Contribution to the Patient
Closest to the patient-centric circle is what is also known as the ANA Standards of Practice,11 which demonstrate the critical thinking model known as the nursing process. The nursing process is how the nurse should be organizing and thinking about the daily care of the patient. Because nurses have become more task oriented and physician order driven, the decision was made by the framework development team to highlight the nursing process as an integral contributor to excellent patient care. "The nursing process encompasses all significant actions taken by registered nurses and forms the foundation of the nurse's decision-making."8(p4) This is the nurse's direct contribution to the patient.
Contribution to the Profession
The next circle represents the ANA Standards of Professional Performance and describes the level of expected behavior in the professional role.8 The framework development team felt strongly that professional nurses affect and influence healthcare through professional performance. Research demonstrates that professional development is an important domain for a Magnet work environment.2 This circle also represents the investment that nurses place in themselves and their contribution back to the nursing profession.
Contribution to Society
The IOM has published 6 dimensions of quality, which include safe, timely, efficient, effective, equitable, and patient-centered care. The impact made by nurses on the dimensions of quality demonstrates nurse's integral role in our healthcare system. The dimensions of quality are noted in the outer and innermost circles. Excellent Patient Care was placed in the middle of our framework, which reflects the sixth IOM dimension of quality, Patient-Centered Care. The patient is placed in the center of our framework based on the Code of Ethics for Nursing, which states, "the nurse's primary commitment is the patient, whether an individual, family, group, or community."10(p9) Although nursing focuses on the outcomes of the patient in the center of our framework, our responsibility to quality and safety extends to the entire community. The ANCC2(p56) expects that organizations maintain a strong community presence and is seen as a productive corporate citizen. This is our contribution to society.
The Framework in Action
As the region was moving toward system Magnet designation, 1 facility was preparing for redesignation. To ensure no lapse in its Magnet designation, this facility was going to move forward with individual redesignation while the system prepared for future system designation. Banner Good Samaritan Medical Center adopted and rolled out the education faster than other facilities. The incorporation of the framework contributed to the successful redesignation of the facility in 2010. In a Magnet exemplar (Figure 2), the framework (Figure 3) was used to illustrate the application and modification of the framework in the practice setting (Figure 2).
- See more at: http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1172653#sthash.wDsW2KWc.dpuf