Edinburgh Napier University

  Background: Service improvement to enhance care quality is a key nursing responsibility. Developing sustainable skills and knowledge to become confident, capable service improvement practitioners is important for nurses in order to continually improve practice. How this happens is under researched. Aim and research design: A hermeneutic pas, longitudinal study in Northern England aimed to better understand service improvement lived experiences of participants as they progressed from undergraduate adult nursing students to registrants. Method: Twenty, year 3, student adult nurses were purposively selected to participate in individual semi-structured interviews just prior to graduation and up to 12 months post-registration. Hermeneutic circle data analysis was used. Findings: Themes identified were (1) service improvement learning in nursing; (2) socialisation in nursing practice; (3) power and powerlessness in the clinical setting; and (4) overcoming service improvement challenges. At the end of the study, participants developed seven positive adaptive behaviours to support their service improvement practice and the ?Model of Self-efficacy in Service Improvement Enablement? was developed. Conclusion: This study provides a model to use to enable student and registered nurses to develop and sustain service improvement capability.