The Professional Practice Model of Nursing at Robinson Memorial Hospital is patient-centered and is based on our core values of respect, integrity, compassion, and excellence. The Registered Nurse, as the coordinator of the delivery of care, utilizes the nursing process and collaborates with all disciplines to make professional nursing practice decisions within their scope of practice that are essential to the care of the patient.
The foundation of our Professional Practice Model is evidence-based practice, which supports the framework within which nurses make decisions about the delivery of care in order to provide high quality care and services reflecting the best standards of health care. Evidence-based practice is the incorporation of best evidence from research, clinical expertise, patient's values, and other recognized sources of nursing knowledge. Nursing Practice at Robinson Memorial Hospital incorporates the nursing theory of Self-Care Deficit by Dorthea Orem. This theoretical framework provides the conceptual model for nursing practice and represents a caring approach that uses experiential and specialized nursing knowledge to design and provide nursing care.
The basic premise of the theory of Self-Care Deficit is the ability to care for self and/or others to maintain a balance of health and well-being. Within Orem's theory, a deficit occurs when situations arise that limits an individual's efforts to meet their own needs and perform self-care. The Registered Nurse uses the nursing process to identify these deficits and develop an individualized plan of care. A therapeutic relationship is established between nurses, patients, their families, and other members of the healthcare team to accomplish those nursing care interventions and to maximize collaborative, interdisciplinary practice.
The Professional Practice Model encompasses five nursing councils that are integrated, interlinked, and interactive to meet the primary goal of optimal patient outcomes. The councils serve to facilitate leadership, communications, information sharing, and decision-making processes, all of which guide and support the nurses in the practice of nursing.
The Five Councils
The Leadership Council, consisting of Nurse Leaders, develops and approves leadership strategies, provides oversight, direction, and support for the delivery of professional nursing care and practice at Robinson Memorial Hospital.
The Professional Practice Council, consisting of Staff Nurses, Clinical Nurse Specialists, Patient Care Services Directors, Managers, and ad-hoc non-nursing members, promotes evidence-based nursing care and provides oversight and review of the development of Patient Care Services standards, protocols, policies, procedures, and guidelines.
The Nursing Research & Scholarly Activities Council provides oversight for nursing research efforts and scholarly activities within the Patient Care Services department. Membership consists of Staff Nurses and Nurse Leaders.
The Performance Improvement Council develops, implements, and monitors strategies for improving outcomes and serves as a resource for unit-specific performance improvement opportunities. The Performance Improvement Council also serves as the medication accuracy subcommittee. Membership consists of Staff Nurses, Clinical Nurse Specialists, Patient Care Services Directors, Managers, and ad-hoc members.
The RN Advisory Council is a forum for the Staff Nurse to meet with the Vice President, Patient Care Services on a bimonthly basis and participate in an advisory capacity as a representative of their department to provide input, share information, ideas, and discuss priorities about work-related or practice-related issues. Membership consists of the Patient Care Services Vice President and Staff Nurses from all Patient Care Services Departments.
Our Patient-Centered Professional Practice Model supports the following concepts of Professional Nursing Practice:
• Our primary focus is the patient, which includes the family or significant other
• Autonomy of nurses to make nursing practice decisions
• Accountability of each nurse for their clinical practice and the outcomes of nursing care
• Conscientious application of critical thinking and evidence-based decision-making
• Practice according to professional standards and ethical principles
• Effective communications and collaboration among healthcare providers
• Continuity of care between providers and between settings
• Coordination and cost-effective use of resources
• Development of clinical nurses to assume professional roles in practice, leadership, mentoring, education, and research
• Adoption and support of Robinson Memorial Hospital's Mission, Vision, Core Values and the Philosophy of Patient Care Services
References: Cherry, B. & Jacob, S. R., Issues, Trends and Management Third Edition, St. Louis, 2004, Mosby.
Dochterman, J. & Grace, H.K. Current Issues in Nursing Sixth Edition, St. Louis, 2001, Mosby. George, J.B. Nursing Theories: The Base for Professional Nursing Practice Fifth Edition, St. Louis, 2002, Mosby. ANA Code of Ethics For Nurses, June 30, 2001.