Understanding Professional Advocacy: A Mixed Method Protocol to Explore Professional Nurse Advocacy and Professional Midwifery Advocacy in one UK NHS Trust. (Preprint)

Abstract

In the UK, the concept of Professional Advocacy was introduced in the midwifery profession in 2017. In response to the C-19 pandemic, the Chief Nurse for England directed it be rolled wider to the UK Registered Nurse population, developing the Professional Nursing Advocate role. To date, however, little is known about the impact of the professional advocacy roll on the day-to-day experiences of the nursing and midwifery workforce, nor if it helps improve quality in practice, nurse/midwife wellbeing and retention.

The research will explore how the Professional Nursing Advocate (PNA) and Professional Midwifery Advocate (PMA) roles are embedded in one UK NHS Acute Trust, with focus toward: the PNA/PMA experience; the whole nursing/midwifery staff use of the role; Quality Improvement in Practice (QiP); nurse/midwife wellbeing and nurse/midwife retention.

This multistage mixed method study is designed over four workstreams: Workstream 1 explores the organisational context of PNA/PMA roles and organisational statistics on QiP, wellbeing and retention. Workstream 2 uses semi-structured interviews with PNA/PMAs in that organisation to understand their experiences of being a PNA/PMA, what they do in the role, and how they feel it may impact on nurse/midwifes QiP, wellbeing and retention. Workstream 3 is twofold: Part A will survey the organisations whole nurse and midwifery population to understand nurses/midwives’ awareness/access/understanding of the role. Part B will hold focus group with nurses/midwives. The first focus group will be with nurses/midwives who have actively used the PNA/PMA role. The second focus group will be with nurses/midwives who have not yet consulted with PNA/PMA. Workstream 4 will co-design, with PNAs/PMAs, nurses and midwives, recommendations to inform local policy, practice, and implementation of the PNA/PMA role across the organisation.

Integration of the findings from the 4 workstreams will lead the organisational implementation of the PMA/ PNA role, map nurses/midwives’ routes to access PMA/PNA’s, develop strategies for how the role can be used in relation to QiP, staff wellbeing and retention, and provide recommendations for local policy.

The findings will be translated to inform national policy and implementation of the PNA/PMA role and will be translated to inform allied health professionals’ development of the professional advocacy role.