Nursing Professional Nursing Practice Framework



What and why we need nursing Professional Nursing Practice Framework?
It is a schematic diagram that will conceptualize the nursing practice framework, which demonstrates nursing values, cultures, theory, structures and foundation at Taiwan Adventist Hospital (TAH). By using a Professional Nursing Practice Framework, it will help every TAH nurse to practice consistently and strive to deliver excellent quality and professional nursing care.

Structure: Taipei 101 and Taiwan Adventist Hospital
Taipei 101 is the most well-known landmark in Taiwan and located in the center of Taipei City. It was considered the tallest building in the world in 2004 and became second tallest when BuriKhalifa in Dubai completed in 2009. TAH nurses picked Taipei 101 building because it is an earthquake-proof building, it is solid and strong and it illustrated the strength and determination of our nurses in carrying out our Professional Nursing Practice Framework.

The 101 building symbolizes the elements on how TAH nurses through 4 shared governance nursing councils that followed 5 forces of the Magnet Program. Leadership Council addresses the Transformational Leadership elements, Professional Development council addresses the Structural Empowerment and New Knowledge, Innovations, and Improvements elements, Professional Practice Council addresses the exemplary Professional Practice elements, Magnet Ambassador follows Magnet concept by advocating, promoting and celebrating empirical outcomes.

Processes: Lanterns/ Quality caring model, and rainbow/SHARE spirit (hospital values)
Lanterns represent the Chinese culture beliefs of sending wishes and blessing up to the sky to make wishes and blessing come true. We use the lanterns to illustrate Joanne Duffy PhD, RN, FAAN nursing theorist 8 quality care factors in the Quality Caring Model (QCM), in our delivery of nursing care. The eight caring factors are:

1. Mutual problem solving
2. Attentive reassurance
3. Human respect
4. Encouraging manner
5. Appreciation of unique meanings
6. Healing environment
7. Basic human needs
8. Affiliation needs
Adapted from: Duffy, Joann PhD, RN, FAAN 2009 Quality-Caring Model

Rainbow/SHARE spirits
The rainbow was identified as being colorful, bright and hopeful. It acts as a bridge between the SHARE spirits which is the Adventist Health System Values and the Duffy caring model. The SHARE spirits were adopted through the customer service principles of Disney, Marriott and Nordstrom enterprises. The SHARE spirit and Duffy model compliments each other in the following manner:
S="sense people's needs before they ask" fits well with basic human needs and attentive assurance QCM caring factor.
H="help each other out" it matches with encouraging manner and affiliation needs.
A="acknowledge people's feeling" it matches with appreciation of unique meanings.
R="respect the dignity and privacy of others" it corresponds with human respect and healing environment
E="explain what is happening" it fits with mutual problem solving.

Care Delivery Model
In Taiwan, family members are actively in involved in the care of the patient during hospitalization, it is very common and culturally expected that a caregiver stays at the bedside with the patient 24 hours a day. Therefore, we believe our patient care delivery model is a Patient/Family Involved Nursing Care Delivery Model. The model focuses on engaging family members as part of the care team, nurses actively communicate and provide ongoing instruction, training, and explanation during hospitalization. Family members are always included in the patient care decision process. Regardless of inpatient or ambulatory care, the nursing QCM and SHARE spirit are integrated into the process of care delivery.

Adapted from: Regulation from Ministry of Health and Welfare hospital man power requirement

Taiwan Adventist Hospital building, it contains a continuum of care from ambulatory, to inpatient, to home care then to the community. The nurses deliver professional nursing care within the scope of the hospital services.

Outcome
Using evidence based practice and nursing research as means of providing innovation and continuous professional nursing improvements to achieve a level of nursing performance proven by data will be comparable or better than the national and international bench mark.