Practice development within a neonatal intensive care unit. Innovation or expectation

Practice development encompasses a variety of activities, which interlink and affect strategies for change management and enhancing quality of care. The concept is not new, as those involved in the continual evolution of healthcare will acknowledge. However, within the current climate of health care whose focus centres on modernisation, best practice and the use of evidence to support clinical practices increasing recognition has been given to the term.The birth of practice development within the nursing profession was primarily introduced during the transitional and reforming period of the late 1970s and early 1980s. At this time the nursing profession was shifting from task-orientated and ritualistic practices towards a holistic, patient- centred and in neonatal units a family-centred approach to care, which included standardisation and evaluation of practices. The quest for nursing to be recognised as a profession in its own right appears to have been a crucial phase in enhancing the role of practice development, a concept supported by the desire for nurses to form their own evidence base for practice. The progression in the 1990’s towards a family-centred oriented approach to care using nursing models to support care planning, as opposed to the application and acceptance of a medical model of care appeared to increased the emphasis on clinical effectiveness and outcomes in neonatal care. Subsequently the modernisation process and the clinical governance framework seek a commitment from organisations not only for the provision of high quality healthcare, but to endorse practice development activities through inter professional team working which is centred on the neonate and their families.