Mary Casey

Partnership – success factors of interorganizational relationships

AIM Key factors of successful interorganizational partnerships are applied to the context of nursing and midwifery education. BACKGROUND Reports in nursing education emphasize the need for more collaborative partnerships between the education and healthcare sectors of nursing and midwifery education. EVALUATION There is little research examining the implementation of interorganizational relationships particularly in nursing. KEY ISSUES Key success factors are grouped into seven areas of trust and valuing the partner, leadership and managing change, a partnership framework, communication and interaction, equity and involvement in decision making, power and the role of partnership coordinator. CONCLUSION There is a need for contextual research in relation to implementing partnership in nursing and midwifery. IMPLICATIONS FOR NURSING MANAGEMENT Partnership arrangements are essential for quality nursing and midwifery education. This article adds knowledge by way of application of these factors to organizations that provide nursing and midwifery education. Nurse managers have an important role in determining the quality of learning experience within the health service. It is essential, therefore that both nurse managers and nurse educationalist know the key factors which promote successful interoganizational relationships to ensure these factors are manifest in practice.

Nurses’, midwives’ and key stakeholders’ experiences and perceptions of a scope of nursing and midwifery practice framework

AIM This paper reports on the qualitative findings from a national review of a nursing and midwifery scope of practice framework. BACKGROUND Scope of professional practice frameworks offers a system of rules and principles to regulate its members and demonstrate its responsibility to society. Key issues in reviewing the scope of practice include notions of specialist and advanced practice, accountability, autonomy, competence, supervision, continuing professional development and delegation. Evaluation of scope of practice frameworks has particular application value to nurses, midwives, regulatory bodies and healthcare employers across the globe. DESIGN A mixed methods approach was used. This included a national survey of nurses and midwives and focus groups and interviews with key stakeholders. The qualitative data are reported in this paper. METHODS Focus groups and interviews were conducted among a convenience purposive sample of key stakeholders, including nurses and midwives working in the widest range of services and settings in 2014. The participants contributed to thirteen focus groups and thirteen interviews. FINDINGS Six global themes, as follows: Evolution of the nursing and midwifery professions and practice; Scope of practice: understanding and use; Expanding scope of practice; Professional competence; Practice setting and context; Reflections on the current framework. CONCLUSION Practitioners understand the scope of professional practice and while some see it as empowering others see it as potentially restrictive. Nurses and midwives are generally willing to expand their scope of practice and see it as resulting in improved patient care, improvement in overall quality of standards and increased job satisfaction.

Individual-level outcomes from a national clinical leadership development programme

Abstract A national clinical leadership development programme was instituted for Irish nurses and midwives in 2010. Incorporating a development framework and leadership pathway and a range of bespoke interventions for leadership development, including workshops, action-learning sets, mentoring and coaching, the programme was introduced at seven pilot sites in the second half of 2011. The programme pilot was evaluated with reference to structure, process and outcomes elements, including individual-level programme outcomes. Evaluation data were generated through focus groups and group interviews, individual interviews and written submissions. The data provided evidence of nurses’ and midwives’ clinical leadership development through self and observer-reported behaviours and dispositions including accounts of how the programme participants developed and displayed particular clinical leadership competencies. A key strength of the new programme was that it involved interventions that focussed on specific leadership competencies to be developed within the practice context.

Service impact of a national clinical leadership development programme: findings from a qualitative study

AIM The study reported here was part of a larger study, which evaluated a national clinical leadership development programme with reference to resources, participant experiences, participant outcomes and service impact. The aim of the present study was to evaluate the programmes service impact. BACKGROUND Clinical leadership development develops competencies that are expressed in context. The outcomes of clinical leadership development occur at individual, departmental and organisational levels. METHODS The methods used to evaluate the service impact were focus groups, group interviews and individual interviews. Seventy participants provided data in 18 separate qualitative data collection events. RESULTS The data contained numerous accounts of service development activities, initiated by programme participants, which improved service and/or improved the culture of the work setting. CONCLUSION Clinical leadership development programmes that incorporate a deliberate service impact element can result in identifiable positive service outcomes. The nuanced relationship between leader development and service development warrants further investigation. IMPLICATIONS FOR NURSING MANAGEMENT This study demonstrates that clinical leadership development can impact on service in distinct and identifiable ways. Clinical leadership development programmes should focus on the setting in which the leadership competencies will be demonstrated.

Am I covered?': an analysis of a national enquiry database on scope of practice

AIM Analysis of a national database of enquiries to a professional body pertaining to the scope of nursing and midwifery practice. BACKGROUND Against a backdrop of healthcare reform is a demand for flexibility in nursing and midwifery roles with unprecedented redefinition of role boundaries and/or expansion. Guidance from professional regulatory bodies is being sought around issues of concern that are arising in practice. DESIGN Qualitative thematic analysis. METHOD The database of telephone enquiries (n = 9818) made by Registered Nurses and midwives to a national regulatory body (2001-2013) was subjected to a cleaning process and examined to detect those concerns that pertained to scope of practice. A total of 978 enquiries were subjected to thematic analysis. FINDINGS Enquiries were concerned with three main areas: medication management, changing and evolving scope of practice and professional role boundaries. The context was service developments, staff shortages and uncertainty about role expansion and professional accountability. Other concerns related to expectations around responsibility and accountability for other support staff. CONCLUSION Efforts by employers to maximize the skill mix of their staff and optimally deploy staff to meet service needs and/or address gaps in service represented the primary service context from which many enquiries arose. The greatest concern for nurses arises around medication management but innovation in healthcare delivery and the demands of service are also creating challenges for nurses and midwives. Maintaining and developing competence is a concern among nurses and midwives particularly in an environment of limited resources and where re-deployment is common.