Advancing knowledge on practice change: linking facilitation to the senses framework

Authors


Correspondence: Julie Cooper, Lecturer, School of Health Sciences, City University London, Northampton Square, London EC1V 0HB, UK. Telephone: 44 (0) 20 7040 5977.

E-mail: julie.cooper.1@city.ac.uk

Abstract

Aims and objectives

To explore the facilitating factors that enabled staff on a rehabilitation ward for older people engage in change activities.

Background

The importance of facilitation in practice change is widely acknowledged; however, little nursing research has taken place in relation to its nature. Following identification in the early phases of an action research study that learned helplessness states and the use of socially structured defence techniques were preventing staff on a rehabilitation ward for older people from engaging in practice development, some change was achieved. What facilitated this to take place needed to be explored.

Design

An action research approach was used.

Methods

Data gained from 13 in-depth interviews with staff and managers together with three years of researcher field notes were analysed using thematic analysis.

Results

The continuous presence and neutrality of the researcher who worked together with staff on their issues of concern using a flexible ward-based approach, combined with giving staff the opportunity to explore what it was like for them working in this area, were considered key in helping staff to engage with change.

Conclusions

Analysis of findings suggests that the senses framework presents a theoretical approach to facilitation that can help staff move out of learned helplessness states and reduce the need for the use of socially structured defence techniques.

Relevance to clinical practice

This study identifies a facilitation approach that enabled staff to engage with practice change. Although carried out in the UK, its findings have wider relevance through the application of a theoretical perspective for practice change facilitation that has not before been considered in this literature, and which is likely to be of interest to those involved in practice change internationally.

Ancillary