title: Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.
abstract: BACKGROUND
  Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations.
  
  
  OBJECTIVE
  The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum.
  
  
  METHODS
  A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach.
  
  
  RESULTS
  Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff.
  
  
  CONCLUSIONS
  Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential.
authors.affiliation: Faculty of Health and Social Care, London South Bank University London, United Kingdom; University College London Hospitals, London, United Kingdom. Electronic address: baillil2@lsbu.ac.uk.
authors.forename: Lesley
authors.initials: L
authors.lastname: Baillie
authors.affiliation: Faculty of Health and Social Sciences, University of Bedfordshire, United Kingdom. Electronic address: Barbara.Bromley@beds.ac.uk.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bromley
authors.affiliation: Faculty of Health and Social Sciences, University of Bedfordshire, United Kingdom. Electronic address: Moira.Walker@beds.ac.uk.
authors.forename: Moira
authors.initials: M
authors.lastname: Walker
authors.affiliation: University of Surrey, Guildford, Surrey, United Kingdom. Electronic address: r.l.jones@surrey.ac.uk.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jones
authors.affiliation: University of Bedfordshire, United Kingdom. Electronic address: Fortune.Mhlanga@beds.ac.uk.
authors.forename: Fortune
authors.initials: F
authors.lastname: Mhlanga
mesh_terms: D004508:Education, Nursing, Baccalaureate / Q000592:standards* / Q000639:trends; D017144:Focus Groups; D006801:Humans; D008611:Mentors / Q000523:psychology*; D017145:Models, Educational; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D058996:Quality Improvement / Q000592:standards; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Clinical practice; Dissertation; Evaluation; Service improvement projects; Student nurses