Conceptual Models of APRN Practice: International Examples
Conceptual Models of APRN Practice: International Examples
SickKids APRN Framework
A conceptual model of APRN (CNS and NP) practice was developed in Canada for the care of children and adolescents (LeGrow, Hubley, & McAllister, 2010). The model was informed by four other models: the Strong Memorial Hospital model (King & Ackerman, 1995; Mick & Ackerman, 2000); the Illness Beliefs Model (Wright, Watson, & Bell, 1996); the Five Practices of Exemplary Leadership (Kouzes & Posner, 2002); and the CNA (2000) Advanced Nursing Practice National Framework, which includes APRN competencies. SickKids is a family-centered model that was designed to capture the essence of the pediatric APRN role in five domains: pediatric clinical practice, research and scholarly activities, interprofessional collaboration, education and mentorship, and organization and system management. It is applicable to various pediatric practice settings across the continuum of care from the community to the hospital.
The model has been implemented throughout the organization. It has provided a common language for the conceptualization of the APRN role, to establish common expectations and competencies, establish professional development opportunities, and develop a competency-based performance evaluation. This is a promising model to conceptualize the APRN role. However, research is needed to assess the ability of the model to evaluate the impact and outcomes of pediatric APRN practice.
Model of Exemplary Midwifery Practice
In 2000, Kennedy introduced a model of exemplary midwifery practice to identify essential characteristics, specific outcomes, processes of care provided, and their relationship to specific health outcomes of women and/or infants (Fig. 2.9). The development of the model was informed by critical and feminist theories and a Delphi study using input from recipients of midwifery care and exemplary midwives, not all of whom were master’s or doctorally prepared APRNs.
The model is schematically presented as three concentric spheres. The inner sphere describes three dimensions of exemplary midwifery practice: therapeutics, caring, and the profession. Therapeutics illustrates how and why midwives choose and use specific therapies. Caring depicts how the midwife demonstrates care for and about the client, and the dimension of the profession examines how exemplary practice might be enhanced and accepted. The middle sphere of the model depicts five processes of exemplary midwifery practice: support for the normalcy of birth, vigilance and attention to detail, creation of a setting that is respectful and reflects the woman’s needs, respect for the uniqueness of the woman and family, and updates on knowledge, personal and peer review and balance of professional personal life. Lastly, the outer sphere depicts five qualities of exemplary midwifery practice: (1) exceptional clinical skills and judgment, knowledge of self and limits, clinical objectivity, confidence, intelligence and intellectual curiosity; (2) commitment to empowering women, integrity and honesty, humility, realistic, gentle, warmth, nurturing and understanding and supportive; (3) commitment to the profession, accountability, motivation, love of the work of midwifery; (4) commitment to family-centered care, tolerance, nonjudgmental, compassion, interest in others, flexibility; and (5) belief in the normalcy of birth, commitment to the health of women and families, patience, maturity, wisdom, persistence, positive outlook, and calm.
Although laudable efforts have been made to develop a conceptual model of exemplary midwifery practice, additional work is needed. For example, conceptual and operational definitions of the multiple concepts and the relationships among and between them need further clarification. In addition, because not all CNM participants in this study were educated and trained as APRNs, the model needs to be examined and tested in APRN-prepared CNMs to evaluate its utility and it ability to guide APRN CNM practice and improve outcomes for women and their families.
The post Conceptual Models of APRN Practice: International Examples appeared first on Custom University Papers.