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

The implementation of a model of person-centred practice in older person settings
“I never realised that the most important thing for some of our residents is a nice cup
of tea. I thought it was about their care”.
Whilst trust between staff and residents needs to be nurtured and perhaps over time
residents/guests will be more confident to discuss aspects of their care priorities,
none the less this was a revelation for many staff.
One of the evaluation processes that had the greatest impact on the three sites was
the WCCAT (McCormack et al 2007). The process of two people observing practice
reduced the subjectivity of the observations and reduced the effect of justifying
practices that were highlighted. The feedback process outlined this and made the
whole process effective in helping tams to consider, or reject questions raised in the
observation. In one site where there are four units, nurses from two of the units
refused to engage in the programme. One of the two units did have a charge nurse
attend for the first few sessions, but left after that saying that they were already
person-centred and could not see the relevance of the programme. The second of
the two units did not have a nurse attend at all. The contrast in the care between the
four units was so obvious that it could no longer be ignored. Two units had
developed their practices significantly and the impact of their work was visible by the
results of the WCCAT evaluation in particular. The other two sites had stood still with
no real evidence of change. It was almost like having a control group and an
intervention group in an experimental research study. The learning from this
evaluation resulted in the charge nurse from one of the two sites joining the PD
group.
Significant Issues
Each site had their own issues that at times really challenged the group to continue
with the programme. One site had difficulties with gaining support and credibility for
their work which was at times seen as too slow. Although the work progressed it was
indeed at a slower pace as staff were free to opt out of the programme if they wished
and bringing new recruits up to speed with the PD group was time consuming. The
challenge for the team was to create an understanding within the organization that
change was necessary, that environmental changes alone would have little effect on
culture and that staff needed support to learn new ways of doing their work. For
those involved in the programme their progress was obvious and a marked contrast
developed between the areas that engaged in the programme and those areas that
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