Abstract
BackgroundContinuing professional education (CPE) for nurses is deemed an essential component to develop, maintain and update professional skills. However, there is little empirical evidence of its effectiveness or factors which may influence its application into practice. ObjectiveThis paper explores a continuing professional education programme on the safe administration of medication and how new knowledge and skills are transferred into clinical practice. DesignRealist evaluation provided the framework for this study. Realist evaluation stresses the need to evaluate programmes within “context,” and to ask what “mechanisms” are acting to produce which “outcomes.” This realist evaluation had four distinct stages. Firstly, theories were built as conjectured CMO configurations (Stage 1 and 2), then these cCMO were tested (Stage 3) and they were then refined (Stage 4). MethodsData was collected through document analysis and interviews (9) to build and refine CMOs. The conjectured CMOs were tested by clinical observation, interview (7), analysis of further documents and analysis of data from reported critical incidents and nursing care metric measurements. ResultsThis study has shown the significant role of the ward manager in the application of new learning from the education programme to practice. Local leadership was found to enable a patient safety culture and the adoption of a quality improvement approach. The multi-disciplinary team at both organisation and local level was also found to be a significant context for the application of the education programme into practice. Reasoning skills and receptivity to change were identified to be key mechanisms which were enabled within the described contexts. ConclusionThe findings from this study should inform policy and practice on the factors required to ensure learning from CPE is applied in practice. The realist evaluation framework should be applied when evaluating CPE programmes as the rationale for such programmes is to maintain and improve patient care.
Highlights
Continuing professional education (CPE) for nurses is deemed an essential component to develop, maintain and update professional skills
The Context Mechanism Outcome configurations (cCMOs) configurations were refined through an iterative process (Manzano, 2016) with the data from Stage 1 and 2
While a relationship between context, mechanism and outcome was not established in two of the proposed Context mechanism outcome (CMO), the factors which can influence the application of knowledge developed in CPE into practice have been identified
Summary
Continuing professional education (CPE) for nurses is deemed an essential component to develop, maintain and update professional skills. Continuing professional education (CPE) is essential to develop, maintain and update professional skills and practice, in order to ensure that nurses respond effectively to care requirements and provide a high standard of patient care (Atack and Luke, 2008; Pool et al, 2016). The tangible outcomes of CPE often prove difficult to measure (Clark et al, 2015) and variables such as organisational culture, and the motivation and ability of individual professionals to influence change present challenges for evaluation (Lee, 2011) One such element within the organisational culture which has been identified as influencing the transfer of CPE into practice is the role of leadership. While other work has reported the positive impact of the role of man agers in supporting the transfer of CPE into practice (Clark et al, 2015; Lee, 2011; Mann et al, 2009; Stolee et al, 2009)
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