Aim: to identify: (1) nursing competencies for FCC in a hospital setting; and (2) to explore perspectives on these competencies among Dutch and Australian professionals including lecturers, researchers, Registered Nurses and policy makers. Design: A multinational cross-sectional study using Q-methodology. Methods: First, an integrative review was carried out to identify known competencies regarding FCC and to develop the Q-set (search up to July 2018). Second, purposive sampling was used to ensure stakeholder involvement. Third, participants sorted the Q-set using a web-based system between May and August 2019. Lastly, the data were analysed using a by-person factor analysis. The commentaries on the five highest and lowest ranked competencies were thematically analysed. Results: The integrative review identified 43 articles from which 72 competencies were identified. In total 69 participants completed the Q-sorting. We extracted two factors with an explained variance of 24%. The low explained variance hampered labelling. Based on a post-hoc qualitative analysis, four themes emerged from the competencies that were considered most important, namely: (a) believed preconditions for FCC; (b) promote a partnership between nurses, patients and families; (c) be a basic element of nursing; and (d) represent a necessary positive attitude and strong beliefs of the added value of FCC. Three themes appeared from the competencies that were considered least important because they: (a) were not considered a specific nursing competency; (b) demand a multidisciplinary approach; or (c) require that patients and families take own responsibility. Conclusions: Among healthcare professionals, there is substantial disagreement on which nursing competencies are deemed most important for FCC. Impact: Our set of competencies can be used to guide education and evaluate practicing nurses in hospitals. These findings are valuable to consider different views on FCC before implementation of new FCC interventions into nursing practice.
This thesis describes an Action Research (AR) project aimed at the implementation of Evidence Based Practice in a mental health nursing setting in the Netherlands. The main research question addressed in this thesis is: In what way is Action Research with an empowering appropriate to implement Evidence Based Practice in a mental health nursing setting in the Netherlands and what is the effect of this implementation on the care experienced by the client, the nursing interventions and the context in this setting compared to a comparative setting? To answer this main research question, the following questions derived from it were addressed: What is Evidence Based Practice? What is known about implementing evidence-based practice in nursing through Action Research? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be more successful? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be successful? How is EBP implemented through AR with an empowering intent and what are the outcomes for the use of evidence, the context and the facilitation in the setting? What is the effect of the implementation of EBP in mental health nursing using AR with an empowering intent on the care experienced by the client, the nursing interventions and the context compared to a comparison setting? The first two questions were answered by a search of the literature while the remaining questions were answered during the AR study conducted in two mental health organisations in the Netherlands.
Nursing Leadership is an important competence to develop in order to provide quality of care and prevent attrition of nurses. This research program looked into the perceptions and experiences of nurses on practising leadership. Next to that supporting the development of nursing leadership was addressed. The program has a mixed-method, action research design in which 75 in-depth interviews and 24 focus group interviews and quantitative data of 435 nurses form the backbone. According to hospital nurses, nursing leadership is related to proactiveness and voicing expertise in order to deliver good nursing care. Nevertheless, they do not feel fully competent and knowledge deficits were detected on aspects of the bachelor nursing profile, such as evidence based practice. Working-culture factors can either inhibit or encourage nursing leadership. The further awareness of unconsciously using expertise and knowledge deficits as well as team development towards a continuous safe learning environment are necessary steps for the enhancement of nursing leadership. A Nursing Leadership model was developed in which generic personal leadership competencies combined with expertise of the nurses' level of education and degrees form the essence of shared leadership in teams focussed on the realisation of good nursing care.
MULTIFILE
