Developing a Nursing Professional Practice Model of Care and Evaluating Staff Perceptions in a Dialysis Clinic

A Professional practice model supports nurses to provide patient focused care and create a suitable environment for both the patients and the nurses. One of the significant advantages of the professional practice model is that they create a professional practice environment which empowers the nurse especially at the unit level to make practice decisions which have a positive impact on improving the quality of care. Nurses therefore play a more significant role in fostering an environment that achieves positive patient outcomes, through individual accountability. Professional practice models promote accountability, collaboration, team work and also consultation. It also enhances decision making and implements structural changes which support the professional nursing practice. The model is also set to align the nurse’s individual values with the organization’s vision and mission and aligned with ANA code of ethics and professional standards.

Background According to Chamberlain, Bersick, Cole, Craig, Cummins, & Duffy, Et al (2013), the use of professional practice models has increased significantly in the last two decades. This is to address the frustration and job dissatisfaction which have triggered a massive exodus from the nursing profession. A clear Professional practice model acts as a framework for the nursing staff to provide professional care to patients and the community by supporting the patient nurse relationship, improving the quality of care (Meehan, 2012). It also gives Nurses the power to implement their professional values in different health care settings. Through collaborative approach with other nursing colleagues, nurses are empowered to make decisions on issues that affect their practice. They are more accountable to exercise control in delivery of care under which they are responsible.

Professional practice models promote good working environments which improve quality of patient care and help achieve positive patient outcomes. They increase retention and recruitment to the nursing profession as a result of reduced turnover, which also helps address the challenge of nursing shortage. Purpose The purpose of this project is to develop a Nursing Professional Practice Model of Care for nurses. It is based on seven assumptions and the 10 primary curative factors on human beings, health, environment and nursing. The theory has wide applications to the nursing practice, especially on issues with philosophical and ethical implications. According to the theory, nurses are persons with experiences on human health illnesses mediated by scientific, professional personal, esthetic and ethical human transactions. Nurses have the ability to promote family or individual growth through effective caring the theory describes caring as the heart of nursing, and a key factor to promote a nursing –patient relationship with compassion and love to establish a healing environment which can only be practiced interpersonally (Lukose, 2011).

The major four elements of the theory include the caritas process, transpersonal caring relationship, caring moments and caring healing modalities, which are all essential in caring and healing process. Brady & Cummings, (2010) also acknowledge that professional practice models promote effective leadership development, which help create a supportive, protective and caring working environment achieving positive patient outcomes. When implemented, this model will enable nurses implement performance improvement systems and engage efficiently with their nursing employees. For a dialysis clinic, this model will also enhance on their working environment through nurses safety, and improved working relationship. The knowledge obtained from the project will benefit the dialysis healthcare practitioners to come up with appropriate structures, policies and programs that aim at improving their working environment and relationship to improve on quality of health care.

It will also play a significant role in defining the relationship between nurses and their leaders hence directly improving job satisfaction and low turnover, which have a negative effect on quality of patient care. Summary of chapter 1 Chapter one has provided the background for the project the specific problem through which the project aims to solve. The professional practice model developed in this capstone project aims at solving the challenges experience in the nursing profession on poor working environment and its impact on the job satisfaction and achieving positive patient outcomes. The chapter highlights the significance of the professional practice models which include supporting nurses to provide focused care in a suitable environment for the patients and their families. Other advantages include empowering nurses to make professional decisions, team work as well as leadership and professional development.

The model is for a dialysis unit, and aims to address the numerous challenges experienced by nurses working in this sector. The search included Meta-analysis, Meta-synthesis and the systematic reviews on PPM published in English after 2000. Use of professional practice models in healthcare setting Promoting accountability among nurses Various studies have shown that patients benefit significantly from nurses who practice under a professional practice model. This is because PPM promotes professional values and accountability among nurses as well as enhancing ongoing competence, collaboration and creativity, which in turn promote robust decision making, reliance on evidence based practice (Chamberlain et al, 2013). According to Chamberlain et al, professional practice models share dominant attributes, with their primary goal being supplementing the relationship between the nurse and the patient.

Glassman, (2016) also acknowledges that professional practice models elevate the nursing practice by transforming tasks to knowledge and emphasizing on the significance of patients and their families as they are the center to the nursing practice. A wide range of other studies further show that professional practice models promotes nursing engagement with their colleagues, patients as well as with their leaders, which contributes to directly improving the quality of patient care (Brady & Cummings, 2010). This is because PPM fosters and environment which supports nurses to take control of their profession Achieving excellent nursing and patient outcomes A study carried out by Ribeiro, Martins, & Tronchin, (2016) acknowledges that the majority of healthcare organizations use professional practice models to achieve excellent patients and nursing outcomes. The study analyzed the literature published on the last decade on the effect of the PPM in the healthcare environment, using an integrative literature review.

According to the study, the professional practice models provides a foundation to the nurses to provide high-quality patient centered care. It enables nurses to reflect on how they communicate, collaborate and develop professionally, which makes it an effective for nurses to assess their effectiveness in the nursing practice. Another study by Hoffart, & Woods (1996) identifies five elements of the professional practice models which include values, professional relationships, management approach, and delivery of professional care and lastly rewards and compensation. The professional values include autonomy of nurses, collaboration, teamwork and accountability. These elements are therefore similar to the elements identified other studies including Ribeiro, Martins, & Tronchin (2016) although they are differences on how these elements are classified. A systematic review carried by Twigg, Davis, Coventry, & Slatyer, (2016) including articles published up to 2012 in English searched from the major nursing databases which include CINAHL, MEDLINE, EMBASE, Scopus and the ISI Knowledge web, further acknowledges the six essential components of the professional practice models.

These include the patient outcomes, the practice environment, dependent and the interdependent nurses’ practice, recognition, development and reward for nurses and lastly research and innovation. Keit et al, further emphasizes that given these important aspects of a professional practice model it makes sense for hospitals or health care settings to have a professional practice model to help nurses overcome the current challenges that they encounter in their nursing practice. However, majority of the institutions have not developed PPM to transform their basic working environment. Professional practice models in dialysis unit setting There is limited literature on the development and implementation of professional practice models in dialysis unit. However, according to Storey, White & Weber, (2011) professional practice models are applicable in the different healthcare settings primarily hospitals and clinics.