Managing the development of practice
While the concept of practice development is nebulous and ill defined, most nurses can recognize when they and their colleagues are engaged in the process. Like research, writers often present the process of developing their practice as very linear. This can lead to practitioners becoming confused when their attempts to introduce change are met with barriers and resistance. This chapter explores the nature of practice development in nursing, describing how individual, organizational and structural factors can either drive or suppress it. The implementation of most developments in practice draws heavily upon the theories of introducing change and innovation. Indeed, within this chapter, the author asserts that practice development is merely a specialized form of innovation. Managing the development of practice, whether as a practitioner, manager or facilitator, is a complex process which involves considerable skill in balancing the needs and desires of patients, professionals and the organization. Indeed, it is these interpersonal aspects of practice development activity that often make the process seem messy and uncoordinated. By examining actual developments, we hope to illustrate how success can be achieved, and failure minimized. Finally, the 'laggards' get their day, when the chapter looks at the nature of resistance to change, and how and why people react as they do to proposed changes in their day to day work.
Practice development is now a key feature of modem health care delivery. Health care professionals are being encouraged to develop both