Research program

The Nursing Research and Practice Development Unit is undertaking a five year practice development program (described in the flowchart below).

The work brings together a program of emancipatory practice development work which is being introduced to clinical units throughout the hospital. The purpose of this type of work is to improve the effectiveness of person centred care, in other words to ensure care delivery meets the needs of patients and their families.

Each practice development activity uses staff knowledge and expertise to identify the need for change, encourage reflection on and in practice, support staff to challenge themselves and each other as well as to promote the empowerment of staff.

Engagement in such activities results in the development of staff, improved teamwork and staff satisfaction, sustainable changes in practice and ultimately increases the effectiveness of person centred care.

Program of practice development work

Staff members select practice development activities based on the requirements of the individual clinical environment as well as their own personal needs.

Activities offered through practice development include:

Action research

Action research is a qualitative critical research methodology. Several units and individual clinicians are using action research, supported by the NRPDU, to collectively plan, act, observe and reflect on specific areas of clinical practice in order to improve patient care and its effectiveness.

• TLC - Teamwork, Learning, Change
  A 3-year action research pilot study involving two clinical units at CHW to investigate whether the implementation of a facilitated program of Practice Development enables individuals and teams to realise a philosophy of family-centred care in everyday practice. This pilot has been extended to two clinical units at Sydney Children's Hospital and one paediatric ward at St George Hospital.
• REACH
  This is international research collaboration between the Royal Hospitals, Belfast, Northern Ireland, CHW, South Eastern Sydney Illawarra Prince of Wales Hospital and Northern Sydney Central Coast Area Health Service. REACH offers a pathway to lifelong learning through an effective appraisal process, an attributes framework, a personal development contract, reflective practice, the development of a portfolio and formal and work-based learning opportunities. Four units from CHW are currently participating.
• Heart Beads
  The project Heart Beads: A creation of the child's journey seeks to implement and evaluate the 'Heart Beads' program for children undergoing cardiac related procedures at the Children's Hospital at Westmead, whereby beads related to events and procedures during the child's hospitalisation are given to the child/family. The resulting string of beads 'tells the story' of the child's treatment and condition. The project is led by Gabbie Scarfe & Lexi Dengler (Nursing Unit Manager and Clinical Nurse Educator, Edgar Stephens Ward) and supported by Sarah Redshaw and Val Wilson from the Nursing Research and Practice Development Unit. The Heart Beads project has involved interviews with families and staff exploring what participation in the Heart Beads program has meant for them. The research has shown the overwhelming enthusiasm of parents and children for the bead program and the importance of assisting families to make sense of their experiences which are otherwise a blur, and enabling them to put together a story that they can relay to others. Some children have taken their beads to school to show their teachers and classmates and explain to them what they went through.

Action learning

Action learning is a well established strategy for reflective inquiry at an individual, collective and organisational level. There have been several Action Learning Sets established at The Children's Hospital at Westmead (CHW), based on the connection between reflection and action. The sets provide the opportunity for set members to use high challenge/high support to work on real issues and take the time to reflect and learn from their own experiences.

Workshops

The NRPDU team has facilitated staff development days for a number of departments using creative techniques such as artwork, guided meditation and reflective writing aimed at helping staff explore the context within which they provide care, their role within such context and the importance of teamwork.
The team has also facilitated evidence-based practice workshops aimed at providing staff with baseline skills in formulating clinical questions, literature searching, identifying levels of evidence, critical appraisal of papers and implementation of evidence into practice. The workshops conducted form part of the program of practice development work undertaken in individual units.

Critical companionship

Several members of the NRPDU team act as critical companions to nurses both within and external to the organisation as experienced clinicians helping others to become truly person-centred. This is achieved through critical reflection and dialogue which helps the learning clinician to understand what they need to change and how they can make those changes in order to transform practice.

Within the practice development program each activity is evaluated to provide evidence of effectiveness. Evaluation data is collected before, during and after each activity in order to systematically address the study aims and capture the process, impact and outcomes of the changing context of practice. Each evaluation will be combined to provide layers of evidence that will inform future development of the practice development program at the Children's Hospital at Westmead.