Page 660 - alligood 8th edition_Neat

CHAPTER 32 Phil Barker 641
Education that correlated with the speed of assessment, and a
Barker and Buchanan-Barker offer a free training decrease in incidents of violence, self-harm, and use of
manual for download from their website (www. restraints. Nurses themselves reported that the Tidal
tidal-model.com). This package is used as the basic Model enhanced professional practice and encour-
preparation for implementation of the model, ensur- aged fuller engagement with persons-in-care. It was
ing fidelity to the values, principles, and processes useful in helping persons fulfill care plans and enabled
of the Tidal Model, while allowing creative, locally nurses to focus their interactions on persons’ needs.
relevant implementation. Support workers were more able to help persons iden-
The Tidal Model has been integrated into under- tify goals and targets for the day and carry them out;
graduate and postgraduate programs in most UK they described the Tidal Model as a way of raising
universities and has been the focus of many graduate their profile and professional esteem (Stevenson &
and postgraduate projects and theses at many inter- Fletcher, 2002, p. 35). Similar findings, using the same
national universities from the United States to the method, were reported in Birmingham, the second
Philippines. At the University of Ottawa, Canada, city in England to implement the Tidal Model (Gordon,
and Dalhousie University in Nova Scotia, the Tidal Morton, & Brooks, 2005), Glasgow, the largest city in
Model is included in undergraduate and graduate Scotland (Lafferty & Davidson, 2006), and Dublin, the
courses. The Tidal Model anchors the mental health capital of Ireland. These studies provide evidence
nursing residency program developed collaboratively for the implementation of this person-centered theory
by five tertiary mental health centers in Ontario. The in practice.
holistic, strength-based, narrative Tidal Model holds Barker and Walker (2000) studied senior nurses’
great promise for inclusion in educational programs views of multidisciplinary teamwork in 26 acute psy-
concerned with theory-based practice and person- chiatric admission units and the relationship to the
centered care. care of persons and their families. While nurses face
challenges in implementing “working in partnership,”
Research the study provides some direction for further inquiry
The Tidal Model developed from a clinical research around the interprofessional nature of the theory.
program. All International Tidal Model network The transition for nurses to a solution focus in
members are encouraged to evaluate the model in interactions was the subject of study by the Newcastle
practice. A research and development consultancy team (Stevenson, Jackson, & Barker, 2003). Nurses
was established as a loose network for Tidal Model participated in a specially tailored solution education
implementation and development projects. The con- initiative, and the impact was assessed for both nurses
sultancy provides a framework for evaluation of the and persons-in-care using multiple data sources. This
Tidal Model in action from the perspective of orga- study provides strong evidence of significant im-
nizational outcome, professional experience, and provement in nurses’ solution-focused knowledge,
user/consumer experience (Barker & Buchanan- performance, and use in practice. Persons-in-care
Barker, 2005). The important task of evaluating also found the approach helpful.
the implementation, processes, and outcomes of The Royal Ottawa Mental Health Centre Tidal
the Tidal Model in practice is ongoing in Canada, team replicated the Newcastle study and assessed the
Ireland, Japan, and New Zealand and across the impact of implementation of the Tidal Model on
United Kingdom. selected outcome measures over four time periods in
Two evaluation studies (Fletcher & Stevenson, the three pioneer programs, with similar results par-
2001; Stevenson & Fletcher, 2002) explored outcome ticularly in the Mood program. They also replicated
measures important in evaluating the Tidal Model and the Newcastle study over four time periods in the
evaluated the impact of the Tidal Model assessment in Forensic Program at the Brockville site. The Tosnu
practice (Stevenson & Fletcher, 2002). Results of both team completed a user-focused evaluation of the
studies indicate an increase in the number of admis- Tidal Model implementation. In Birmingham, on the
sions and a decrease in the length of stay. There was a Tolkien ward, a 4-month evaluation has been com-
decrease in need for the highest level of observation pleted and published (Gordon, Morton, & Brooks,