Understanding Professional Advocacy: A Mixed Method Approach to Explore Professional Nurse Advocacy and Professional Midwifery Advocacy in one NHS Trust

Abstract

Abstract Background: In the UK, specific Professional Nurse Advocates (PNA) and Professional Midwifery Advocates (PMA) centres nurses and midwives as integral to quality improvement in practice (QiP), workforce retention and transformation. However, little is known about the potential impact the PNA/PMA role might have on the daily practice of nurses and midwives, quality in practice, professional wellbeing, and retention. This project, funded by one large NHS Trust in the UK, seeks to explore, and understand the impact (if any) of the PNA/PMA role in relation to nurse/midwife involvement in QiP, professional wellbeing, and the retention of nurses/midwives in that Trust. The focus is on the key issues of the lived experience of current PNA’s/PMA’s; the wider nursing/midwifery workforce perspective of the use (or no use of) of the PNA/PNA role; the link (if any) on quality improvement in practice (QiP); and the workforce impact (if any) on nurse/midwife professional wellbeing and nurse/midwife retention in the organisation. Methods: This study is mixed method and multistage design: Workstream 1 identifies the organisational context statistics of QiP, wellbeing and retention to understand difference (if any) before and after the implementation of the PNA/PMA role. Workstream 2 explores the experience of being a PNA/PMA using semi-structured interviews (n 15). Workstream 3 is twofold: Part i surveys the nurse and midwifery staff (n = 450) awareness/access/understanding of the PNA/PMA role. Part ii includes two focus groups (n = 20) to detail the experiences of those who have actively consulted with a PNA/PMA, the other for those who have not yet consulted with PNA/PMA. Workstream 4 collates collected evidence to co-design, with PNAs/PMAs, nurses and midwives, recommendations for local policy, practice, and the implementation of the PNA/PMA role across the organisation. Discussion: The integrated findings will inform the future organisational implementation of the PMA/ PNA role, strategies to develop the PNA/PMA role in relation to QiP, staff wellbeing, retention and sustainable approaches for increasing the number of PNA/PMA’s. The evidence will inform local and national implementation policy across diverse NHS services and future development of the professional advocacy role for allied health professionals. Trial registration NA