Table 4 Outcomes from the project gained through facilitated feedback and non-participant observation of nursing practice.
Outcome | Action | Action cycle |
|---|---|---|
Non-participant observation of nursing practice revealed that nurses discussed pain with older patients when they were working with them. | Nursing staff use all available opportunities to speak to older people about their pain. | Communication Action cycle one |
Nurse: 'We discuss how we can improve practice and how we may better help older patients to understand their care.' | Reflection revealed that many older people had impaired hearing. Action - nursing staff encouraged all members of the MDT to stand closer to older patients when they were speaking to them. | Â |
Post research semi-structured interviews revealed that older people perceived that; 1. nursing staff assessed and treated their pain regularly, 2. they were partners in their care. | Â | Â |
Improved reflection skills | The nursing team introduced; - Reflection and feedback at the end of a shift for junior nurses who take charge. | Communication Action cycle one |
Ward managers developed an understanding of the significance of role modelling behaviour. | - Attend the morning medical ward round to role model how it should be conducted and encouraging junior nurses to ask questions. | Communication Action cycle one |
| Â | - Take a patient caseload when the junior nurse is in charge of the unit to role model how to communicate with nurse in charge. | Interruptions Action cycle two |
Senior ward nurses adopted a more facilitative approach to communicating with junior staff. | - Ask junior nurses guiding questions, rather than providing answers. | Communication Action cycle one |
Ward nursing staff began to undertake new initiatives and evaluate these | - Incorporated changes into off duty gained through facilitated sessions. | Â |
| Â | - Setting target dates for implementing and evaluating changes, e.g., discuss pain with older people when they are working with them. | Communication Action cycle one |
| Â | Â | Pain assessment practices |
| Â | Completing a pain algorithm | Action cycle three |