The Evolution of a Nursing Professional Practice Model

The Evolution of a Nursing Professional Practice Model

Through Leadership Support of Clinical Nurse Engagement, Empowerment, and Shared

Decision Making

Anursing professionalpractice model (PPM) is the guiding theoreti-

cal and conceptual model

that frames the foundation

for nursing professional

practice.1,2 Utilization of a

professional practice model

guides nursing practice and

fosters professional identity,

encouraging alignment to the

organization’s mission and

vision, job satisfaction,

improved quality of patient and

family outcomes, and enhanced

interprofessional communication.2 When a model guides professional nursing practice, nurses can articulate

the impact of nursing care on improving patient and family outcomes. With leadership endorsement and sup-

port, the PPM’s theoretical framework becomes the lens through which nurses see themselves; therefore, a

decisive imperative factor in selecting the underpinning theory for an organization’s PPM is core in its appli-

cability to the staff’s practice. Nurse Leader 325

Jennifer Cordo, MSN, ARNP, NE-BC, and Deborah Hill-Rodriguez, MSN, MBA, ARNP, NE-BC

Afree-standing pediatric hospital on its Magnet ® journey

striving for its third designation identified an opportunity to engage staff in the evolution of the organization’s practice model. Application of the shared leadership structure for joint decision-making empowered staff to “own” the PPM’s devel-

opment and implementation. Nurse leaders within the organization first embraced the concept of clinical nurses engaging their peers across the organization in identifying Comfort Theory’s compatibility with the organization’s val- ues and mission. Comfort Theory was selected as the theory



most applicable to the staff ’s practice by a voting process by nurses across the organization. Comfort Theory’s universality and application to both nurses, staff, and patients/families was easily understood and simple enough to guide practice. Comfort Theory’s inherent emphasis on physical, psychospiri- tual, sociocultural, and environmental aspects of comfort contributed to a proactive multifaceted approach to care to guide nursing practice.3 The easily applied framework of Comfort Theory within pediatric practice is strengthening and satisfying for pediatric patients, families, and nurses, and benefit organizations that value a culture of comfort.3

Comfort is a positive outcome that has been linked empiri- cally to positive institutional outcomes such as increased patient satisfaction and cost–benefit ratios.3

PRACTICE MODEL EVOLUTION Exemplary professional nursing practice must be designed, implemented, and advanced over time.4 As the nursing profes- sion continues to advance its unique discipline and practice, it

is vital that nursing practice and research are guided by theory derived from nursing knowledge.2 As a Magnet-designated organization striving to obtain its third designation, an oppor- tunity was recognized to enhance the current practice model to a true professional practice model based on a theoretical framework. A professional practice model defines the relation- ship between an organization and the nurses, and is unique to each organizational culture. The first step in the model evolu- tion was to identify the core elements required within a pro- fessional practice model. The ANCC Magnet Recognition Program® book Magnet: The Next Generation: Nurses Making the Difference was used as the foundation for the PPM develop- ment.4 Drenkard et al.4 identified basic elements of exemplary professional nursing practice to be included in the develop- ment of a PPM. The PPM needed to include at minimum nursing’s values, leadership, collaboration, professional develop- ment, and a care delivery system. Other elements may be included, but these key attributes must be addressed and included in the design and implementation.