Professional Documents
Culture Documents
In Nursing
4 Expert opinion
The process of changing practice
Dissemination
Implementation
Diagnosing the challenges to
changing practice
Identifying all the groups involved in, affected by, or
influencing the proposed change (s) in practice
Assessing the characteristics of the proposed change that
might influence its adoption
Assessing the preparedness of the health professionals to
change and other potentially relevant internal factors
within the target group
Identifying the potential external barriers to change
Identifying the likely enabling factors, including resources
and skills
Methods exists for gaining
a purchase
Surveying key groups of stakeholders (such as senior staff,
managers, and patient representatives
Adapting ward meetings or clinical supervision sessions so
that potential problems can be identified, recorded and fed
into the strategic planning process
Establishing a focus group of professionals, managers and,
where appropriate, patient representatives, to identify
pertinent barriers and drivers
Isolating some of the barriers to research uptake in clinical
practice
Common complexities associated
with nursing and research use
Professional culture
Clinical information
Environment
Individual decision – maker
Knowledge and educational attainment
Valuing research
Valuing change
Forces working for and against an evidence-based
organizational culture
Planning for and managing
resistance and change
Social marketing mode
The model has six stages:
Research the group(s) you wish to target and identify the
resources you have available to help you achieve the
change
Select the 'raw materials' for the change you want to
introduce
Develop and pilot the materials used to facilitate the
change
Implement the change
Evaluation
Feedback
Precede—proceed mode
Its name is derived from the fact that it specifies the steps
that should precede any change and the ways in which
organizations should proceed with the change
Clinical guidelines
Reminder
Multifaceted interventions
Mixed effects
Audit and feedback
Little or no effect
Strategies to Overcome Challenges
Lack of collaboration
Implement a collaborative planning model