Developing and implementing a nursing professional practice model in a large health system

A large healthcare system was challenged to develop a nursing professional practice model that would apply to and be understood by nurses at all levels and across all entities of the organization. A team was convened, composed of direct care nurses, educators, clinical nurse specialists, Magnet program directors, managers, and directors, representing 5 hospitals, the organization institute for nursing, and system support services. The group drafted a model describing nursing across the organization. The draft model was vetted in nursing governance councils across the entity. The model includes a theoretical framework; a mission, vision, and values; elements of professional practice; internal accountabilities; and nursing outcomes. Nurses learned about the model through Web-based and face-to-face training, through participation in a professional practice model blog and group discussions.     

Rebuilding a professional practice model. The return of role-based practice accountability

There is no patient care without clinical practice. To improve the quality of health care, organizations must build a finely tuned and resilient clinical enterprise, one founded on clear role accountability and decision authority within the team. The author views scope of practice and professional standards as the foundation for practice accountability and decision authority. A case is made that an interdisciplinary, professional practice model is an appropriate delivery model in today's health care environment; a model that places the professional role in its rightful place as decision maker and supports the role's inherent accountability to evaluate and monitor practice performance. The importance of measuring professional practice performance is seen as a key link toward better understanding ways to reduce error and ensure patient safety.     

Collaborative care: a professional practice model.

Healthcare economics has caused dramatic changes in resource assessment, utilization, and reorganization in hospitals. To address the mismatch between demand and resources and to ensure quality at the bedside, staff members at a 354-bed acute care facility designed and implemented the Collaborative Care Model (CCM). The authors describe this theory-based, collaborative, multidisciplinary professional practice model.     

An innovative professional nursing practice model.

Nursing, as with health care delivery, is changing to meet the greater challenges brought about by managed care and the accompanying external forces in the marketplace. Nurses, with their vast resources of knowledge and experience, are crucial in achieving optimal quality care. Given the opportunity to redefine and strengthen the impact of nursing practice at Piedmont Medical Center in Atlanta, Georgia, a group of advanced practice nurses began developing a unique practice model. The resulting Professional Nursing Practice Model--a theoretical framework created for nurses by nurses--presents a common vision of human beings, health, and nursing in accordance with the values and beliefs of nursing. This model demonstrates the importance of a person-centered, value-driven nursing practice across the continuum of health from birth to death.     

Promoting professional nursing practice: linking a professional practice model to performance expectations

Professional practice models (PPMs) provide the conceptual framework for establishing professional nursing practice. Integrating a PPM requires complex organizational change. One strategy for integrating a PPM is to directly link the PPM with performance expectations to ensure that underlying beliefs are integrated into everyday practice. This article describes the development, implementation, and successful outcomes of a clinical advancement system that was aligned with a PPM.     

The influence of liberal education on professional nursing practice: a proposed model.

Nursing has embraced philosophically the importance of liberal education to professional practice. Yet there has been little exploration of how and if liberal education influences professional action. Based on a series of studies designed to examine the role of liberal education in professional practice, this article describes six competencies related to liberal and professional education and puts forth a model of practice that appears to be influenced by liberal education.     

Differentiated group professional practice in nursing: a demonstration model.

This innovative professional practice model was developed to assist in the redesign of the current nursing care delivery system in hospitals. It is expected that this model will facilitate the promotion of professional practice and that the results will be positive ones for patients, nurses, and hospitals. As Barry and Gibbons wrote recently, "Changing circumstances have become so compelling that it is no longer a question of whether familiar systems need redesigning, but rather how soon and by what means a different system will take place of the existing one."     

Achieving a professional practice model. How primary nursing can help

The authors of this article show how a change to primary nursing causes a series of predictable changes in hospital organizations and nursing departments. They conceptualize the series of changes as a continuum. Using their continuum as a framework, they analyze primary nursing at six acute care hospitals, noting how the changes in nursing practice affect seven key variables in the organization. Nursing leaders may wish to use the insights provided by the framework to push their organizations further toward the goal of more autonomy, power, and achieving a model of professional practice.     

The transformational model for professional practice: a system integration focus

Healthcare organizations face the increasingly difficult challenge of providing services that are of high quality, reasonable cost, and easy accessibility for their constituents. Mergers and acquisitions are one strategy for accomplishing this, but in doing so it is critical to have a "road map" to create an integrated system, rather than merely a consortium of hospitals. The University of Pittsburgh Medical Center has successfully created an integrated healthcare system of 19 hospitals. The authors describe the professional practice model used as a framework for success in integrating patient care.     

高职护理专业实践教学的管理及效果

目的 探讨有效的高职护理专业实践教学模式.方法 对实验组护生进行实践教学模式改革,采用“2+1”和“16 +2”的“在校实训-临床见习-临床实习”一贯式的工学交替教学模式,并改革实践考核方法,通过护理技能评价护生的综合技能.结果 在操作成绩、理论成绩和综合成绩方面:实验组护生的得分高于对照组,差异均具有统计学意义(P＜...     

The professional practice of nursing administration. Integrated nursing practice

The role of the nurse executive is dynamic, requiring a high degree of leadership skill and managerial competence linked with clinical nursing knowledge and research. Preparation for the role requires an integrated curriculum in nursing administration and life span leadership development. Recognition of the professional level of differentiated practice as nursing administration is essential if professional nursing is to remain vital in the 21st century. Transformed schools should be named schools of nursing administration, and the new product should be the nurse executive who has the ability to function in a wide variety of settings on earth and in space.     

Toward an integrative model of professional practice

A review of nursing practice demonstrates repeated attempts to focus on direct professional responsibility to clients, but failure to do so consistently in an effective professional model. The cycles of growth of the profession depict the long-standing subordination of nursing to hospital administration and medicine and suggest that nursing is ready to move into an integrative, collaborative stage of development. A trilevel model of professional practice is proposed, based on differentiated roles for graduate, baccalaureate, and associate degree levels of education. An organizational structure that places nursing clinicians directly responsible to clients would facilitate nursing's response to clients' health concerns whenever and wherever they occur.     

Developing a robust professional practice model using a shared governance approach

This article describes the development and implementation of a framework for nursing practice in a freestanding children's hospital and the subsequent improvement process used to transition that framework into a robust professional practice model (PPM). The development of a PPM encompassing all aspects of nursing in all clinical settings is an important milestone on a successful Magnet journey. Strategies for linking the PPM to core processes and structures of nursing are shared. Plans for further study to demonstrate the relationship of a PPM to patient outcomes are discussed.     

Integrating a nursing professional practice model and nursing informatics in a collective bargaining environment.

The integration of a professional practice model of nursing and nursing informatics support for that model is congruent with the goals of a professional nursing union. Thus, the collective-bargaining unit can be a powerful ally to nursing management in achieving the integration of a professional practice model of nursing and nursing informatics. This alliance is based on a shared vision of the nature of professional nursing practice and a common concern for the quality of working life and working environment of the professional nurse. This alliance can provide the basis for decision making about the type of nursing information system to be selected or developed for installation in a particular organization. Use of a participatory decision-making process will ensure that all nursing stakeholders are committed to the decision made and prepared to assist with the resolution of implementation issues as they arise. A harmonious alliance of nursing management and the nursing union ensures a partnership that will protect the clinical nursing caregiver and provide a unified voice for nursing within the organization to resist any attempt by other stakeholders to implement an information system that will not meet the needs of nursing. If nursing management and the collective bargaining unit share the concept of a professional model of nursing practice and view nursing informatics as a tool to assist the nursing staff to operationalize the professional model of nursing, then collaboration in resolving issues related to the implementation of nursing information systems will facilitate the process of achieving the integration of a professional practice model of nursing and nursing informatics support for that model.     

Hawthorne effects and research into professional practice

The Hawthorne studies in the 1930s demonstrated how difficult it is to understand workplace behaviour, and this includes professional performance. Studies of interventions to improve professional performance, such as audit, can provide useful information for those considering using such methods, but cannot replace judgement. In particular, there is no single phenomenon that can be labelled 'the Hawthorne effect'. The process of triangulation, considering a subject from different perspectives, might overcome the problems of Hawthorne effects better than using a single method such as controlled trials.