Browsing by Person "Øye, Christine"
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Item Facilitation of a workplace learning intervention in a fluctuating context: An ethnographic, participatory research project in a nursing home in Norway(Foundation of Nursing Studies (FoNS), 2018-10-14) Dahl, Hellen; Dewing, Jan; Mekki, Tone Elin; Håland, Astrid; Øye, ChristineBackground: This single-site nursing home study is part of a larger cluster-randomised controlled trial that aimed to reduce staff use of restraint. The cluster-RCT study involved 24 nursing homes, and investigated the effect of a standardised education intervention to reduce restraint in dementia care with a person-centred care approach. This article draws on empirical data from one of the nursing homes in the control group of the trial, at which the education intervention was tailored to better account for contextual circumstances. Aim: To explore how a tailored education intervention can reduce the use of restraint in a nursing home. The study aims to investigate what local contextual circumstances influenced the process of facilitation of the intervention. Methods: The study was theoretically informed by the Promoting Action Research Implementation in Health Services (PARiHS) framework, with practice development principles to address local learning needs and contextual issues. External facilitators tailored the education intervention in collaboration with the nursing home leader and staff. A participatory design with data collection based on principles of critical ethnography was used to evaluate the intervention. Results: Fluctuation emerged as the core theme from the evaluation: fluctuating enthusiasm among staff, fluctuating nursing home culture and fluctuating responses by care home residents. Conclusion: The study offers insights into the interplay between a tailored facilitation intervention and fluctuating contextual circumstances in a nursing home. Implications for practice: A successful education intervention requires facilitators who can take into consideration and adapt to fluctuations in the context Facilitation skills must include the ability to value team experiences, recognise learning needs, provide feedback and participate in finding solutions in the moment Flexibility is important in terms of how new knowledge can be used in person-centred ways, notably in attempts to reduce the use of restraint in dementia careItem A person-centred observational tool: Devising the Workplace Culture Critical Analysis Tool®(Foundation of Nursing Studies, 2020-02-12) Wilson, Val; Dewing, Jan; Cardiff, Shaun; Mekki, Tone Elin; Øye, Christine; McCance, TanyaThe Workplace Cultural Critical Assessment Tool (WCCAT) is a participant observational tool developed a decade ago to capture evidence about workplace culture that can then be used to support practice development initiatives. The WCCAT has been applied extensively across the world in a range of healthcare settings. Since its inception, practice development has progressed and it is now explicitly linked to advancing person-centred cultures. With this in mind, it seemed timely to revise the WCCAT to reflect the progress made within practice development, and strategically link the tool to person-centred practice and achieving person-centred outcomes. This revision (WCCAT®) has been undertaken by members of the International Community of Practice (the authors of this article), whose focus is person-centred practice research. This article outlines the process undertaken for the revision and for the alignment of the revised tool with the Person-centred Practice Framework. Guidance is provided on when, why and how to use the tool to capture participant observational data that highlights evidence of person-centred practice. Detailed information and cues to support the observer in collecting and analysing data are provided, along with suggestions for facilitating feedback of data and subsequent action planning to support changes in practice. The benefits and limitations of using the WCCAT® are outlined.Item The inter-play between facilitation and context in the promoting action on research implementation in health services framework: A qualitative exploratory implementation study embedded in a cluster randomized controlled trial to reduce restraint in nursing(Wiley, 2017-06-13) Mekki, Tone Elin; Øye, Christine; Kristensen, Bodil; Dahl, Helen; Haaland, Astrid; Nordin, Kristin Aas; Strandos, Marta; Terum, Toril Marie; Ydstebø, Arnt Egil; McCormack, BrendanAim: To explore the inter-play between external facilitation and nursing home contexts relative to intervention outcomes. Background: The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter-play and relationship between framework sub-elements of evidence, context and facilitation and the prospective utility in non-English speaking contexts warrant further illumination. Design: In an overarching single-blind cluster-randomized controlled trial, we applied participatory action research and ethnography from August 2011-June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere. Methods: Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators' after each education session, ethnographic field studies (6 homes), and co-analysis workshops (5). Directed content analysis was used to analyse data. Results: Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced- or not. The PARIHS framework was found to be relevant in a non-English nursing home setting, albeit some elements merit further conceptualization. Conclusions: Our findings confirm the prospective utility of the PARIHS framework for implementation in a non-English context, particularly the notion of implementation processes as dynamic and multifaceted. 2017 John Wiley & Sons Ltd.