMF. Results: A widely accepted National DMF allowing nurses and midwives in Australia to engage in planned changes to professional practice, grounded in the professional judgement of the individual nurse or midwife, and collaboration with the consumer. Conclusions: The project's grounding in consensus influenced the process and outcomes of consultation. A nationally consistent framework, incorporating useful decision-making tools for two professions and principles to guide implementation and evaluation, was a distinct achievement.The article adds to accumulated knowledge by:. • identifying the professional and political factors influencing consultation and outcomes in cross-border standard development and. • exploring key considerations for future projects to produce national or international professional standards that are relevant across borders and across professions. Relevance to clinical practice: Decision-making tools that assist nurses and midwives in determining their scopes of practice and guide them in delegating aspects of consumer care to other health care workers are an essential component of any suite of professional practice standards