Nursing - Professional Practice Model

Mission

As a Catholic, regional hospital, we improve the health and quality of life for the people we serve in a manner that reflects the healing mission of Jesus.

Vision

Through our Catholic healing ministry, St. Cloud Hospital will be the leader in Minnesota for quality, safety, service, and value.

Values

Collaboration – Demonstrated by joining others in furthering our commitment to the common good.

Hospitality – Demonstrated by the cordial and generous reception of all persons “so they may truly be served as Christ.”

Respect – Demonstrated by an affirmation of the inherent dignity of each person.

Integrity – Demonstrated by the faithful observance of ethical practices.

Service – Demonstrated by a commitment to excellence in all that we do.

Trusteeship – Demonstrated by responsible use of all resources.

Triple Aim plus People – The triple aim includes enhancing the experience of care, improving the health of the community, and reducing the cost of care. We will also attract and retain the best people while fostering a culture that allows us to be at our best every day. Nursing is key in the health care system in identifying specific populations and accepts responsibility for the aims by partnering with individuals and families, redesigning care, using population health management, incorporating financial management into care and working with system opportunities and design.

An approach to the planning, delivery, and evaluation of health care, patient- and family-centered care is organized around the needs and priorities of patients and their families. It is grounded in mutually beneficial partnerships among patients, families, and the health care team. A patient’s family is however the patient defines it. We actively partner with the patient and family to develop the plan of care. Patient- and family-centered care applies to patients of all ages, and it may be practiced in any health care setting.

Minnesota Nurse Practice Act – Registered nurses practice under the rules and regulations of the Minnesota Nurse Practice Act. The practice of professional nursing includes independent nursing functions, interdependent functions and delegated medical functions which may be performed in collaboration with other health team members or may be delegated by the professional nurse to other nursing personnel.

The Code of Ethics – Nursing’s Code of Ethics is the promise that we as RNs are doing our best to provide care for our patients and communities, supporting each other in the process so that all RNs can fulfill their ethical and professional obligations.

The Nursing Scope and Standards of Practice – The Scope and Standards express a level of performance to characterize, measure, and provide guidance for achieving excellence in practice. They define the expectations for a Professional (RN), Advanced (APRN), and Practical (LPN) nurse. The Standards reflect the values and priorities of the profession and are based on research and knowledge from nursing and various other sciences and disciplines. They also describe the full range of practice outlining the expectations of the professional role within which all RNs must practice. Standards of Practice (Nursing Process) – Assessment, Diagnosis, Outcomes Identification, Planning, Implementation, Evaluation Standards of Professional Performance – Quality of Practice, Culturally Congruent Practice, Education, Professional Practice Evaluation, Communication, Collaboration, Ethics, Evidence-Based Practice and Research, Resource Utilization (enhancing value and efficiencies), Leadership, Environmental Health.

Coordination of Care – The coordination of care model describes the integration of patient- and family-centered care within a collaborative multidisciplinary team environment. Care is provided based on the identification and prioritization of patient needs, complexity, referrals, and level of coordination of care needed. The outcome of coordination of care is a patient with healthy balance of mind, body, and spirit. Clinical RNs assess patients for anticipated discharge needs and plan for transition to the next level of care, through the IDEAL model.

Care Management – Care management is a collaborative practice which includes patients, nurses, social workers, providers, professional disciplines, caregivers, and the community. Care management supports the achievement of optimal health, access to care, and appropriate utilization of resources, balanced with the patient’s right to self-determination.

Nursing Provision of Patient Care – We strategically and proactively plan for the provision of nursing care by evaluating our patient care delivery models. Effective staffing, identifying and maintaining the appropriate number and mix of nursing staff, is crucial to the delivery of safe, quality patient care. Multi-dimensional data is gathered and reported to support informed and effective decision-making. RNs are proactive participants in staffing and assignment practices including self-scheduling. Through our PPM, RN retention and recruitment is identified as a high priority.

Professional Growth – We establish a culture of learning that promotes professional growth and development, supports the mission, ensures high quality care and enhances patient safety and outcomes. St. Cloud Hospital invests financially in continuing education and tuition reimbursement, and supports national certification and membership in professional organizations.

Autonomy – RNs are expected to practice autonomously consistent with professional standards within our scope of practice.

Innovation and Dissemination – Innovation is a novel set of behaviors, routines, and ways of working directed at improving health outcomes, administrative efficiency, cost effectiveness, revenue enhancement, or users’ experience; and implemented by planned and coordinated actions. As healthcare leaders, all RNs foster and value innovation by introduction of new ideas, methods, or devices that progressively transform nursing. Our innovative methods and projects are disseminated through posters, presentations, and publications.

Nursing-Sensitive Indicators – Nursing-sensitive indicators reflect the outcome of professional nursing care. Patient outcomes such as pressure ulcers, falls, and patient satisfaction, improve when there is a greater quantity or quality of nursing care. St. Cloud Hospital submits data to the National Database of Nursing Quality Indicators and other databases to benchmark ourselves against other organizations.

Performance Improvement – RNs use a data analytical approach to performance improvement, designed to bring multiple disciplines together to evaluate care focused on pertinent patient processes or outcomes. The Plan, Do, Study, Act model is used to guide the process for improvement. Rapid cycle change and LEAN are additional methods of performance improvement processes. Transforming Care at the Bedside (TCAB) is an outcome of an exceptional rapid cycle change process and continues to grow throughout the organization.

Evidence-Based Practice – We use The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care to search for and critically appraise the most relevant evidence to guide our clinical practice and improve sustainable outcomes.

Nursing Research – RNs at St. Cloud Hospital participate in activities to support clinical inquiry and develop new knowledge by participating in or conducting nursing research.

Clinical Ladder Program – The program recognizes and rewards the clinical nurse for participation in activities and education that benefit their unit, hospital, and community. Clinical nurses who have advanced in the clinical ladder program are considered resources to their peers.

Magnet Designation – Magnet designation is the highest international recognition for excellence in the delivery of nursing services that are provided in a professional practice environment. SCH has been Magnet designated since 2004. Magnet honors the strong nursing and multidisciplinary team practice and each individual’s commitment to quality patient care and exceptional patient outcomes.

Shared Governance – At St. Cloud Hospital, Shared Governance is practiced through a decision-making model which encompasses a partnership between staff and leaders, collectively working toward a common goal of providing quality patient- and family-centered care. This model empowers RNs to use their clinical knowledge and expertise to impact decisions regarding their professional practice. RNs at St. Cloud Hospital serve in key roles by participating in hospital based patient care committees structured by shared governance and administrative teams.

• Administrative Patient Care Committee (APCC) /Administrative Nursing Practice (ANP)
• Clinical Patient Care Committee (CPCC)/Clinical Nurse Practice (CNP)
• Administrative Nurse Practice Committee – Performance Improvement (ANPC-PI)
• Resource Management Committee
• Education Committee
• Leadership Committee
• Patient Safety Committee
• Workplace Violence Prevention Committee
• Patient Experience Committee
• Nursing Research Review Board (NRRB)
• Nursing Research and EBP Committee
• Clinical Documentation Committee
• Product Value Analysis Committee
• Department/Unit Staff Meeting
• Department Based Unit Committees

Transformational Leadership – RNs at St. Cloud Hospital are transformational leaders. Through transformational leadership, RNs advocate for resources (fiscal and technical), develop and
support department goals, and improve the overall work environment. The RN leader engages in teamwork as a team player and team builder by transforming attitudes, values, and behaviors.

Staff Engagement – As measured by the Nursing Excellence Survey and the Gallup Q12 Employee Engagement Survey, nurses at St. Cloud Hospital are enthusiastic and display a positive attitude and
willingness to perform and learn at work. Engaged employees are valued by the organization and all employees are active in action planning to optimize the work environment. Recognized as a World Class Organization, CentraCare Health has been named the #1 Best Place to Work in Minnesota.

Healthy Work Environment – A healthy work environment and resiliency is fostered by Our Best Begins With Me principles. Our nurses have adopted the American Association of Critical-Care Nurses Healthy Work Environment standards which include techniques for skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership.

Collaborative Practice – Nurses at St. Cloud Hospital are committed to cultivating a collaborative practice. Our nursing practice is based on the patients we provide care for; we coordinate and collaborate with other disciplines to best serve the patient. We value the knowledge and expertise of others and understand that successful patient outcomes depend on the collaboration between nursing and the interdisciplinary team.

Culture of Safety – The commitment to a culture of safety stems from the teamwork and leadership of all disciplines. Our practices are evidence-based and patient-centered. Through speaking up on behalf of the patient, communication is heard and acknowledged. Our “Just Culture” approach balances the need for a learning environment with the equally important need to hold people accountable for their actions and improve systems.

Coaching and Mentoring – RNs at St. Cloud Hospital use coaching and mentoring to achieve their full potential, both personally and professionally. RNs precept and mentor RNs and students by taking a personal interest in them and fostering their professional growth and development. RNs advise, encourage, and support one another, faculty, and students to continually build the skills and behaviors required to meet patient needs.

Recognition – Recognition is formal and informal acknowledgement of the nursing profession. Formal recognition includes the Our Best Begins With Me Award, Daisy Award, Mission Matters, Nursing Research and EBP Awards, and Nurse Week Poster Awards. Informal recognition comes from patients, families, peers, and leaders.

Community (Population) Health – As community leaders, RNs from St. Cloud Hospital are committed to improving the health of our populations locally, regionally, and globally.