Page 376 - Encyclopedia of Nursing Research

NuRSING PRACTICe MODeLS n 343

Nurses Credentialing Center Magnet recog- use of professional practice mod-
nition guided by Aiken’s (2002) work, there els (PPMs) and collaborative governance
has been a renewed attention to the develop- are examples of practice model, and these N
ment of nursing practice models in the clin- expand the concept of shared decision mak-
ical setting. ing. A PPM is designed to advance devel-
Nursing management and health care opment, use, and translation of knowledge
executives have worked to developed many across disciplines to improve patient care
administratively driven practice models that outcomes; enhance nurse satisfaction; and
influence the delivery of nursing care. These acknowledge the contributions of all pro-
administrative practice models have been viders to deliver cost-effective, high-quality,
developed in response to changes in health safe patient care (Institute of Medicine, 2001,
care and have incorporated dimensions such 2002). One example of a PPM has been devel-
as interdisciplinary practice, differentiated oped, implemented, and evaluated at the
practice, and communication as integral com- Massachusetts General Hospital in Boston,
ponents of the framework. The goal of most of Massachusetts (Ives erickson, 1998, 2007).
these nursing practice models focuses on fos- The model is based upon “the values, princi-
tering strategies that decrease cost, improve ples and beliefs that support the individual-
quality outcomes, increase nurse satisfaction, ized work of each discipline” (Ives erickson,
enhance professional autonomy, and control 1998, p. 4). The current PPM contains nine
over practice and team work while decreas- elements. They include vision and values,
ing conflict and fostering communication standards of practice, narrative culture, pro-
among disciplines. ultimately, outcomes of fessional development, patient centeredness,
effect not only increase satisfaction with the clinical recognition and advancement, col-
work environment but may also increase laborative decision making, research, and
financial compensation and ultimately innovation and entrepreneurial teamwork.
impact on patient satisfaction with care. The professional practice environment (PPe)
Models of shared governance, professional is evaluated regularly to assess staff satisfac-
practice, and collaborative governance reflect tion across disciplines. An instrument called
are examples of nursing practice models that the PPe survey (Ives erickson et al., 2004)
foster these goals. and the revised PPe survey (Ives erickson,
Shared governance is designed to Duffy, Ditomassi, & Jones, 2009) were devel-
increase nursing’s presence in the health care oped and tested as a measure of the staff’s
system by differentiating responsibilities of perception of the PPM.
providers based on education and experience The collaborative governance model
while compensating expert practitioners focuses on the contribution of all profession-
financially. This model provides opportuni- als within the organization, including nurses
ties for shared decision making and orga- and providers from across other disciplines
nizational participation of care providers and therapies. Collaborative governance is
through committee work (Anthony, 2004). used to implement many of the components
evaluation of successful implementation and of the PPM. A committee structure is devel-
sustainability of this model over time has oped to involve staff from across disciplines
varied. Cost and commitment to the gover- to participate in the leadership of patient care
nance process have been issues, although services. Interdisciplinary team building
evaluation reports indicate satisfaction with is used to bring about change. emphasis is
staff participation in decision making and placed on communication among caregivers
teamwork. Some continue to use the model, and respect for each discipline’s contribution
whereas others have abandoned it for other to quality patient care. The model offers indi-
structures. viduals who deliver patient care at all levels