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

The implementation of a model of person-centred practice in older person settings
However, as has been highlighted in the findings, those units where the DoN
provided active facilitative leadership, probably arising from their personal leadership
styles, achieved a much greater degree of change to the practice culture and
enabled a greater sense of achievement by the internal facilitator:
“Strong support and protected time was assured by our Director of Nursing … [and]
was readily given and consistent. This was a crucial factor to enable us to try and
fulfil our roles to the best of our abilities.” (Internal Facilitator Reflection)
“Ongoing support from management was crucial to the success of the programme,
facilitating the release of participants and supporting the ongoing action plans proved
vital in the current cost containment environment. Management’s acknowledgement
of the need for the programme and seeing it as a vital link in maintaining standards
also helped me work effectively.” (Internal Facilitator’s Reflection)
The role and contribution of other managers such as general managers and older
people services managers was never clearly explored. This was another
consequence of the embargo. We saw a varying but generally low level of interest
and engagement from these managers over the two years of the programme which
added to the general feeling that more senior service managers do not encourage
and promote innovation that is practice led. It may be that these managers were
unclear about their role in this respect, something that may need exploration in the
future practice development work in Ireland.
In summary, the data clearly demonstrates the importance of the role of managers in
practice development work especially those at the interface with practice. The
methodology of practice development focuses on empowering staff to develop skills
that enable them to make changes themselves, to do so in a critical and reflective
way and to learn how to use those skills repeatedly in their practice. Without the
support of managers, such growth, development and self-exposure falls on barren
ground, is limited when the interface with management is encroached and the
benefits are never fully realised:
“A wonderful programme for team building and getting all grades working together for
the benefit of the clients - changing the culture and involving patients/clients in their
daily care and giving choice to residents, thus empowering them and improving staff
morale. The role of the Internal Facilitator has been critical. Strong leadership is
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