A professional practice model should be simple and translatable to the daily practice of nursing in order to promote excellence. The purpose of this project was to create a professional nursing practice model that is representative of frontline nursing staff using the method of appreciative inquiry and qualitative analysis.
Background
A key element of a successful nursing program is a professional practice model that guides all aspects of care. A limitation to some models is that they have not been created or led by frontline nurses .This leads to a practice model that cannot be recognized or articulated by nursing staff. The aim of this project was to discover the vision for a professional practice model from frontline staff and then translate that vision into a simple model to guide all aspects of nursing care.
Methods
Appreciative inquiry within qualitative design was used to survey 25 professional nurses at the project facility. The nurses were asked to provide narrative responses to questions designed to assist them to discover their most positive experience and vision for professional nursing. Examples of the questions and follow up questions included: Talk about your best day at work as a nurse. What was your role? What made it the best? Narrative responses to 6 questions were analyzed using inductive content analysis to code, categorize and develop themes from the narrative data. Deductive analysis was then used to deductively place the categories and themes into six common dimensions of nursing professional practice models.
Results
Narrative content analysis revealed more than 500 codes related to the vision for professional nursing practice. These codes were abstracted into 50 categories and then 6 main themes surrounding the unique responsibility that nurses possess to assure a meaningful and therapeutic relationship with not only the patient but also the family. The themes found included advocacy and being a strong line of defense against adverse events, empathy and acceptance, being a leader of teams and of collaboration, continual growth and support for education and nursing research in order to practice at the top of license. An over arching theme was leadership in support for a healthy environment that forms the base of a professional nursing practice environment. These themes were then synthesized and taken back to professional nursing staff for verification. The final themes were then categorized into structures within the environment that support professional nursing, processes that support professional nursing and the outcomes of professional nursing. The final model was constructed into a visual by nursing staff which portrayed the structures, processes and outcomes of professional nursing at our hospital within a context of our hospital's image in the community.
Conclusions and implications for practice
Professional practice models are abundant. However, a practice model that is created and lived by frontline staff is one that leads to excellence. Appreciative inquiry is an effective method to elicit that positive vision and create excitement and support for the model.