Browsing by Person "McCormack, Brendan"

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A Bridge Over Turbulent Waters: Illustrating the Interaction Between Managerial Leaders and Facilitators When Implementing Research Evidence
(Blackwell, 2016-01-20) van der Zijpp, Teatske Johanna; Niessen, Theo; Eldh, Ann Catrine; Hawkes, Claire; McMullan, Christel; Mockford, Carole; Wallin, Lars; McCormack, Brendan; Rycroft-Malone, Jo; Seers, Kate
Background: Emerging evidence focuses on the importance of the role of leadership in successfully transferring research evidence into practice. However, little is known about the interaction between managerial leaders and clinical leaders acting as facilitators (internal facilitators [IFs]) in this implementation process. Aims: To describe the interaction between managerial leaders and IFs and how this enabled or hindered the facilitation process of implementing urinary incontinence guideline recommendations in a local context in settings that provide long-term care to older people. Methods: Semistructured interviews with 105 managers and 22 IFs, collected for a realist process evaluation across four European countries informed this study. An interpretive data analysis unpacks interactions between managerial leaders and IFs. Results: This study identified three themes that were important in the interactions between managerial leaders and IFs that could hinder or support the implementation process: realising commitment negotiating conditions and encouragement to keep momentum going. The findings revealed that the continuous reciprocal relationships between IFs and managerial leaders influenced the progress of implementation, and could slow the process down or disrupt it. A metaphor of crossing a turbulent river by the building of a bridge emerged as one way of understanding the findings. Linking Evidence to Action: Our findings illuminate a neglected area, the effects of relationships between key staff on implementing evidence into practice. Relational aspects of managerial and clinical leadership roles need greater consideration when planning guideline implementation and practice change. In order to support implementation, staff assigned as IFs as well as stakeholders like managers at all levels of an organisation should be engaged in realising commitment, negotiating conditions, and keeping momentum going. Thus, communication is crucial between all involved. 2016 Sigma Theta Tau International.
A complex intervention to reduce avoidable hospital admissions in nursing homes: A research programme including the BHiRCH-NH pilot cluster RCT
(National Institute for Health Research, 2021-03) Downs, Murna; Blighe, Alan; Carpenter, Robin; Feast, Alexandra; Froggatt, Katherine; Gordon, Sally; Hunter, Rachael; Jones, Liz; Lago, Natalia; McCormack, Brendan; Marston, Louise; Nurock, Shirley; Panca, Monica; Permain, Helen; Powell, Catherine; Rait, Greta; Robinson, Louise; Woodward-Carlton, Barbara; Wood, John; Young, John; Sampson, Elizabeth
Background An unplanned hospital admission of a nursing home resident distresses the person, their family and nursing home staff, and is costly to the NHS. Improving health care in care homes, including early detection of residents’ health changes, may reduce hospital admissions. Previously, we identified four conditions associated with avoidable hospital admissions. We noted promising ‘within-home’ complex interventions including care pathways, knowledge and skills enhancement, and implementation support. Objectives Develop a complex intervention with implementation support [the Better Health in Residents in Care Homes with Nursing (BHiRCH-NH)] to improve early detection, assessment and treatment for the four conditions. Determine its impact on hospital admissions, test study procedures and acceptability of the intervention and implementation support, and indicate if a definitive trial was warranted. Design A Carer Reference Panel advised on the intervention, implementation support and study documentation, and engaged in data analysis and interpretation. In workstream 1, we developed a complex intervention to reduce rates of hospitalisation from nursing homes using mixed methods, including a rapid research review, semistructured interviews and consensus workshops. The complex intervention comprised care pathways, approaches to enhance staff knowledge and skills, implementation support and clarity regarding the role of family carers. In workstream 2, we tested the complex intervention and implementation support via two work packages. In work package 1, we conducted a feasibility study of the intervention, implementation support and study procedures in two nursing homes and refined the complex intervention to comprise the Stop and Watch Early Warning Tool (S&W), condition-specific care pathways and a structured framework for nurses to communicate with primary care. The final implementation support included identifying two Practice Development Champions (PDCs) in each intervention home, and supporting them with a training workshop, practice development support group, monthly coaching calls, handbooks and web-based resources. In work package 2, we undertook a cluster randomised controlled trial to pilot test the complex intervention for acceptability and a preliminary estimate of effect. Setting Fourteen nursing homes allocated to intervention and implementation support (n = 7) or treatment as usual (n = 7). Participants We recruited sufficient numbers of nursing homes (n = 14), staff (n = 148), family carers (n = 95) and residents (n = 245). Two nursing homes withdrew prior to the intervention starting. Intervention This ran from February to July 2018. Data sources Individual-level data on nursing home residents, their family carers and staff; system-level data using nursing home records; and process-level data comprising how the intervention was implemented. Data were collected on recruitment rates, consent and the numbers of family carers who wished to be involved in the residents’ care. Completeness of outcome measures and data collection and the return rate of questionnaires were assessed. Results The pilot trial showed no effects on hospitalisations or secondary outcomes. No home implemented the intervention tools as expected. Most staff endorsed the importance of early detection, assessment and treatment. Many reported that they ‘were already doing it’, using an early-warning tool; a detailed nursing assessment; or the situation, background, assessment, recommendation communication protocol. Three homes never used the S&W and four never used care pathways. Only 16 S&W forms and eight care pathways were completed. Care records revealed little use of the intervention principles. PDCs from five of six intervention homes attended the training workshop, following which they had variable engagement with implementation support. Progression criteria regarding recruitment and data collection were met: 70% of homes were retained, the proportion of missing data was < 20% and 80% of individual-level data were collected. Necessary rates of data collection, documentation completion and return over the 6-month study period were achieved. However, intervention tools were not fully adopted, suggesting they would not be sustainable outside the trial. Few hospitalisations for the four conditions suggest it an unsuitable primary outcome measure. Key cost components were estimated. Limitations The study homes may already have had effective approaches to early detection, assessment and treatment for acute health changes; consistent with government policy emphasising the need for enhanced health care in homes. Alternatively, the implementation support may not have been sufficiently potent. Conclusion A definitive trial is feasible, but the intervention is unlikely to be effective. Participant recruitment, retention, data collection and engagement with family carers can guide subsequent studies, including service evaluation and quality improvement methodologies. Future work Intervention research should be conducted in homes which need to enhance early detection, assessment and treatment. Interventions to reduce avoidable hospital admissions may be beneficial in residential care homes, as they are not required to employ nurses. Trial registration Current Controlled Trials ISRCTN74109734 and ISRCTN86811077. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 2. See the NIHR Journals Library website for further project information.
A Kaleidoscope of Hope: Exploring Experiences of Hope Among Service Users and Informal Carers in Health Care Contexts
(SAGE, 2017-07-06) McCormack, Brendan; Borg, Marit; Cardiff, Shaun; Dewing, Jan; Jacobs, Gaby; Titchen, Angie; van Lieshout, Famke; Wilson, Valerie
Background: There is a large and diverse literature on the concept of hope in health care. This literature covers a broad spectrum of perspectives, from philosophical, conceptual, and theoretical analysis through to attempts at measuring the concept of hope with differing health care users. Aims: To explore the concept of hope through the secondary analysis of existing data sets, with the intention of understanding hope in the context of person-centeredness. Research Question: What is the experience of hope among service users and informal carers in different health care contexts? Method: Secondary analysis of data derived from three research studies. Findings: We identified four key themes that together illustrate what we describe as a kaleidoscope of hope, reinforcing the view that there is no one presentation of hope and that practitioners must engage authentically with service users to determine the most effective and appropriate intervention strategies. Conclusions: Hope is not a singular phenomenon, and in the context of person-centered practice there is a need for practitioners to engage authentically with service users and listen carefully to what may bring hope for them. 2016, The Author(s) 2016.
A qualitative exploration of living with dementia in supported living environments using a peer researcher approach
(Elsevier, 2022-02-02) Daly-Lynn, Jean; Ryan, Assumpta; McCormack, Brendan; Martin, Suzanne
Background The aim of the paper is to examine the experiences and perspectives of people living with dementia who live in supported living environments. Methods Peer researchers conducted semi-structured interviews with twenty-two people living with dementia in nine different supported living environments. Results Three themes developed from the thematic analysis: “You can come and go when you like” (Independence and Autonomy); “Everybody the staff and all, all works together” (Collaborative Relationships); and “When I came first, I saw this –I said is this all mine?” (Correct Fit of the Environment). Participants reported living environments that fostered their independence, choice, and control. Collaborative relationships with staff members and family caregivers were important to live the life of their choice. Finally, the correct environment created a sense of ownership and belonging within this space. Conclusions These findings illustrate that supported living can be an environment that empowers individuals on their dementia journey.
A qualitative study of family members' experiences of their loved one developing dementia and their subsequent placement in a nursing home
(Wiley, 2021-02-07) Fekonja, Zvonka; Kmetec, Sergej; Novak, Barbara; McCormack, Brendan; Mlinar Reljić, Nataša
Aim: To investigate the family members' experiences with receiving help and support while their loved one develops dementia and their subsequent placement in nursing homes.
A systematic review of electronic assistive technology within supporting living environments for people with dementia
(SAGE, 2017-10-09) Daly-Lynn, Jean; Rondon-Sulbaran, Janeet; Quinn, Eamon; Ryan, Assumpta; McCormack, Brendan; Martin, Suzanne
Health and social care provision needs to change in order to meet the needs of an increase in the number of people living with dementia. Environmental design, technology and assistive devices have the potential to complement care, help address some of the challenges presented by this growing need and impact on the lived experience of this vulnerable population. This systematic review was undertaken to identify the research on the use of electronic assistive technology within long-term residential care settings. A total of 3229 papers published from the inception of each of the databases up until May 2016 were retrieved from searches in four major databases. Sixty-one were identified to be included in the review. The inclusion criteria were: original peer reviewed journals; an electronic assistive technology intervention; with residents or tenants living with dementia or their family or paid caregivers; in supported living environments or residential care. The data extracted from the included studies focused on the methodology, technology, outcomes and the role of people living with dementia within the research. Overall, an extensive variety of technical interventions were found, with a broad range of methodological heterogeneity to explore their effect. Additionally, wide-spanning outcomes to support the potential of technology solutions and the challenges presented by such intervention were found.
Acceptability and use of a patient-held communication tool for people living with dementia: A longitudinal qualitative study
(BMJ, 2020-05-05) Leavey, Gerard; Corry, Dagmar; Waterhouse-Bradley, Bethany; Curran, Emma; Todd, Stephen; McIlfatrick, Sonja; Coates, Vivien; Watson, Max; Abbott, Aine; McCrory, Bernadine; McCormack, Brendan
Objectives: To assess the acceptability and use of a low-cost patient-held communication tool.
Adopting the concept of ‘Ba' and the ‘SECI' model in developing person-centered practices in child and adolescent mental health services
(Frontiers, 2022-01-05) Attard, Christie; Elliot, Michelle L.; Grech, Paulann; McCormack, Brendan
The concept of knowledge is divided into explicit and tacit knowledge; explicit knowledge refers to the knowledge that can be articulated, written and stored, while tacit knowledge refers to personal experiences, values, beliefs and emotions of an individual. By Nonaka's theory, explicit and tacit knowledge do not lie separately but interact together by interactions and relationships between human beings. Thus, the SECI model is based on the assumption that knowledge is created through the social interaction of tacit and explicit knowledge; known as knowledge conversion. The SECI model is based upon four modes of knowledge conversion; socialization, externalization, combination and internalization. 'Ba' is considered to be a shared platform for knowledge creation. 'Ba' is a shared space, be it physical, mental or a combination of both that serves as a foundation of knowledge creation. Ba involves sharing of tacit knowledge i.e. emotions, feelings, experiences and mental images. It also involves the formation of a collective relationship which is open to the sharing of practices, values, processes and culture. This concept focuses mainly on the individual as a person who holds the knowledge rather than just on the knowledge itself. It aims to create a common space to bring people together where they can dialogue to share and create knowledge. As in the relationships formed in person-centered practices, relationships formed in Ba are based on not just the sharing of objective knowledge but also on sharing values, beliefs, and emotions. It also reflects the formation of a person-centered environment as a basis for person-centered research where healthful relationships with the participants are formed. Furthermore, Ba will aid in creating a sense of connectiveness and dialogue, thus focusing on the idea that the development of new practices is done with others rather than to others. In this article we will discuss how these Eastern concepts can be adapted and used to develop person-centered practices within child and adolescent mental health services, specifically related to rehabilitation and recovery. The concepts of personhood will be discussed, followed by a reflection on current practices adopted when working with children and adolescents.
An evaluation of the role of the clinical education facilitator
(Wiley-Blackwell, 2006-02) McCormack, Brendan; Slater, Paul
Aims and objectives.- The objective of the study was to identify whether clinical education facilitators made a difference to the learning experiences of nurses in a large teaching hospital. Background.- Strategies for enabling continuous professional development are well established in healthcare organizations as key components of approaches to lifelong learning. The benefits of continuous professional development include the maintenance of high standards of care, the improvement and development of services, ensuring the competency of all nursing staff and guaranteeing the accountability of nurses for their actions. The role of clinical education facilitator is relatively new and little evaluation of this role has been undertaken. Conclusions.- This study highlights important issues to be considered in developing a 'learning culture' in a hospital organization, through the adoption of such roles as clinical education facilitators. Whilst the roles have had an important function in the active coordination of learning activities in the hospital, there is little evidence of the role directly impacting on the learning culture of clinical settings. Learning mechanisms have been identified. The results of this evaluation can be subjected to further testing through ongoing evaluation of the outcomes arising from the learning mechanisms in place. Given the emphasis on work-based learning and continuing professional development in health care, then this ongoing evaluation can yield important information about future directions for nurse education. Relevance to clinical practice.- The study highlights the importance of supported learning in the workplace. However, more importantly, it identifies the need for a culture of professional practice to be developed in order to sustain learning in practice. Classroom-based learning alone, cannot create a culture of development in nursing and there is thus a need for models of work-based learning to be integrated into practice environments.
An exploration of midwives’ perceptions of newborn resuscitation programmes for midwifery students
(Elsevier, 2021-05-15) Ljungblad, Linda Wike; Skovdahl, Kirsti; McCormack, Brendan; Dahl, Bente
An Exploration of Person-Centredness in Practice
(American Nurses Association, 2011-05) McCance, Tanya; McCormack, Brendan; Dewing, Jan
Person-centredness' is a term that is becoming increasingly familiar within health and social care at a global level; it is being used to describe a standard of care that ensures the patient/client is at the centre of care delivery. In this article we explore the relevance of person-centredness in the context of nursing, taking account of the ongoing critical debate and dialogue regarding developments in this field. Person-centredness is recognised as a multidimensional concept. The complexity of the concept contributes to the challenge of articulating its shared meaning and describing how it can be applied in practice. The aim of this paper is to explore some of the issues pertaining to language and conceptual clarity, with a view to making connections and increasing our shared understanding of person-centred care in a way that can impact nursing practice. We begin by describing the development of the concept of person-centredness, after which we discuss the synergies with patient-centredness and other related terms, and consider how nurses can operationalise person-centredness in their practice.
Articulating expertise and professional artistry: New methodological principles for critical creative research
(SAGE, 2019-08-01) Kinsella, Niamh; Pentland, Duncan; McCormack, Brendan; Burns, Jane
This poster presents a critical perspective of a methodology for research that facilitates articulation of professional artistry and expertise in practice with persons living with dementia. This critical perspective was developed during research which intended to explore the principles and philosophy underpinning professional artistry or expert practice with occupational therapists. Existing literature in occupational therapy reflects a concern with developing and expressing the principles of professional artistry, practice expertise and professional judgement (Mattingly 1991, Turner and Alsop 2015) for the purpose of raising consciousness of the value of occupational therapy and supporting development of role clarity and professional identity (Unsworth and Baker 2016). The argument that there is a need to develop research methodologies that support articulation of artistry and expertise related to professional philosophies will be presented in this poster. The case for research strategies incorporating critical creativity (McCormack and Titchen 2006) and creative methods as a way of articulating practice principles that are often deeply embodied in a practitioner’s being will be presented in this poster. A critical creative case study methodology will be described, and reflective dialogue about this critique facilitated with poster viewers. The key messages presented in this poster are: philosophical and methodological principles of creativity can facilitate expression of expert knowledge that is inherently tacit and embodied; and incorporating such principles facilitates practice development and research that is consistent with, and reflective of, our professional philosophy.
Assistive technology: Occupational therapy assessment and services for people with dementia
(SAGE, 2024-05-21) Curnow, Eleanor; Maclean, Fiona; McCormack, Brendan
Introduction: Research suggests that services are not effectively providing suitable assistive technology for people with dementia. There is a need to understand the challenges facing practitioners to identify where service changes should be focussed to improve this situation. Method: This study used an online survey to explore the experiences of 41 occupational therapists working with people with dementia, and/or assistive technology. Eight participants subsequently agreed to participate in online discussion groups. Group discussions were transcribed and checked. Data responses from group discussions and open questions in the survey were analysed thematically using the person-centred framework to identify domains supporting or obstructing effective assistive technology service delivery. Results: Forty-one occupational therapist participants described challenges to providing person-centred assistive technology services. These included restricted access to assistive technology interventions, limited knowledge regarding developments in the field, variable funding, unsupportive systems, limited relevant training and difficulties working across health and social care sectors. Conclusion: There is a need to revise the systems surrounding the provision of assistive technology for people with dementia. Occupational therapists need access to training relative to this field, and systems need to be adapted to support the provision of person-centred care by widening access to assistive technology.
Balancing life and death during the golden minute – midwives’ experiences of performing newborn resuscitation
(Dove Press, 2020-09-17) Ljungblad, Linda Wike; Skovdahl, Kirsti; McCormack, Brendan; Dahl, Bente
Purpose: To explore midwives’ experiences in performing newborn resuscitation on maternity wards.
Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review
(FoNS, 2019-11-13) Carvajal, Ana; Haraldsdottir, Erna; Kroll, Thilo; McCormack, Brendan; Errasti-Ibarrondo, Begona; Larkin, Philip
Background: Registered nurses are increasingly expected to provide person-centred end-of-life care. However, there is a gap between patients’ needs and the capacity of nurses to meet the existing recommendations on provision of this care. Identifying the relevant barriers and facilitators can inform the development of strategies to support person-centred nursing.
Becoming a person-centred facilitator of learning in a hospital setting: Findings from a participatory action-oriented study with hospital-based educators
(Elsevier, 2024-12-13) Robinson, Betty Ann; McCormack, Brendan; Dickson, Caroline
Aim Investigate the experience of hospital-based educators becoming person-centred facilitators of learning. Background Hospital-based educators working with staff are not well-prepared for their role. No person-centred pedagogical approaches exist specifically for use in hospital settings. Educators are positioned to advance person-centredness in clinical practice. To do so they need knowledge and skills in person-centred approaches. Little is known about how educators transform from teacher-centred approaches to person-centred facilitation. This study investigated how educators learn about and use person-centred principles to acquire educational theory and become person-centred facilitators. Design Participatory, action-oriented research Methods Guided by four person-centred principles blending relational inquiry and practice development, 10 educators participated in group and individual sessions over 18 months. Data were analyzed using relational inquiry and critical creative hermeneutics. Results Becoming person-centred facilitators was enabled through three principles: starting with self, developing community and belonging and bumping against culture and inviting transformation. Participants became person-centred facilitators through intrapersonal, interpersonal and contextual transformations during moments of discovery, reconciliation and action. Competence developed by experiencing and using four methodological principles of taking a relational stance; using active learning to learn in and from practice; being collaborative, inclusive and participatory; and linking creativity with cognition. This model resulted in improved trust, strengthened relationships and more meaningful and robust learning outcomes. Conclusions Hospital-based educators can be enabled to become person-centred facilitators by providing them with person-centred learning opportunities. The four methodological principles, as a model for person-centred education, provided an effective preparation and orientation to educational and person-centred theory.
Being person‐centred in community and ambulatory services
(Wiley-Blackwell, 2021-02) Dickson, Caroline; Peelo‐Kilroe, Lorna; McCormack, Brendan; McCance, Tanya; Bulley, Catherine; Brown, Donna; McMillan, Ailsa; Martin, Suzanne
Being person-centred in qualitative interviews: reflections on a process
(Foundation of Nursing Studies (FoNS), 2018-11-14) Sandvik, Berit Margrethe; McCormack, Brendan
Background: In this article we reflect on the first author’s (Berit Margrethe BM) experience of conducting seven qualitative research interviews with public health nurses trained in parenting guidance by Interational Child Development Program (ICDP) at the University of South East Norway. The interviews focused on how the public health nurses use a particular set of competencies in their daily work at the health center. A person-centred practice framework was used to reflect on whether person-centred prerequisities and person-centred processes could be recognised in the completed interview processes, and how a greater focus on a person-centered approach could improve the quality of data collection. It is the results of this reflection that is presented in this paper. Aims: Understand how a researcher can use person-centred principles to facilitate qualitative interviews. Findings: Being reflexive is essential to a person-centred approach in qualitative research interviews. It is about the researcher's ability to facilitate an engagement that promotes authenticity, self- determination and reciprocity. Knowing oneself without letting conscious and unconscious values and perceptions overshadow the potential opportunities that arise in gaining an understanding of the informant's values and perceptions is essential. Through being vigilant in all senses, a holistic mutually respectful dialogue can be created, through which new knowledge and understandings are generated. Conclusion: Considering person-centredness in the planning and undertaking of research methods is important. Whilst there is an increasing evidence base about person-centredness in health and social care practice, there continues to be a dearth of publications that focus on person-centredness in research methods.
Can we talk about it? A qualitative study exploring occupational therapists’ decision making in judging when to ask an older person about drinking alcohol
(Cambridge University Press, 2020-08-03) Maclean, Fiona; Dewing, Jan; Kantartzis, Sarah; Breckenridge, Jenna; McCormack, Brendan
Older people now currently drink alcohol more frequently than previous generations, indicating a need to understand how this influences health and wellbeing in older adults. However, knowledge and awareness of the changing role alcohol plays in the lives of older people is not necessarily widely understood by allied health professionals in acute hospital contexts. In turn, conversations about drinking alcohol in later life may not be routinely addressed as part of practice, limiting an older person's choice to make informed decisions about their drinking. This paper qualitatively examines when occupational therapists (N = 17) in an acute hospital setting will initiate a conversation with older people (65+ years) about their drinking, guided by a theoretical lens that encompasses both person-centredness and collective occupation. Adopting a qualitative methodology, this study illustrates a typology of reasoning describing how, and in what circumstances, therapists ask older people about their alcohol use. Three themes were generated that provide further insight into the typology, these being ‘hesitancy in practice’, ‘failure to link life transitions to alcohol use’ and ‘challenges of focusing on healthfulness’. These findings provide a potentially useful tool for therapists, services and organisations to self-assess their approach to asking older people about alcohol use; a necessary element of professional health-care practice as social trends in alcohol use continue to increase.
Challenging and redesigning a new model to explain intention to leave nursing
(Nordic College of Caring Science, 2020-06-22) Slater, Paul; Roos, Mervi; Eskola, Suvi; McCormack, Brendan; Hahtela, Nina; Kurjenluoma, Kaisa; Suominen, Tarja
Background It is important to have a full and detailed understanding of the factors that influence intention to leave nursing. It has been shown to be the best predictor of actual turnover, and turnover has a significant financial impact and also on the provision of care.