Developing discharge practice through education: Module development, delivery and outcomes
Introduction
This article discusses the development of a part time, post registration discharge practice education module including its content, delivery and outcomes. The module is entitled, Facilitating Timely Patient Discharge.
This title was devised to align with the national multi-professional toolkit (Department of Health, DH, 2004b) and to endorse the proactive multi-professional concept of discharge practice. It was aimed at a range of practitioners working in health and social care settings, detracting from an approach focussed solely on ‘nursing’ or ‘medicine’ (Gair and Hartery, 2001, Opic, 1997).
The module was validated by the Birmingham City University in the UK and upon successful completion 12 degree level university academic transferrable credits are awarded. This module can be selected on the Dimensions in Healthcare pathway – a new and flexible approach to learning beyond registration, linked to the National Health Service (NHS) Knowledge and Skills Framework (KSF), used to design job descriptions nationally, initiated by the Department of Health (Department of Health, 2004a, Department of Health, 2004b). The KSF framework describes the knowledge and skills required for different pay banding for registered staff from band 5 (junior posts) to Band 8 (senior posts).
Section snippets
Background
There has been a renewed and lasting focus upon discharge practice throughout NHS Trusts over the past decade (DH, 2003). For nurses, this focus was promulgated by the ten key roles for nursing, one of which was ‘leading admission and discharge of patients’ (DH, 2000). Further momentum originated from the NHS focus on reducing length of stay and the introduction of ‘Lean’ principles.
Lean is a method used to reduce wastage through overlaps and unnecessary steps in manufacturing processes (DH,
How education is traditionally delivered
The Heart of England Foundation Trust (HEFT) is not too dissimilar to other acute trusts, in terms of its traditional approach to education delivery. Nursing education and training was delivered primarily from a Practice & Professional Development Team. There were informal links to the knowledge and skills framework (Department of Health, 2004a, Department of Health, 2004b) governance, operational or quality agendas but a lack of clarity in terms of assessing the impact of education back into
Developing the module
The module development commenced in 2005; innovative ideas were generated from practice settings within the HEFT shared with Birmingham City University. Such a collaborative approach is commensurate with the educational remit of a consultant nurse post, ‘influencing and developing new education modules’ (Manley, 1997, Manley, 2000a). Nevertheless, the concepts education, training and teaching, are frequently used synonymously and the difference between each is not well understood. While there
Delivery of the module
A problem faced by Trusts, is the difficulty in releasing clinical staff from their place of work (Ayer, 1998, Chapman and Howkins, 2003). When revisiting the delivery the module team explored the options and benefits of a modified approach; delivering the module away from the University to maximise student uptake and attendance (Ayer, 1998). It was agreed to deliver the module on site, at the Hospital and to deliver each session over 3 h per week. The students were expected through project and
The assignment
An academic assignment was set as a 3000 word case study, written at Level 6. The rationale underpinning the approach was to enable Birmingham City University to assess the academic outcome, accredit the students with twelve points at degree level and link the work to practice issues. Case studies require the consideration of storytelling which is a traditional means of sharing information and in doing so develops student skills to become a more reflective practitioner (McDrury and Alterio, 2007
Evaluation of the module results
Throughout the module student attendance was not compulsory for every session, which resulted in part and full module attendance. The rationale was to facilitate adult learning where the student can decide if they needed to attend the lecture or not.
Limitations
In the spirit of adult education students are allowed to attend lectures where they feel learning is needed, hence it is not possible to measure the extent to which incomplete attendance may have adversely influenced the results of the case study assignment mark awarded, or their self assessment using the questionnaires.
Permission to share the individual results from the questionnaires was not sought from the students and these could not be shared.
Conclusion
Modernising nursing careers offers one framework in which nurses will train, develop and apply life long learning in the future (O’Dowd, 2007). It is also feasible, that as workforce and service redesign priorities gathers pace, education funding routes could also change to a position where funding is directed away from professional development and toward workforce and service reconfiguration. Only by truly reflecting the clinical and service needs together into the commissioning process, as
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