Background: To provide high-quality and cost-effective person-centred care, organisations need employees who are committed to perform at their best. Employee work engagement, defined as a positive, fulfilling approach to work, is known to correlate favourably with employee wellbeing and performance and with the service climate. Extended understanding about the meaning of work engagement can promote the development of environments that are both conducive to person-centred practices and good places to work. Aim: To explore the meaning of work engagement in the context of person-centred practices in municipal healthcare facilities for older people. Methods: A total of 16 individual interviews were conducted with a purposive sample of registered nurses and nursing assistants working in municipal healthcare facilities for older people in Norway. Data were analysed using a stepwise-deductive-inductive approach. Findings were generated inductively from the themes that emerged in the interviews and were later reflected on in relation to both theory and practice. Findings: Work engagement is manifest at individual and collective levels, involving intrapersonal, interpersonal and social/group components. Engagement is experienced as contributing to employee work capacity and team effectiveness with respect to person-centred processes. Conclusion: At individual, collective and environmental levels, employee engagement facilitates the development of person-centred practices in organisations providing long-term care for older people, to the benefit of residents and staff. Implications for practice: • Work engagement should be recognised as a condition that fosters employees’ ability and willingness to suspend judgment and appreciate the service user’s perspective • Individual-level engagement is contagious, facilitating development of supportive work environments, which, in turn, enables person-centred practices • Engagement should be approached simultaneously as an intrapersonal, interpersonal, and social/group process, with individual- and group-level outcomes

Background: Arts-based research practices draw upon music, visual art, poetry and other media as methodological tools throughout the research process. There is also growing recognition of the contribution of arts-based practices, including music as method, to interdisciplinary fields of health, social sciences, humanities and education. Research into: i) the role of music as a therapeutic intervention; and ii) the use of creative approaches to practice development are clearly evident in the literature. What is less evident is the role of music as method. This article is a critical reflection on the novel use of music recordings during qualitative interviews in a small-scale study exploring the role of music in the work and lives of black, Asian and minority ethnic women working in a UK domestic violence and abuse charity. Aim: To describe a critical reflection on music as method in a small-scale qualitative research study. Implications for practice: Music has potential as a model and method in qualitative health and social care research practice, particularly with sensitive topics such as drug misuse or homelessness Music is a means of developing compassion and critically reflective practice development in the field of domestic violence and abuse and other areas of practice

Across the Western world, healthcare services are contending with the challenge of ageing populations. Switzerland is no exception, and faces the need to adapt its healthcare system to the needs of older persons. A disease-oriented approach is ill suited to the varied abilities, preferences and degrees of resilience among older people, and person-centred care is better placed to respond effectively to this situation (Ekman et al., 2013). Our team at the Institute of Higher Education and Research in Healthcare (IUFRS) of the University of Lausanne has developed a research programme to improve the healthcare experiences of older persons during hospitalisation and transition to discharge. We have identified different models and theories that promote a better understanding of the factors that impact on older persons ’lives during these phases and of how to take them into account in nursing practice in order to encourage a person-centred approach. The transition of care from hospital to home is a vulnerable time in the continuum of care for older persons (Arbaje et al., 2014). Transitional care is defined by Coleman and Boult (2003, p 549) as a ‘set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or different levels of care within the same location’. At the theoretical level, Meleis ’transitions theory (2000) provides a perspective for interpreting and planning comprehensive discharge for hospitalised older persons. In designing our research programme, this theory helped us to link the older person’s health problems (conditions of transition) in relation to hospitalisation (nature of transition), discharge preparation (nursing interventions) and the effects on the person (response models) (Mabire et al., 2015). From the transitions theory, Naylor et al. (2017) developed their transitional care model to guide nursing practice during this period. This model includes eight components: Patient engagement Caregiver engagement Complexity and medication management Patient education Caregiver education Patient and caregiver wellbeing Care continuity Accountability

Background: Skilled practice development facilitators are a key factor in practice development. Facilitators not only need technical skills, but also the ability to establish trustful relationships and an environment in which team members feel safe to explore their practice. Aims: The aim of the study was to explore how participants at the International Practice Development Collaborative’s Foundation Practice Development School in German-speaking Switzerland succeed in developing their roles as facilitators in their clinical settings, and which factors support or impede their path towards becoming experienced facilitators. The secondary aim was to identify factors that could inform future practice development foundation schools. Methods: A qualitative approach was chosen, using the structured dialogue technique in the context of group discussions. Data analysis was performed by means of knowledge mapping, following Mayring’s qualitative content analysis. Findings/results: A total of 30 participants of the foundation practice development schools held between 2015 and 2018 attended the group discussions. As novice facilitators, they were highly motivated after the school, but they needed courage to critically analyse their practice within their busy day-to-day work and to take a leading role as facilitators. The study participants are clear that time and space for reflection, support from managers and learning opportunities are preconditions for a successful journey as practice developers. Conclusions and implications for practice: A special focus is needed on the reflective skills of novice facilitators to enable them to take time for self-reflection in busy workplaces The implementation of a mentoring programme for foundation school participants in German-speaking Switzerland has to be considered The involvement of the managers of school attendees needs to be considered from the outset, hence refocusing the preparation work of participants More practical guides and basics in German should be made available

Background and context: This article presents reflections on critical participatory action research into the development of critically reflective practice, conducted by the first author alongside practitioners who work preventively in the field of domestic violence and abuse. It is part of a doctorate in health science undertaken in response to the need to question assumptions, presuppositions and meaning perspectives in what is a complex and harmful area of interprofessional practice. Aims: The research aims are to develop knowledge and professional/interprofessional practice in this ill-defined area of practice in two phases – phase 1: creating opportunities for interprofessional critical reflection; and phase 2: examining the impact this has on individual and collective practice. This article offers an emerging framework for critically reflective interprofessional practice, and critical reflections on phase 1 of the study, from the perspective of insider/practitioner/researcher, through the lenses of sincerity and significance in qualitative research. Implications for practice: The article concludes by proposing potentially important implications for practice development in the following areas: Interprofessional practice The conditions required for developing critically reflective practice How we reveal, understand and work with power dynamics when working with conflict, violence and abuse

Background: Small Acts of Friendship is a project to help make the experiences of older people in an acute NHS hospital more humane. Aim: This research aims to explore how the project encourages human flourishing on wards for older people, using Dewing and McCormack’s (2017) model. We cover the barriers and emotions brought up by such a project, as well as looking for evidence of flourishing and a flourishing workplace. Methods: The qualitative method of experience-based co-design was used to set up and evaluate the project. Data consisted of interviews and observations with staff, relatives and patients involved in the project, and were analysed using comics as a tool for an iterative, deep analysis. Results: The results show how staff and patients responded to the project; the responses have been aligned to stages of Dewing and McCormack’s model. In one area the Small Acts of Friendship project was found to have resulted in a change in culture towards person-centred care. Implications for practice: Reflecting on the project brought out emotions that might ordinarily remain under the surface of practice for staff who look after older people, so they may need to be supported Hospital wards for older people can make changes towards a flourishing workplace through a project such as this

Background: The Student International Community of Practice is a global network of more than 30 doctoral candidates affiliated with the Centre for Person-centred Practice Research, at Queen Margaret University, Edinburgh. An ongoing challenge the community faces is its changing and growing membership; as members progress and complete their doctoral studies they leave the group, and as the centre grows new community members (doctoral candidates) join.
\nAim: To explore and describe the experience of being a member of the Student International Community of Practice, using a creative process of reflection and collaborative analysis, and to identify the implications for the future of the community and the integration of new members. 
\nConclusion: The Student International Community of Practice is a valuable social learning experience for those who are members. It will continue to be a flourishing safe space if, despite its changing membership, we pay explicit attention to our agreed purpose, ways of working and values. 
\nImplications for practice/academic research: 
\nBelonging to a sustainable and flourishing community of practice enhances learning, and decreases isolation and loneliness on the doctoral journey
\nA community of practice is sustainable when it is underpinned by a clear purpose, agreed ways of working and values, to which all members consistently pay explicit attention

Background: Attending to culture is central to developing workplaces that are safe and effective – those
\nthat prioritise learning to support continuing quality, person-centred relationships and the wellbeing
\nof providers and recipients of care. Culture at the microsystems level, where care is experienced
\nand provided, directly impacts on staff and patients but is generally given much less attention than
\norganisational cultures at the meso level. This paper presents a refinement of a previously published
\nmiddle-range theory of culture change derived from a concept analysis of effective workplace culture.
\nIt draws on findings from a project that set out to embed a safety culture and grow quality improvement
\nand leadership capability through a regional patient safety initiative in frontline teams across four
\nacute NHS hospital trusts in south-east England.
\nAims and objectives: To refine theoretical understanding about how to recognise and develop effective
\nworkplace cultures at the microsystems level based on practical insights from the Safety Culture
\nQuality Improvement Realist Evaluation (SCQIRE) project.
\nMethods: The evaluation approach for the SCQIRE project combined realist evaluation and practice
\ndevelopment methodology. Realist evaluation was selected to answer the question ‘what works for
\nwhom and why when embedding a safety culture, improvement capability and leadership in frontline
\nteams?’ Key to this approach is the local development, testing and refinement of ‘CMO’ relationships
\nbetween: contexts (C); mechanisms, for example triggers and explaining why components work (M);
\nand outcomes (O). Drawing on project data, the enablers, attributes and consequences of an effective
\nworkplace culture have been used to critically examine the factors that contributed to frontline teams’
\nability to create and sustain a safety culture.
\nFindings: A total of 24 CMO relationships resulted in four emerging programme theories that described
\nwhat worked, why and for whom in relation to: 1) frontline teams developing their safety culture; 2)
\nfacilitators working with frontline teams to embed safety culture, quality improvement and leadership;
\n3) organisations supporting frontline teams; and 4) the patient safety collaborative initiative.
\nConclusions: It is concluded that the close relationship between person-centred values, ways of
\nworking and continuing effectiveness mean it is not possible to develop a safety culture without
\nalso being person-centred in relationships. Other theoretical refinements proposed include greater
\nemphasis on the role of appreciative active learning, person-centredness in everyday relationships
\nand an integrated approach to learning, development and improvement embedded at both micro and
\nInternational Practice
\nDevelopment Journal
\nOnline journal of FoNS in association with the IPDC and PcP-ICoP (ISSN 2046-9292)
\nWorking together
\nto develop practice
\nPerson-centred Practice
\nInternational Community
\nof Practice
\n2
\n© The Authors 2019 International Practice Development Journal 9 (2) [4]
\nfons.org/library/journal-ipdj-home
\nmeso levels. The theory strengthens individual enablers of safety culture, with particular attention
\ngiven to quality clinical leadership based on an inclusive, participative, collaborative approach involving
\nall stakeholders, and to facilitation that embraces all the skills required for learning, developing and
\nimproving with person-centred values. Organisational enablers emphasise the need for a corporate
\nbody of facilitators to support frontline teams, as well as the role of senior organisational leaders in
\nenabling a bottom-up approach to supporting quality and innovation.
\nImplications for practice:
\n• Safety and person-centred values are interdependent with ways of working in relationships and
\nongoing team effectiveness. None of these can be considered without the others
\n• Investment in quality clinical leadership is essential for the development of high-performing
\nteams, safety culture, achievement of shared meanings and direction, and valuing of engagement
\nof both staff and patients
\n• Facilitators supporting frontline teams require corporate support and a wide range of skills
\nincluding leadership, the ability to promote engagement in co-creating meaning, and appreciative
\nlearning that draws on the workplace as a powerful resource
\n• Senior organisational leaders need to model organisational values in every situation but also
\nbe skilled at enabling frontline teams to become empowered through supporting a bottom-up
\napproach to innovation and change

Background: Poor control and concordance with treatment in children’s asthma remain a priority, despite advances in treatment. Play and storytelling are often neglected as ways of improving health literacy in children with asthma and their families.
\nAims: The author, a nurse entrepreneur, tests the idea of seeing citizens and communities as assets, who can cascade asthma knowledge in fun ways, to complement the dominant service-led and needs-focused paradigms. This reflection explores the evidence base for how children learn through play and how it accords with her own nursing instinct. 
\nConclusion: Children, their families and communities can learn, recall and share asthma knowledge learned through play. Storytelling can foster co-operative behaviours and encourage children to take responsibility. Asthma in children is often an emotive subject, drawing citizens and organisations towards health professionals to offer themselves as assets: people with skills and strengths to share. 
\nImplications for practice: 
\nThe incorporation of play-based asthma education in the community is intuitive but would represent a cultural change that could be challenging. Simple approaches, such as telling a well-known fairytale, appear more acceptable than more complex approaches such as incorporating play into group consultations or ‘asthma parties’
\nSole nurse entrepreneurs can face challenges in securing funding to test innovations that lack impact measures: a ‘Catch 22’ situation 
\n

<b>Background</b><br/>Collaboratively exploring what matters to people, their understanding of concepts and ideas for innovation can be a challenge in practice development, research and education due to potential difficulties in articulating complex issues. Visual Inquiry is described as a process which involves the use of generic images to facilitate dynamic dialogue between the inquirer and participant/s, in order to support shared understanding and co-production of knowledge.<br/><br/><b>Aim</b><br/>The aim was twofold, firstly to describe the Visual Inquiry method and secondly to explore the experiences of using Visual Inquiry in practice development, research and education.<br/><br/><b>Research Design</b><br/>Qualitative data was generated from a group of academics (n=8) who took part in a Co-operative inquiry, exploring their experience of using this method (Visual inquiry) in fifteen independent studies.<br/><br/><b>Findings</b><br/>Eight academics (inquirers) drew on their experience of using Visual Inquiry from fifteen independent studies. Analysis of the qualitative data identified eight themes in relation to the process and outcomes of using Visual Inquiry; Evocative Participation; Playfulness; Holding vulnerability; Welcoming authenticity; Illumination; Surfacing depth; Unearthing possibilities; Evoking surprise and Provocation.<br/><br/><b>Conclusion</b><br/>Visual Inquiry was found to be a useful method for opening up dialogue which allowed the facilitator to adapt a flexible approach and the participant to richly articulate insights on their cognitive, emotional and experiential worlds.