In Magnet® hospitals, transformational leaders join together with empowered, accountable clinicians to elevate the practice of nursing to new levels. But exemplary professional practice is more than simply establishing a strong nursing practice—it is all about the potential of what the practice of professional nursing can achieve. It is the true essence of a Magnet organization.
One of the 5 components of the American Nurses Credentialing Center’s Magnet Model, exemplary professional practice, focuses on excellence, collaboration, quality, safety, and best practices to realize extraordinary results.
Exemplary professional practice is built upon the successful integration of 2 key components, the professional practice model (PPM) and the care delivery system (CDS). The nursing PPM is a pictorial representation of the elements that interface, creating a dynamic environment, leading to the development of a positive work environment and outstanding outcomes. The PPM includes nursing’s values, leadership, collaboration, professional development, and CDS. Other components may be included in the PPM, but these key attributes must be included and addressed in the design and development. Most PPMs found in Magnet hospitals draw from evidence-based theoretical frameworks. The Magnet Model itself forms the basis for many PPMs by incorporating the model’s 5 major components, as well as the 14 Forces of Magnetism. It must be remembered that the nursing PPM exists in the overall culture of a healthcare organization and must align with it. Nursing’s strategic vision, values, and priority initiatives should parallel the organization’s mission vision and values.1
The second key component of a successful exemplary professional practice is the CDS. The CDS is integrated within the PPM and promotes continuous, consistent, and accountable delivery of nursing care. “In Magnet hospitals, CDSs are patient- and family-centered, efficient, and collaborative. Staffing models demonstrate the value of patient care assignments that provide continuity, match nurse competencies with patient needs, and are flexible to meet changing workload and patient acuity.”1(p60) The emergence of CDSs has opened the door to the development of new nursing roles and nursing activities. New nursing roles include the resource nurse, admission and discharge nurse, nurse patient navigator, quality outcomes nurse, and many others that support patient or hospital operation needs. Staffing models are another important element of the CDSs. Numerous innovative practices have emerged as organizations continuously improve the care provided and patient experience. For example, rapid response and stroke teams have been formed in some organizations to meet patient needs during times of increased acuity. Monitoring the outcomes of a CDS structure and processes is an essential element of a nursing culture focused on continuous improvement. To assess the effectiveness of care models, metrics must be established to measure effectiveness. This includes the patient’s perspective of the quality of care provided.1
Exemplary professional practice is based on Magnet nurses who are autonomous, exercising clinical and organizational judgment within the context of the larger, interdependent healthcare team. Magnet nurses make evidence-based care decisions according to each patient’s unique needs. Competency assessment and peer evaluation ensure that these decisions are grounded in safe and ethical practice.2 Nurses work in collaboration with interdisciplinary partners to ensure that care is comprehensive, coordinated, and effective. Magnet organizations actively promote collegial relationships and believe that all members of the healthcare team make essential and meaningful contributions to achieve positive patient outcomes.
The rapidly changing healthcare environment brings new challenges to the development, deployment, and effective utilization of PPMs and CDSs. The merger, acquisition, and consolidation of healthcare organizations create challenges in the development of healthcare systems. Merging cultures, PPMs, and CDSs can result in conflict. Wolf et al3 describe the successful use of the transformational model for professional practice4 in creating a more integrated healthcare system. The 3 major challenges they considered as part of the integration process were developing sameness while maintaining local identity, achieving consistency with patient care, and development of staff to meet future challenges. The transformational model for professional practice “is framework for identifying and balancing competing priorities, developing leaders and staff, and maintaining an unerring focus on the organization’s values and goals.”3(p181) The continued development of complex healthcare systems will require creative models of professional practice to ensure continuity across the continuum of care.
A professional practice that is exemplary takes time to develop, design, implement, and advance over time. Transformational leadership, strategic direction, and a solid set of operational plans and processes for the organization are required. Systems are in place looking inward and outward that are self-reflective yet able to detect best practices that may be emerging outside the organization. An environment is created that supports employees to produce outstanding workforce, clinical, service, and community-related outcomes.1 Magnet organizations are leading the way in the creation of professional practice environments that result in improved patient outcomes.
1. Drenkard K, Wolf G, Morgan S. Magnet the Next Generation-Nurses Making the Difference. Silver Spring, MD: American Nurses Credentialing Center; 2011.
2. American Nurses Credentialing Center. Magnet Recognition Program® Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2008.
3. Wolf G, Hayden M, Bradle J. The Transformational Model for Professional Practice. J Nurs Adm. 2004; 34 (4): 180–187.
4. Wolf G, Boland S, Aukerman MA. A transformational model for the practice of professional nursing, part 1: the model. J Nurs Adm. 1994; 24 (4): 51–57.