Background High quality palliative care requires skilled staff who keep up to date, despite busy clinical environments. The increasing pressure of mandatory training poses another challenge for palliative care learning.

Aim The aim of this initiative was to implement a ‘bottom up’ approach to professional development for hospice ward nurses using a Plan-Do-Check-Act (PDCA) cycle, supported by a clinical practice facilitator over 1 year.

Method Planning from January to April 2011: data was collected from three sources to triangulate findings on professional development needs: • Questionnaire: ward nursing staff • One to one interviews: multidisciplinary team members • Thematic analysis: anonymised personal development plans from ward nurses' appraisals over past 12 months Analysis provided understanding of ward nurses' learning preferences, perceived gaps and learning needs, barriers to participation in learning and factors which they felt would facilitate professional development. The next stage – ‘doing’ – involved identifying and trying out multiple approaches: • designing and giving each nurse a mandatory training record • whole-ward focus on specific mandatory training requirements, paced across the year • identifying and supporting ward champions in specific areas, for example, wound care, diabetes, etc. • establishing a weekly protected learning hour for ward nurses, involving medical and other staff in teaching and learning together • one to one coaching in computer skills for online learning • establishing clinical and practical ‘topic of the month’ for ward staff nurses, and separate parallel programme for clinical support workers. In December, questionnaires will be repeated to ‘check’ change in confidence, attitude, behaviour and perception. Analysis of this, and on-going evaluation of learning activities, will inform the ‘action’ phase of the cycle.

Conclusion Details of the PDCA cycle will be ready for reporting by February 2012.