Core Practice Principles

PRINCIPLE I:  Responsibility for Relationship and Decision Making

1.  The Primary Nurse is a registered nurse who is responsible for establishing a relationship and an individualized plan of care with the patient for a defined period of time.

2.  This nurse is accountable for planning, coordinating, delivering, and evaluating the patient’s care, and for effectively transferring that accountability if the patient is moved off the unit.

3.  The patient and family are able to identify their Primary Nurse by name and understand that she/he is responsible for planning and coordinating their care.

4.  The Primary Nurse is responsible for communicating the plan of care to other members of the health care team.

5.  The Associate Nurse is a registered nurse who cares for the patient in the absence of the Primary Nurse -- on other shifts or days off.  The Associate Nurse follows the plan of care developed with the patient and left by the Primary Nurse.

PRINCIPLE II: Responsibility for Work allocation and patient assignments

1.  A professional practice model is a patient-centered care delivery system where assignments match the skills of the caregiver with the needs of the patient.

2.  Registered nurses have the authority to determine the kind and amount of nursing care a patient will receive, the activities of care that require the expertise of a registered nurse and the activities of care that can be delegated to other members of the healthcare team utilizing principles of effective delegation.

3.  Work is allocated and delegated based on scope of the role, and the knowledge and skill of the caregiver.

4.  The care team of registered nurses, licensed practical nurses, nursing assistants, and others will support and maximize one another’s contribution.

5.  Overall, increased continuity and consistency will be achieved in the assignment process.

PRINCIPLE III:  Communication Between Members of the Healthcare Team

1.  Primary Nurses proactively provide information to others who need it and seek information from those who have it.

2.  Patients and families experience cooperation among all members of the health care team. Members of the healthcare team treat the patients and each other with dignity, respect and sensitivity.

3.  Consistency in care and continuity in relationships of members of the health care team is maximized.

PRINCIPLE IV:  Management

1.  Managers lead through and support the changes in care delivery and support professional practice and care teams.

2.  Managers lead, support, role model, coach and mentor staff by articulating expectations and by using situational leadership to promote the growth and development of staff in three competency domains: clinical/technical, communication/relationship management and critical thinking.

3.  Managers lead to create an environment in which healthy relationships thrive.

PRINCIPLES RELATED TO PRACTICE ENVIRONMENTS

PRINCIPLE V: Process Improvements

1.  Work processes will be simplified and barriers to care will be removed so that patients and families have what they need in a timely and responsive fashion…each time.  Unit staff and manager responsibility for changes will be clearly differentiated.

PRINCIPLE VI: Caring, Healing Milieu

           
1.  Patient care will be provided in an environment that is therapeutic.  Specifically, patient care practices will be attentive to the mind, body, and spirit: the patient will experience a relationship with the responsible nurse; and patients and families will be actively involved in managing their care as facilitated by the nurse, physician, and other members of the health care team.

2. Caring, healing practices will be visible in practitioner relationships, clinical practices and the physical setting.