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Using nursing theory to introduce change in practice.

ABSTRACT This article outlines the theoretical basis of nursing using Carper's (1978) fundamental patterns of knowing and explains how this theory can be integrated with practice. The authors also describe how Carper's theory was used to introduce change related to the reduction in junior doctors' hours through the development, implementation and evaluation of nurse practitioners. Using a SWOT analysis exercise and various workshops, practitioners have been able to develop professionally and integrate the art and science of nursing.

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    ABSTRACT: To investigate the factors that influence the successful implementation of audit in a palliative care setting. Quality assurance is a necessary component of contemporary health care. In the past, palliative care has not generally been subject to systems of audit and quality management. However in recent years the need for all health care organizations to have clear policies and procedures for maintaining quality has become more pressing. An action research project was conducted to investigate the implementation of audit in a palliative care setting, which involved the application and modification of the Support Team Assessment Scale (STAS). A collaborative approach was adopted and this facilitated the identification of factors vital to successful introduction of the audit methodology into the unit. These included effective teamwork, the input of an external facilitator, good relationships with management and prompt and relevant feedback on progress. The use of STAS was fully integrated into the work of the unit and a robust programme of audit has been established. Combining the cyclical nature of action research methodology and the audit process with Lewin's change theory provided a clear conceptual framework for the research. This approach would be applicable in a range of health care settings to bring about improvements in quality management.
    Journal of Advanced Nursing 09/2002; 39(4):360-9. · 1.53 Impact Factor