Framework Development
The corporate-level clinical delivery department initiated and supervised the work of creating the practice framework. This department consisted of RNs prepared at the master's and doctoral level who reported to the vice president (VP) of clinical services. For the purposes of the Magnet document, the VP of clinical services was considered the system chief nursing officer (CNO) and led the framework development team of system (corporate)- and facility-level RNs. The first step was to create a straw model that would be the rough draft used to initiate discussion with the nursing stakeholders in Banner Health.
A set of guiding principles was discussed before drafting the straw model during this development stage, which included that the framework should demonstrate a dynamic nonlinear state, be evidence based, and build on existing standards in the healthcare community. Foundationally, because nursing at Banner Health is defined based on the American Nurses Association (ANA)7(p6) Social Policy Statement as "the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations," the incorporation of the ANA standards was a given. In developing the rough draft, 4 assumptions were also made. The first assumption is that the Banner nurse's primary focus is the patient, which includes the patient's family and community. The next 3 assumptions supported that accountability, communication, and innovation become embedded in the framework.
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