Nurses' perceptions of the impact of a renal nursing professional practice model on nursing outcomes, characteristics of practice environments and empowerment--Part II.

The purpose of this study was to examine the effect of a renal nursing professional practice model (PPM) on nurses'perceptions of empowerment, characteristics of practice environments and the impact on nursing care outcomes in a university-based teaching hospital in Canada. Quantitative and qualitative methodologies were used. This paper will focus on the qualitative results. Content analysis was the data analysis method used. The following themes emerged: 1) Attunement, familiarity/knowing the patient, going the distance, 2) Patient outcomes, consistency and continuity of care, autonomy/taking the initiative, 3) Nurse rewards: satisfaction and accountability, empowerment/input, and 4) Facilitating systems: communication, support and assignment. The quantitative results had a significant (p = .005) improvement post-PPM implementation in the nursing foundations for quality of care subscale of the Practice Environment Scale of the Nursing Work Index (NWI-PES) and organizational relationships (p =.016) measured by the Conditions of Work Effectiveness II (CWEQ-II) questionnaires. This study provides evidence for PPMs and primary nursing as effective frameworks to positively impact nursing and patient outcomes in a hemodialysis unit.

Nurses' perceptions of the impact of a renal nursing professional practice model on nursing outcomes, characteristics of practice environments and empowerment--Part I.

A transformational nursing professional practice model (PPM) was developed and implemented in the London Health Sciences Centre's renal program. The purpose of this study was to examine the impact of a renal nursing PPM on nurses'perceptions of empowerment, characteristics of practice environments, and nursing outcomes. Quantitative and qualitative methodologies were used in this study. This paper will focus primarily on the quantitative results. The qualitative results are presented in Part II (Harwood, Ridley, Lawrence-Murphy, White, Laschinger, Bevan, & O'Brien, in press). A "then-and-now" design was used. There was a significant (p = .005) improvement post-PPM implementation in the nursing foundations for quality of care subscale of the Nursing Worklife Index-Practice Environment Scale (NWI-PES) and organizational relationships (p = .016) measured by the Conditions of Work Effectiveness II (CWEQ-II) Questionnaires. This study provides evidence for PPMs and primary nursing as effective frameworks to positively impact nursing and patient outcomes in a hemodialysis unit.

Bridging the "theory-practice gap" in renal nursing: establishing a renal professional practice model. Experiences of the Adam Linton Dialysis Unit.

The renal program (RP) at the London Health Sciences Centre (LHSC) chose to implement a professional practice model (PPM). This paper examines the implementation and maintenance issues of the renal professional practice model (RPPM) at the Adam Linton Dialysis Unit (ALU), one unit of several dialysis units affiliated with the LHSC RP. The discussion includes primary nursing as the care delivery system for the RPPM. Attention is paid to experiences post program transfer--when the renal programs from St. Joseph's Health Centre and LHSC merged. The final focus of this paper is on the practical experiences of nurses at the ALU while using this model. Included are: Systems in place to support the success of this model. How leadership and staff contributed to the model's success. How this model might have improved patient outcomes. How this model could enhance both patient and staff satisfaction.