title: Sustaining a culture of practice development in an acute adolescent inpatient mental health unit.
abstract: OBJECTIVE
  It is recognized that facilitating change in workplace culture is a significant challenge in healthcare service delivery. Practice development strategies and principles provide a framework for initiating and sustaining programs focused on enhancing patient-centered care by concentrating on the therapeutic attributes of nursing. However, little literature exists on explicating "what worked" in practice development programs.
  
  
  OBJECTIVE
  This paper details the processes, people, resources, and relationships that enabled the successful implementation, and led to the sustainability, of a practice development program employed in an acute adolescent mental health unit in Sydney, Australia.
  
  
  METHODS
  Following an external review of the unit, a meeting of key stakeholders was convened and subsequently an advisory panel formed to address specific issues facing nursing staff. This process resulted in the development of an educational package and adoption of the tidal model as the framework for mental health nursing practice in the unit. Clinical reasoning sessions and journal article presentations were incorporated to consolidate and maintain the change in nursing care.
  
  
  CONCLUSIONS
  A planned, structured, and inclusive practice development program has transformed the nursing culture and vastly improved the care provided to adolescents presenting in acute states of distress to this mental health unit.
authors.affiliation: Clinical Coordination South Western Sydney Local Health District Mental Health Service, Sydney, NSW, Australia.
authors.forename: Natalie
authors.initials: N
authors.lastname: Vella
authors.forename: Laura
authors.initials: L
authors.lastname: Page
authors.forename: Clair
authors.initials: C
authors.lastname: Edwards
authors.forename: Timothy
authors.initials: T
authors.lastname: Wand
mesh_terms: D000293:Adolescent; D006801:Humans; D007297:Inpatients; D017410:Practice Guidelines as Topic / Q000592:standards*; D011567:Psychiatric Department, Hospital / Q000458:organization & administration* / Q000592:standards; D011568:Psychiatric Nursing / Q000379:methods* / Q000592:standards
keywords: Adolescent mental health; practice development; tidal model