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Das international erfolgreiche Programm Relationship-Based CareTM wird von vielen Kliniken verwendet, die sich auf den Magnet-Status vorzubereiten. Hier wird die Qualitat der Arbeitsbeziehungen in den Mittelpunkt geruckt. Im Zuge der Einfuhrung des Programmes Relationship Based CareTM wurden zwei innovative Workshops entwickelt, um das Engagement der Fuhrungskrafte und Mitarbeiter von Gesundheitseinrichtungen mit Herz und Verstand einzubinden. Die Workshops wurden entworfen, um neue innovative Lehrmethoden zu integrieren. Im Mittelpunkt stand dabei ein Grundsatz der Erwachsenenbildung, bei welchem der Respekt fur das Wissen und die Erfahrung des Lernenden die Basis bilden sollte. Die Lernenden nahmen an verschiedenen Aufgaben und reflexionsorientierten Ubungen teil, um die Inhalte anzuwenden und zu verinnerlichen. Der Fokus lag hierbei deutlich auf den Kompetenzen der Beziehungsbildung, nicht auf den klinisch-technischen Fahigkeiten der Teilnehmer. Pflegepraktiken fur sich selbst, fur Mitarbeiter, fur Patienten und Familien wurden in Verhaltensweisen umgesetzt. Die Kursteilnehmer lernten Wege, therapeutische und gleichzeitig empathische Beziehungen mit Anderen zu entwickeln. Organisations- und fachbereichsbezogene Messverfahren zeigten die positiven Auswirkungen der Workshops. Festgestellt wurden ein deutlicher Ruckgang der Personalfluktuation ermittelt von den Personalabteilungen sowie eine gestiegene Patientenzufriedenheit, die mittels Fragebogen erhoben wurde. In diesem Artikel werden die Inhalte der beiden sehr erfolgreichen Workshops erstmals einem offentlichen Publikum zuganglich gemacht.

In this chapter, we articulate what for us are the key principles that provide the foundations for methodologies in nursing research that support and inform person-centred practice. We do this through a dialogical approach in which we will demonstrate how we worked with such principles in our research processes. We provide accounts of two methodologies namely participatory action research and critical creativity, which we have used in two separate studies. We share our experiences and the realities of undertaking person-centred nursing research through these methodologies and discuss how this links to the person-centred nursing framework. However, we do not advocate these methodologies as the only ones available to researchers. Person-centred nursing research is about the potential and underlying intent that working in a person-centred way as a (co-) researcher provides, rather than any one methodology. From our dialogue, we generated a visual model that illustrates the essential conditions for person-centred nursing research.

Purpose The purpose of the study was to explore experiences of older people with cancer in ascertaining the attributes of a person-centred approach in sustaining hope and enabling human flourishing. This was a qualitative study comparing patients and professional experiences and perceptions of care across to ward settings. Methods Methods involved 10 semi-structured interviews conducted with patients and focus groups (n = 6) and 10 semi-structured interviews with health professionals. Three dissemination focus groups (n = 14) were also carried out with professionals to allow further analysis of the data. Results Two main themes were identified, including ‘Emotional adaptations of hope: wants and expectations’ and ‘Hope through belittling their illness’. Findings highlight the way hope is conveyed and the emphasis' accorded to issues such as societal perceptions, knowledge, expectations of care, life stage, relationships, identity, and emotions. Findings also reinforce the importance of maintaining hope, recognising the different ways hope is used, and enabling patients to flourish. Conclusion This study highlights how hope is facilitated through the interaction between patients and professionals and that the relational interactive stance. This current study establishes that hope seemed to be temporal, contextual and dynamic in nature, involving an ongoing process. Helping older people with cancer to understand their illness considering the situation of lives and experiences is essential to address expectations and wants.

Aim. To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people.Design. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'.Findings. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued.Relevance to clinical practice. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships.

This paper explores the concept of practice development in the context of professional development and strategies for facilitating learning in practice. In this paper we present the background to the methodology of emancipatory and transformational practice development. Key concepts underpinning a contemporary definition of practice development are unravelled and nine principles for effective practice development proposed. An example of a large-scale national practice development programme with older people residential settings in the Republic of Ireland is presented to illustrate the processes in action. The findings of the first year of the programme are offered and these findings demonstrate the ways in which practice development systematically uncovers the deeply embedded characteristics of practice cultures -- characteristics that often inhibit effective person-centred practice to be realised.

Introduction: (comprising context and problem statement) A national two year practice development programme took place in the Republic of Ireland from 2007 to 2010. The programme was commissioned to support staff to implement a framework for person-centred nursing practice-centred practice in residential settings for older persons. Eighteen sites took part in the programme and staff and managers from a variety of disciplines used a person-centred framework and practice development model to develop their practice. Since the programme finished there is evidence that this work sustained and in some places continued to grow. The Health Service Executive in Ireland (HSE) now wishes to extend this programme to all services incrementally using the same methodology so that care and practices can be more fully integrated from a workplace culture perspective. Short description of practice change implemented: Process and outcome evaluation demonstrated improvements in practice and workplace culture for staff and improvements in care experiences for residents. A number of validated tools were used, both process and outcome that engaged residents and staff. Evidence indicated increased choice for residents and more meaningful relationships between them and staff to name but two. There was for example evidence of changes in workplace culture with improvement to quality of communication and support between staff, greater role satisfaction, improved staffing and resources, and greater commitment to the setting. Aim and theory of change: The overall aims of the programme were to: implement a framework for person-centred practice[1] for older people across multiple settings in Ireland, through a collaborative facilitation model and to carry out an evaluation of the processes and outcomes. The programme drew on numerous principles from different yet complementary theories and approaches: emancipatory practice development, co-operative inquiry and a specific person-centred nursing framework. Targeted population and stakeholders: Eighteen residential units for older people were involved in this programme. Along with residents in targeted sites, staff groups represented different areas within the units and grades i.e. Nurse Mangers, Staff Nurses, Health Care Assistants, Housekeeping, Catering and Administration staff. Timeline: An initial two year programme took place 2007 – 2010. The HSE will now replicate this programme by introducing a further three year national programme to develop cultures of person-centredness system wide which commences in February 2017. Highlights: (innovation, Impact and outcomes) This is an innovative methodology and programme that has been replicated in many different settings internationally such as New South Wales, Netherlands, Norway, Malta, UK, and others. Using this methodology and framework staff were facilitated to critically explore their practice and Comments on sustainability: For long term sustainability it is vital that practice development activities contribute to the professional and personal development of staff and managers. The development of staff key facilitation and practice development knowledge and skills enabled staff to work effectively with colleagues to changes their workplace culture. Comments on transferability: This programme has transferability to any care setting demonstrated in the variety of settings it has been introduces in for example in the New South Wales programme Essentials of Care[2] The focus is on developing cultures of person-centredness that supports person-centred practices. Conclusions: (comprising key findings) The HSE had demonstrated considerable impact on care experiences for both service users and staff through the introduction of this programme in older persons’ residential services. Discussions: Developing workplace culture will impact on the immediate experience of both staff and service users[3]. Recognising the enablers and consequences of workplace culture development means that the focus is on basic assumptions that influence actions[4]. Lessons learned: Involvement and engagement of managers in organisations is essential to the success of culture change. Managers are part of the culture and therefore need to be part of making change. References: 1- McCormack and McCance. Developing a conceptual framework for person-centred nursing. Journal of Advanced Nursing, 2006;565(5):472-479 2- Essentials of Care Program - Projects - NSW Health - NSW Government(Accessed 17/01/2017) Available from: www.health.nsw.gov.au/nursing/projects/Pages/eoc.aspx Accessed 17/01/2017 3- Manley, K, Saunders, K., Cardiff, S., Webster, J. Effective workplace culture: the attributes enabling factors and consequences of a new concept. International Practice Development Journal 2011;1:(2). Available from: http://www.fons.org/library/journal/volume1-issue2/article1 (Accessed 17/01/2017) 4- Schein, E. H. Organisational Culture and Leadership, 2nd edition. Jossey-Bass, San Francisco, CA. 1985