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

The implementation of a model of person-centred practice in older person settings
INTRODUCTION
Given the complexity of person-centred practice, it is important that any evaluation of
it takes account of each of its different attributes and the inter relationship between
them. In this practice development programme, we worked with several models:
practice development model (Garbett and McCormack 2004) and the person-centred
practice theoretical framework of McCormack and McCance (2006). Additionally,
emerging from this programme is a new model of learning in practice development:
Active Learning (Dewing 2008 and 2009; McCormack et al 2009). In addition, we
actively experimented with scale of the programme and the programme leads being
outside the local delivery of the practice development interventions and data
gathering.
The person-centred practice theoretical framework is predicated on the conceptual
stance which suggests – that in order for a person-centred culture to exist a number
of pre-requisites need to be in place/attended to in a systematic way. A care setting
that focuses on these prerequisites will have the foundation attributes of a team in
place who can pay attention to the care environment, its management, leadership
and learning. The combination of prerequisites and the positive attributes of the care
environment, then enable effective care processes to be realised and sustained in
practice. The evaluation of this practice development programme, whilst not
explicitly structured on the concepts that make up the theoretical framework, does go
some way to articulate the attributes of person-centred practice in residential care
settings for older people, from the perspectives of staff, residents and their families.
DEVELOPMENT OF THE CARE ENVIRONMENT/PRACTICE
CULTURE
The Person-centred Nursing Index (PCNI) focuses on many of those attributes that
comprise the ‘care environment’ construct within the person-centred practice
framework. This goes far beyond the physical environment. The PCNI instrument
helps to illuminate how these attributes affect organisational factors such as job
satisfaction, job stress, and outcome variables like nurses’ job commitment and
intention to leave the job due to the absence of the factors that enable personcentred
nursing to happen. In addition it provides some insights into the importance
of the care environment in the development of person-centred cultures. In other
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