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
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
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
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
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
• Autonomy of nurses to make nursing practice decisions
• Accountability of each nurse for their clinical practice and the outcomes of
• Conscientious application of critical thinking and evidence-based
• 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,
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.