Harris Health Nursing believes in the structure of shared governance, a professional model founded on the cornerstone principles of partnership, equity, accountability and ownership that form a culturally sensitive and empowering framework, enabling sustainable and accountability-based decisions to support an interdisciplinary design for excellent patient care. The Nursing Shared Governance Model established Communities of Practice (CoP) throughout all clinical nursing departments. This initiative created a shift in the organization from a hierarchal decision structure to one in which direct-care professional nurses have authority and accountability for decisions within their practice communities.
Nurses perform at different levels of practice based on their knowledge and experience in a specific clinical setting. The Nursing Professional Practice Model (NPPM) provides the context for differentiating nursing practice congruent with a nurse’s education, experience, professional credentials, and proven level of clinical competency. These practice-level designations are used as the foundation for performance standards, professional recognition and compensation policies throughout Harris Health.
Nursing Clinical Advancement Program
A component of Differentiated Practice is the Nursing Clinical Advancement Program (NCAP), which acknowledges and rewards RNs for their achieved level of professional nursing practice. Using an adaptation of Benner’s framework of Novice to Expert, Harris Health nurses are promoted based on educational preparation, credentials (e.g., specialty certification) and demonstration of the eight competencies delineated by the American Association of Critical Care Nurses' Synergy Model.
Harris Health Nursing has adopted the Institute of Medicine’s definition of professional competence: the habitual and judicial use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individuals and community being served (IOM, 2003, p. 24). Examples of Harris Health’s professional development offerings include orientation and nurse residency programs; continuing nursing education; and formal educational support and development.
Harris Health considers its highly diverse nursing population an asset. However, achieving excellence in Nursing calls for professional enculturation that creates commitment and congruence to an explicit and implicit set of values, practices, and behaviors. The individual and aggregate professional performance of Harris Health nurses will be guided and measured by the standards inherent in the NPPM.