The purpose of this presentation is to describe how focus group methodology can be successfully used to engage nurses in the evaluation and revision of a Nursing Professional Practice Model in a healthcare setting.
A nursing professional practice model (NPPM) is a conceptual representation of nursing within an institution which serves as a framework for nursing practice and interprofessional collaboration. Magnet®-designated organizations must show evidence of on-going evaluation of their nursing professional practice model with involvement of clinical nurses (American Nurses Credentialing Center, 2014).
NPPMs have been evaluated through several approaches including quantitatively via surveys and questionnaires. Since each NPPM is unique to an institution, the validity of using existing instruments to evaluate can be limited. Focus groups are another method to evaluate NPPMs which can provide rich data that can be used to validate the components of the model and inform any need for modifications. Focus groups may also contribute to development of a specific tool (Basol, et al., 2015) or be part of a mixed-methods evaluation approach (Harwood, Downing & Ridley, 2013). Our institution is seeking its fifth Magnet® designation and chose this approach which could be useful to other organizations seeking to evaluate their NPPM utilizing a qualitative research methodology. The purpose of this study was to evaluate nursing staff understanding and perceptions of the NPPM. The aims of the study were to obtain increased knowledge of how the NPPM is understood and used by nurses and how its relevance to current practice can be enhanced.
Methods:
The study design was qualitative using focus groups. Participants were Registered Nurses from all levels, settings and shifts. Four focus groups were held and structured interview questions were used by the moderator. Two clinical nurses were sub-investigators on the study and assisted with field notes during the focus groups. Data analysis consisted of review of the audiotapes, transcripts and field notes with identification of major and minor themes to reach saturation. Data and thematic concordance were verified by an experienced qualitative researcher consultant.
Results:
Major and minor themes were identified. Major themes included that the NPPM is multifaceted and empowers nurses. Themes and values articulated include caring and compassion, evidence-based practice, quality patient care, education and certification, nursing voice, visible leadership, and holistic and complementary care.
Conclusion:
The focus group research approach was effective in evaluation of the NPPM. The NPPM was found to be relevant and reflective of nursing practice. Study participants indicated that the NPPM needs to be more visible throughout the organization and offered several suggestions for this. It was felt that the NPPM needs to be diligently communicated to nurses new to the organization as representative of the nursing culture and expectations. The evaluation revealed that a few minor revisions to the NPPM were indicated. A follow up group was convened and accomplished a minor redesign of the NPPM based on the focus group results.
Use of a focus group research study design is an innovative way for nursing leadership to promote the development of research skills of clinical nurses and to engage them in evaluating NPPMs relevance to current nursing practice and the interprofessional environment.