Professional models of care promote retention

Nurse Leader Insider, April 30, 2007

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Professional models of patient care delivery are constantly changing and improving. Employees in any profession want to work in an organization that provides a great product or service, and nurses in healthcare settings are no different. They want to work in settings that provide great patient care.

Health consumers have high expectations for healthcare delivery systems, and it is only right that they should expect safe, quality, individualized care. To address patient expectations for quality care, healthcare systems must develop nursing care delivery systems that encourage, support, and develop nurse autonomy and decision-making.

Allow nurses to practice to the best of their ability
Employers should construct and implement systems that allow nurses to practice within their full scope of practice. Practice policies and procedures should be based on nursing practice standards and evidence-based outcomes. Employers must recognize, through support of clinical research and nurse-directed care improvements, that nurses contribute knowledge and expertise to quality patient care and patient outcomes. The positive influence of professional models of care on nurse retention is well documented through ANCC Magnet Recognition Program® research studies.

Nurse-directed patient care
Establish unit and organizational cultures that encourage and demand nurse-directed care. In professional practice models, nurses make autonomous decisions within their scope of practice and control care-delivery standards in the practice environment. Nurses are responsible and accountable for all nursing practices. They establish practice standards, set patient care goals, make decisions concerning managing and monitoring patient care, and measure patient outcomes. Work with your staff and administration to develop and implement policies that mandate nurse authority to control nursing practice by developing nursing care policies.

Review your organizational structure periodically with staff, and discuss the impact of communication and decision-making at the point of care. Use staff meetings to share examples of decisions made by nurses on your unit that directly influenced positive patient outcomes. You might even begin staff meetings by asking staff to share how their decisions made a difference in patient care and improved satisfaction. You also can ask them to share a decision that made them feel uneasy or uncertain, and either confirm their actions or ask fellow staff to discuss how they would have reacted to that type of situation. Reaffirm your commitment to nurse decision-making at the point of care, and assess staff needs for continuing education programs that promote self-development in decision-making and leadership skills.

Editor's note: This excerpt was adapted from HCPro's book "A Practical Guide to Recruitment & Retention: Skills for Nurse Managers." Click here for more information.

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