Measuring implementation

I'm curious to know how implementer wards are going about measuring the degree to which the interventions are actually being used on a day to day basis. I know the research team used "fidelity measures", and we intend to use the Staff-Patient Conflict Checklist to measure the levels of conflict and containment, but obviously if we're using the interventions appropriately and regularly, there will be fewer/no incidents of conflict and containment. I'm trying to come up with ideas of how we can measure/record the actual use. Calm Down Methods includes a log book for the use of items, MHM will have notes/minutes of meetings, but the likes of Soft Words and Reassurance are "softer" interventions which are equally effective, but how on earth do you record it! Nursing notes is fine, but I feel we need a way of recording generally - feels as though it should be a form of some sort, but that's only useful if it's used. I feel as if I'm being a bit vague here, but I guess you'll understand what I mean! :S

Thanks in advance for any replies!!

Sian

Hi Sian,

I don't know whether this will help, because I am not a big fan of counting things unless there is a really strong reason, and even then, only for as along as it is necessary and not a moment longer.

I would suggest you think about fidelity in a different way. More in terms of trying to work with your team to maximise the potential of the interventions. So, for example, you could take time to talk to the team about selected soft words posters and ask them to share examples of how they've used or applied them, successfully or unsuccessfully. This gives everyone a reminder so that the techniques is accessible to them to choose when they need to - you can't choose what you don't remember. It also harnesses the expertise of your team to sharpen and improve the content of the intervention. For talk down, you may want to use it as a debriefing tool - what was tried, what was not tried, etc.

You could think of similar angles on each of the interventions that ensures they get used and therefore fidelity increases, without relying on counting. Instead rely on your team, make sure they know you are relying on them, and they will come up with the goods, as it were.

Maybe others will have other suggestions.

Good luck,

Len

PS I showed some pictures of your team and their work at the MHND&LF meeting yesterday!

Good idea, we have some debriefs coming up this week, after a particularly difficult spell on the ward, and I think that would be a good way of embedding the use of Soft Words particularly into the approach. Such a powerful little tool which is easily dismissed!
Sian