Glossary
EP - Exemplary Professional Practice

EP1: Describe and demonstrate how nurses develop apply, evaluate, adapt, and modify the Professional Practice Model.

Findings:

Missing

Verifying evidence for how nurses:

  • Modified the Professional Practice Model
  • Applied the Professional Practice Model

Resolution:

  • Additional information regarding how nurses modify and apply the professional practice model
  • Additional verifying evidence provided

Modify

In July, 2010 the Operating Room nurses were interested in modifying the Professional Practice Model in order to be relevant to their practice. Cheryl Owens DNP(c), RN, CNOR scheduled a focus group session with four (4) staff nurses with herself as the moderator. The staff nurses were interested in incorporating the family into their practice in a meaningful way. They identified the beneficial effects of having the family nearby prior to and immediately after the surgery. They also discussed the benefits of communication with the family members with the family members and discussed methodologies that would help them know the status of their relative’s surgery. They talked about the possibility of placing a computerized board in the waiting area that would inform family members of the stage in the process where their loved one is in. They also discussed the possibility of providing beepers to the family members so that they could notify them when their relative was ready to be seen in the PACU. Please review transcription of focus group in (Appendix EP1-A)

Apply

How JCMC nurses apply the Professional Practice Model

(Please refer to full schematic in 0011)

JCMC professional Practice Model Schematic Elements

Application of JCMC’s Professional Practice Model

 Unit Practice Councils (UPCs) are on every unit and the elements of the Professional Practice Model are used.  For example, the hand-off tool is discussed, developed and approved through these councils in obstetrics and medical-surgical

 

 Our nurses in all divisions, obstetrics and medical surgical units embrace and apply our mission of enhancing life through patient centered family focused care.  They apply this by incorporating the family is all aspects of the patients care by including them in hand-offs and allowing liberal visitation privileges.

 

 

 Engagement:  Our nursing staff has applied the concepts of the PPM to their nursing practice by utilization of the white boards.  These boards promote communication with the patient and the family and subsequently they serve as an engagement tool and are used in obstetrics and medical surgical

Safety: The nursing staff have applied the concepts of safety by utilizing the Safety Boards on each unit which identify Falls Risk patients as well as other safety issues-these boards are utilized on medical-surgical units and obstetrics

Clinical Quality:  The nursing staff have applied the concepts of the PPM by the establishment of dash boards that reflect the attainment of quality measures as pertains to a particular division (Appendix EP1-B)

Economic Health:  Our nurses are aware that the institution of excellent quality and safety measures
results in an economic savings for the institution-particularly in obstetrics and medical-surgical units

Benner - Novice to Expert: hand-off tools, rounding tools and white boards are designed to provide a detailed guide as to the important aspects of the plan of care which can assist any nurse no matter what their level of expertise.  This assists the nursing staff to apply the PPM evenly and consistently to all patients

Watson -  Human Caring:  “Establishing a helping-trust relationship-the strongest tool is the mode of communication which establishes rapport and caring”

Communication

The hand-off tool is a means of communication amongst nursing staff-the whiteboard is also a means of communication-nursing staff apply this value while applying  the PPM-our nurses on obstetrics and medical surgical units

Trust

The development of a trusting relationship is an important value and partners closely with communication. Nurses apply and incorporate this value as part of the PPM when communicating to each other during the hand-off as well as when communicating to the patient.

Team Work

Teamwork is an essential value when applying the PPM-rounding and reporting the condition of the patient to the entire interdisciplinary team is a team effort

Excellence

The value of excellence is applied by our nursing personnel by using Evidence Based Practice to formulate hand-off and other communication tools which is applicable to the PPM

Accountability

Our nursing staff are accountable for communicating the patients status and plan of care during hand-offs. 



Our nurses have incorporated and applied the concepts of the Professional Practice Model into their nursing practice. The following statements from our nurses describe how they apply this model to their care:

“I incorporate communication and teamwork in the patient centered-family focused care model in my everyday practice. I provide Discharge instructions to the patients and their family members. I also help them navigate through the discharge process. I individualize the discharge care plan to fit each patient. In one instance, I arranged a simultaneous meeting with the Medical Resident, Assistant Director of Nursing, Pharmacy and the patients nurse to discuss their concerns prior to discharge. This promotes the concept of teamwork and it makes the patient feel comfortable going home.”

Submitted by: Ingrid Cardinas, Discharge Nurse on Medical/Surgical Unit

“In the NICU we have utilized family centered concepts to include 24/7 parental visitation, sibling visitation, skin-to-skin contact with both mom and dad and the promotion of breastfeeding. We also encourage parents to be present for rounds with the physicians in the morning. We also have established call times when they can reach the nurse caring for their infant in order to discuss their concerns.”

Submitted by: Mary Daley MSN, RN NICU staff nurse

“I use family centered concepts by including significant others and family members in the bonding process with the infant. We collaborate and utilize teamwork in order to provide safe delivery of care to all of our patients.”

Submitted by: Laura Alves BSN, RN Post-Partum staff nurse

“I feel that communication is the most important aspect of the care I provide to my patients. When I receive a Total Joint patient from the operating room I teach the family and the patient simultaneously. I tell them the plan of care, explain about the PCA for delivery of medication, and inform them that they will be discharged to a Rehabilitation Center which is an important part of their care. I demonstrate to them and the family members how to use the Spirometer, I feel its important to make the family part of the team. Teamwork is an important value on 6 West.”

Submitted by: Amelia Blanco BSN, RN Medical-Surgical Unit staff nurse

In the OB unit we apply the patient centered family focused concepts frequently. Just recently a patient who was Arabic speaking, felt was most comfortable when her husband was at the bedside with her. Unfortunately, he was the only provider for her family and had to go to work the next day. The patient was so nervous about being left alone so she requested that her 14 year old daughter stay with her. The Nurse Manager and staff nurses made arrangement for the daughter to stay at the bedside. This provided the comfort this patient needed. These are the kinds of things we do to meet the needs of our patients.

Submitted by: Randa MSN, RN, CNM, WHCNP-BC Nurse Educator of Obstetrics

Additional evidence linking to examples provided in original submission:

  • Please review (Appendix EP1-C) for meeting minutes discussing modification of PPM
  • Please review (Appendix EP1-D) Sample of Hand-Off Report from Post Partum area as example of applying the PPM as discussed in original document
  • Please review (Appendix EP1-E) Signed Inpatient Hospice agreement (Compassionate Care Hospice of Clifton) as discussed in original document
  • Please review (Appendix EP1-F) for participants of newborn assessment course required for couplet care
  • Please review (Appendix EP1-G) for course contents relating to couplet care. Please note module 4 discusses couplet care as an approach to care that allows one nurse to take care of mom and baby in a family centered approach
  • Please review (Appendix EP1-H) for policy on visitation in Mother-Child Health *Please note: New language is in red and blue is an expansion of what was already there