文本框: QUALITATIVE EVALUATION OF THE "ADVANCED RESPIRATORY MODULES'" IMPACT ON NURSING PRACTICE IN A PAEDIATRIC CRITICAL CARE ENVIRONMENT: A THEMATIC ANALYSIS Boyle BB. Cardio Respiratory and Critical Care Directorate, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK Background: Senior paediatric nurses on one high dependency and three intensive care areas complete an advanced respiratory module which enables them to make autonomous decisions when altering mechanical ventilation without adhering to any protocol. The course is part of a larger project aimed at advancing nursing practice. Aim: To evaluate the "Advanced Respiratory Modules'" impact on Practice. Method: Representatives of all grades of nursing, educational and medical staff were invited to participate in focus group discussions. These discussions were audiotaped and transcribed, then analysed with the help of NUD*IST software. Results: The transcriptions were coded into fifty catagories from which themes emerged around the course it's self, the concept of reward, the nature nursing and the patterns followed when nursing practice advances. Conclusions: The course is perceived as being labour intensive for particapants and their mentors. It is thought to impact on practice in a positive way and the nurses involved report personal development which goes far beyond weaning mechanical ventilation. Change is happening slowly, and there are paralell developments which are also seen as advancing nursing practice. The challenge will be to use the themes identified to plan future development which will meet all the directorate's needs. 1966