ABSTRACT
The following case study examples demonstrate how nurses and healthcare professionals are making efforts to change behaviour, practice, the community and the environment. Each example illustrates one of the eight quality criteria cited in the previous chapter:
• Holistic view of health • Health alliances/multidisciplinary working • Needs assessment • Research-based approach • Intensive/multifaceted approach • Audit/evaluation • Cultural needs • Importance of the setting, delivery agent and training • Community development • Empowerment
In many cases professional boundaries and statutory organizations have been opened up, have been made more flexible and have developed more co-operative negotiated approaches to areas of health and social need. Issues such as openness, structure, equity and accessibility have been addressed. The approaches empower patients and clients to seek active involvement in various aspects of health promotion. As is evidenced by the case studies, practitioners are bringing together skills in articulating health and social need problems, sustaining alliances and evaluating services, recognizing the benefits of informed practice and care. They are offering flexible services that are wide-ranging and socially orientated and building stronger working teams. They include community health needs assessment based on profiles, development of health promotion programmes and health alliances, community initiatives, specialist services and community-based services across GP and inter-agency boundaries. The list below offers examples of the applications from the case studies:
• a wide range of the delivery service areas such as community, primary healthcare, hospital, voluntary sector
• a wide range of different roles undertaken by nurses, midwives and health visitors in collaboration with other professions and client groups
• illustrations of several types of nursing practice – clinical, managerial, facilitator, leadership roles, voluntary capacity, education and research
• a range of new service developments such as major funding extensions, changes to service, and existing practice well done.
