The Implementation of a Model of Person-Centred Practice In Older ...

The implementation of a model of person-centred practice in older person settings
Participants also reported that this skill could be used in their day–to-day work
to facilitate more meaningful conversations with older people.
(4) High Challenge and High Support: participants found it particularly difficult to
challenge their colleagues initially, especially if they were more senior to them:
“They [the RNs] won’t take it from me”
“I’m fearful about staff saying I’m being too bossy and making things difficult for
me”
“Change can take forever” but it is possible to change”.
The significant learning for participants was (i) surprise at just how resistive
some of their colleagues were and probably that they had not noticed this
before (ii) how often the same message or challenge had to be repeated to the
same people (iii) the negativity and hopelessness their colleagues expressed
(5) Evaluation data collection and what that means to practice:
(i) Environmental walkabouts: doing a walkabout while taking on the role of a
prospective resident/patient, a visitor or a member of staff was enlightening
for the participants as they felt they saw the wards/facilities in a new light
which previously they had been too busy to see. Critical questions were
identified for action planning: “How do we accommodate more personal
belonging?” or “Does the ward layout impact on peoples’ perceptions of the
ward?” They were also able to identify areas where improvements could be
made and this learning was added to the local action planning process: e.g.
“Can more choice be given regarding meals?” or “How do we create more
space for the residents?”
(ii) Observations of care: the majority of participants now found doing of the
observations of care most helpful. They had not looked at the care
environment in this light before and found it to be an eye-opener. They
reported at being amazed at some of the things they observed such as “No
stimulation of patients” or “piped music and television both on together”, the
glare of the lights, inappropriate music and clutter. Several sites committed
to doing these on a monthly basis and introduced this activity (and the walk
about as learning activities for students and new staff).
(iii) Analysis of WCCATs and narratives: participants reported that in reading
the WCCATs and Narratives, they were able to gain a lot of information on
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