Integrating the sciences of improvement, implementation and managing change in nursing practice

Creating and integrating change is central to healthcare practice that is responsive to advancements in technology, best practice evidence and shifting societal needs. Comprising over half the healthcare workforce and accounting for approximately 90% of all patient contacts, nurses and midwives have a substantial presence at every level of health services, systems and their governance. Making change happen is therefore often contingent on a nursing workforce that is willing and able to adapt their practice and support others to do so. Change predominantly involves (a) local-level changes to improve service and team function, (b) changes to facilitate the translation of evidence into practice and (c) changes to achieve strategic service- or system-level goals. Evidence-based approaches: Improvement Science, Implementation Science and Strategic Change Management, can support these broad types of change and with a central role in developing and implementing healthcare change, nurses are increasingly required to have requisite knowledge of these approaches. Despite featuring to varying extents in nursing curricula and research, understanding of how they may inform one another and interface in clinical practice is limited. This paper summarises the current integration of quality improvement, implementation and managing change in nursing curricula and outlines strategies for addressing this to enable nurses to better lead and support change for healthcare improvement.