Creation and Enculturation of a Nursing Professional Practice Model

Saturday, 29 October 2011

Peggy L. Cline, RNC, MSN, APRN-CNS
Kim Moore, RN, MSN, NEA-BC
Nursing Administration, Saint Elizabeth Regional Medical Center, Lincoln, NE

Learning Objective 1: Define the components of the Nursing Professional Practice model and how it was enculturated into practice at Saint Elizabeth Regional Medical Center

Learning Objective 2: Outline the steps from creation to operationalization of the practice model and how the model is utilized in clinical ladder and daily practice

 Creation of a professional practice model that nurses can both identify with and articulate is a fundamental component of the Magnet structure. Our model was created based on the premise that it must reflect the nurse competencies as well as patient self care requisites. When professional nurses use autonomy, authority, and accountability which are the core of our nursing practice model, then safe passage and optimal outcomes are achieved. To create this model, a series of focus groups were held with staff nurses across the organization with the intent to ask them to describe the care that they provided. Consistent themes immerged including creating a healing environment; matching the competencies of the nurse with the needs of the patient; and evidence based care. Using the knowledge of how nurse viewed their practice, a model was developed that staff could articulate and included elements of provider, teacher, advocate, leader, service, and clinical inquiry or research. These competencies were then matched to the needs of the patient including: acuity, diversity, predictability, stability, vulnerability, and family support. The nurse competencies component of our professional practice model is also reflective in the foundation of our differentiated practice/clinical ladder structure. Nurses must address each of the nurse competencies to advance in their professional practice. To articulate and enculturate the model, differentiated practice exemplars are disseminated at monthly shared nursing leadership forums. The model created has interwoven all components of patient care/ nursing expertise and is truly reflective of how nurses practice at our hospital.