Elements of a nursing professional practice model.

The authors define a professional practice model (PPM) as a system (structure, process, and values) that supports registered nurse control over the delivery of nursing care and the environment in which care is delivered. A PPM has five subsystems: values, professional relationships, a patient care delivery model, a management approach, and compensation and rewards. Analysis of five PPMs described in the literature showed that the professional values addressed most often are nurse autonomy, nurse accountability, professional development, and emphasis on high-quality care. Teamwork, collaboration, and consultation consistently appeared as approaches to enhance professional relationships. Primary nursing and case management are the care delivery systems most often used in the models. Decentralizing decision making, expanding the scope and type of unit nurse manager responsibilities, and instituting structural changes to support professional practice were common activities in the management subsystem. Compensation and reward systems generally recognized professional achievement and contribution toward organizational goals. Recommendations for implementing and evaluating PPMs are offered.