Re-designating applicants: Provide a description, with supporting evidence, of the ongoing evaluation of the nursing professional practice model and how clinical nurses are involved.
Nurses at FF Thompson Hospital have embraced the Synergy model of professional practice, and are heavily involved in the ongoing development, implementation, and evaluation of all of its components through the shared-governance council. The five individual councils voted to become one central decision-making body, incorporating the Synergy nurse characteristics of clinical judgment, advocacy, caring practices, collaboration, systems thinking, response to diversity, clinical inquiry, and facilitation of learning. This empowered group of nurses, the Nursing Practice Council, meet once a month with a clinical nurse representative from each unit (Exhibit EP1.1) Each Council member disseminates information from the meeting minutes to the staff at unit level, providing information and assigning tasks to the unit-based teams. The Synergy model of care is discussed on an annual basis within the practice council, identifying areas for improvement and sustainability of the model. In the past twelve months the council has focused on two areas for aligning the model of care with existing practice.
Exhibit EP1.1 - Example of Nursing Practice Council Meeting Minutes
Exhibit EP1.1 Nursing Practice Council February
One example of the ongoing evaluation of the professional practice model is the annual Nurse of the Year application. In 2014 the Practice Council identified a disconnect between the Nurse of the Year nomination form and the Professional Practice Model. The nomination form was designed to identify nurse with overall competence, exemplary professional practice, and community involvement, but it did not align with the tenets of Synergy. The council developed a new nomination form that invited nurses to nominate a colleague who excels at one of the Synergy characteristics. This led to recognition of outstanding nurses who exemplify one or more aspects of the Synergy model in their daily practice, nominated by their peers. The nominator must provide two detailed examples of how the nurse demonstrates excellence in the chosen category. Once all nominations are received, the Nursing Practice Council reviews each nomination and selects a nurse in each category based on closest alignment with Synergy A second example of the re-evaluation of the model is the incorporation of Synergy into the Professional Advancement System (PAS), the annual Performance Appraisal, and nursing job descriptions. The initial step in this process was to revise the peer review used for advancement on the PAS. As of 2013, peer reviewers are asked to rate the applicant on the individual nurse characteristics of Synergy (Exhibit EP1.2). As of 2014, the PAS peer reviews have replaced the reviews formerly used for the nurses' annual Performance Evaluation. This change means that all nurses now have the appropriate peer evaluations to use in their application for the PAS, and also means they do not need two separate peer evaluations each year.
Exhibit EP1.2 Nursing Practice Council PAS
Exhibit EP1.2 Nursing Practice Council - March
The Nursing Practice Council also revised the format for the exemplar of nursing practice required for admission to the PAS at Level III or Level IV. Working with a Masters student they revised and renewed the focus of synergy into the PAS requirement.Once the clinical nurse has completed their PAS folder, it is submitted to the Nursing Practice Council and placed on the agenda for review (Exhibit EP1.3). The exemplar must demonstrate the use of the Synergy model in the demonstration of nursing excellence portrayed in the exemplar (Exhibit EP1.4).
Exhibit EP1.3 Nursing Practice Council Agenda - PAS Review
Exhibit EP1.3 Nursing Practice Council-April
Exhibit EP1.4 Example of Complete PAS
Exhibit EP1.4 Greta Ledgerwood exemplar.pdf
The next two aspects of this integration include revisions to job descriptions and performance review forms to incorporate Synergy. The changes to job descriptions will not be made until the hospital completes the adoption of a new software system for managing both job descriptions and performance appraisals. The Council is working on both of those projects in real time so they can be incorporated as soon as the new software is up and running in 2015.