Margaret Vickers’s research while affiliated with Western Sydney University and other places

Family-centred care (FCC) has been well recognised, accepted and reported in the literature as an optimised way of caring for hospitalised children. While neonatal units strive to adopt this philosophy, published research suggests there are difficulties implementing FCC principles in daily practice. Appreciative inquiry (AI) is a philosophy and methodology that offers a unique, strength-based approach to promoting organisational learning and positive organisational change. As a participatory approach, AI facilitates change from the ground up and lends itself to building effective partnerships or collaborations. This article reports the findings of a one-day workshop using an AI methodology to bring neonatal nurses and parents together to enhance the FCC within a neonatal intensive care unit in Sydney, Australia. Participants (n = 15) developed collaborative insights of optimal FCC that can be built upon to support neonates and their families in the future. Shared visions were formed, strategies identified and a development plan made for ongoing collaborations and partnerships. AI provides a flexible framework that enables the mandatory collaboration needed to develop action plans that can form the catalyst for organizational change in health-care research and practice.

Abstract Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.

To examine and critique how the phases of the 4D cycle (Discovery, Dream, Design, and Destiny) of appreciative inquiry are implemented in a healthcare context. Appreciative inquiry is a theoretical research perspective, an emerging research methodology and a world view that builds on action research, organizational learning, and organizational change. Increasing numbers of articles published provide insights and learning into its theoretical and philosophical underpinnings. Many articles describe appreciative inquiry and the outcomes of their studies; however, there is a gap in the literature examining the approaches commonly used to implement the 4D cycle in a healthcare context. A methodological review following systematic principles. A methodological review was conducted including articles from the inception of appreciative inquiry in 1986 to the time of writing this review in November, 2011. Key database searches included CINAHL, Emerald, MEDLINE, PubMed, PsycINFO, and Scopus. A methodological review following systematic principles was undertaken. Studies were included if they described in detail the methods used to implement the 4D cycle of appreciative inquiry in a healthcare context. Nine qualitative studies met the inclusion criteria. Results highlighted that appreciative inquiry application is unique and varied between studies. The 4D phases were not rigid steps and were adapted to the setting and participants. Overall, participant enthusiasm and commitment were highlighted suggesting appreciative inquiry was mostly positively perceived by participants. Appreciative inquiry provides a positive way forward shifting from problems to solutions offering a new way of practicing in health care and health research.

The aim of this study is to explore neonatal nurses' perspectives of their role in facilitating family centred care in the neonatal intensive care unit. The philosophy of family centred care focuses on the health and wellbeing of the newborn and their family, through the development of a respectful partnership between the health care professional and the infant's parents. Many studies report family centred care in the context of paediatric care; however, few studies explore neonatal nurses' perspective of family centred care in the context of neonatal care. Qualitative interpretative approach. Four focus groups and five individual face-to-face interviews were conducted with neonatal intensive care nurses (total n=33) currently practicing in a tertiary Neonatal Intensive Care Unit in Australia. Each focus group and face to face interview was audio-taped and transcribed. Data was analysed using thematic analysis. Four dominant themes emerged from the data: (1) Getting to know parents and their wishes (2) Involving family in the day to day care (3) Finding a 'happy' medium (4) Transitioning support across the continuum. These findings revealed a general understanding of family centred care principles. Nurses reported the potential benefits and challenges of adopting a family centred care approach to deliver optimal care for neonates and their families. The study highlighted that nurses need ongoing organisation support, guidance and further education to assist them in delivering family centred care effectively. Family centred care is a central tenet underpinning neonatal care. Understanding neonatal nurses' perspectives will be useful when developing strategies to strengthen family centred care in the neonatal intensive care unit, and potentially improve neonatal care and family outcomes.