The Department of Nursing Practice
History of Professional Practice Model
Strong Memorial Hospital’s (SMH) nursing practice model is a directly
descended from the original Magnet Hospital Framework, which was defined according
to a pattern of characteristics observed in hospitals known for their ability to recruit and
retain nurses during serious workforce shortages (McClure, Poulin & Sovie, 1986). The
original description of the magnet framework was generated as an outgrowth of a study
of 41 hospitals identified as “magnets” for nurses. Each of these hospitals was
characterized by a high level of nurse autonomy, consistent evidence of nurse control
over practice, effective communication between physicians and nurses, and the presence
of a strong and visible nursing leader. Nurses practicing in magnet hospitals were
satisfied with the work environment and reported a high likelihood of remaining
employed. SMH was one of those original magnet hospitals.
When the next round of nursing shortage occurred during the late 1980s and early
1990s, SMH again served as a demonstration site for the testing of a professional practice
model based on the Magnet Framework. In this case, an Enhanced Professional Practice
Model (EPPM) defined and categorized the Magnet Framework components and targeted
their implementation on medical and surgical units at SMH and two other hospitals. This
multi-hospital research project was jointly funded by the Division of Nursing and the
National Institute for Nursing Research and was the first ever to study the impact of a
magnet hospital focused intervention on nurse and patient outcomes (Ingersoll, Schultz,
Hoffart, & Ryan, 1996; Ingersoll, Schultz, Hoffart, & Ryan, 1997).
In the EPPM project, characteristics associated with magnet hospitals were
categorized into five conceptual areas – control over practice, continuing education
responsive to staff need, continuity of care delivery, collaborative practice, and
compensation reflective of education and experience. Nurses from units that implemented
this model reported higher levels of job satisfaction and more favorable perceptions of
work group and nurse leader behavior (Ingersoll et al., 1996).
The five conceptual elements tested in the EPPM project remained in evidence at
SMH as the model evolved over time. These “magnetizing” work environment
characteristics have been present regardless of the type of care delivery model (primary
or the more recent patient and family focused approach) in place.
Subsequent review and update of the model by a team of registered nurses (RNs),
advanced practice nurses (APNs) and nurse managers (NMs) during the Summer of 2007
resulted in recommendations for revision of the graphic representation of the model,
addition of the components of Benner’s (1982, 1984) professional advancement model,
and incorporation of the 14 forces of magnetism.
© Strong Memorial Hospital, Department of Nursing Practice
References:
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McClure, M., Poulin, M., & Sovie, M.D. (1983). Magnet hospitals: Attraction and
retention of professional nurses. Kansas City, MO: American Academy of
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© Strong Memorial Hospital, Department of Nursing Practice
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© Strong Memorial Hospital, Department of Nursing Practice