Kate Sanders – Foundation of Nursing Studies Alison Dinning, Jo Cooper, Kathryn Draper – NUH

1. Knowing why we do what we do? Establishing a Unit Practice Council to improve evidence based nursing in acute medicine using Appreciative Inquiry Kate Sanders – Foundation of Nursing Studies Alison Dinning, Jo Cooper, Kathryn Draper – NUH Wendy Walker – University Of Nottingham

2. Nottingham University Hospitals NHS Trust • NUH is the fourth largest teaching hospital in the UK - 87 wards and circa 1,700 beds. • Employs 13,000 staff. • We provide services to over 5.5 million residents of Nottinghamshire and surrounding counties • 3 Sites - Queen’s Medical Centre, Nottingham City Hospital and Ropewalk House. • Many specialist services, include Trauma, stroke, renal, neurosciences, cancer services and trauma • One of the biggest EDs in Europe – approx 450 patients per day (164,000 per year) • The Trust has an annual income of £722.5million • Strong relationship with University of Nottingham and other universities across the East Midlands, including Loughborough University.

3. Context of study • Trust vision to become a Magnet Hospital • Shared Governance – Develop Unit Practice Councils • UPC Project supported by Jenny Leggott (Director of Nursing) • Secondment of Critical Skills Nurse Educator to Trust Preceptorship Team • Focussing on Acute Admissions Areas initially

4. Why Ward B3? • Many Acutely ill patients due to direct Patient referrals from GP and ED • Enthusiastic team • Lots of newly qualified nurses • 90 WTE registered nurses (16 are newly qualified) • 20 non-registered nurses

5. Summary of Project • Establish and evaluate the development of a Unit Practice council on B3 using principles of shared governance • Research supported by Kate Sanders and Foundation of Nursing Studies • Bring decision-making to frontline clinical practice in relation to caring for Acutely ill patients. • Support staff with relevant evidence-based practice • Use an Appreciative Inquiry Approach

6. Collection of data • A validated measure of nurse practice environment collected at month 3, 9 and 13 (Measures autonomy, support, perceived patient safety culture and job satisfaction from Nursing Work Index – revised Aiken and Patrician, 2000) • Qualitative data from two Appreciative Inquiry guided UPC focus groups / study days • Focus group interviews (Analysis using Systematic Framework Analysis – Ritchie et al, 2003)

7. Opportunities • Develop a Unit Practice Council on B3 (with FONS support) as a pilot site for NUH • Use Appreciative Inquiry as a methodology • Opportunity for research lead /team to develop personal knowledge and skills in research and using AI

8. Challenges • Commitment and engagement from frontline clinical staff and patients • Equipping staff with skills and support to implement change. • Allocation of sufficient time • Adoption of a shared governance approach • Using AI as our research methodology

9. However…… • Focus of research has already changed from original aims • Study Day led by FONS facilitator has identified with the ward team that work needs to be focussed on key areas that were not previously identified • Appreciative Inquiry is a really effective methodology to use • Method of collecting data will need to change

10. Thank you