Healthy Work Environments Best Practice Guidelines

1
Healthy Work Environments Best Practice
Guidelines
2008

• Professionalism in Nursing
• Colleen Van Berkel Panel Member
• Judy Costello Panel Member

Date
2
Professional Practice Panel Members

• Andrea Baumann Panel Chair (Hamilton)
• Anne Moorhouse Deputy Chair (Toronto)
• Jacqueline Andrew (Windsor)
• Beth Brunsdon-Clark (Winnipeg)
• Cathy Burke (Newfoundland)
• Heather Campbell (Toronto)
• Judy Costello (Toronto)
• Audrey Danaher (Toronto)

• Martine Myrand Leclerc (Quebec)
• Marisa Neves (Toronto)
• Ann Rhéaume (New Brunswick)
• Monica Seawright (Mississauga)
• Jo Anne Shannon (St. Catherines)
• Colleen Van Berkel (Hamilton)
• Kristin Clevedev (Hamilton)
• Margaret Keatings (Toronto)
• Martha MacLeod (British Columbia)

3
Professionalism in NursingGuideline Development
Process

• An expert panel of nurses from Ontario and across
  Canada chosen for their expertise in practice,
  research and academia.
• The following work plan was developed
• The panel determined the Purpose/
  Scope/Framework/Attributes
• Search terms relevant to professionalism of the
  nurse were developed
• Joanna Briggs Institute (JBI) conducted a review
  of the literature
• Supplemental literature review conducted by
  McMaster University Nursing Health Services
  Research Unit (NHSRU)

4
Healthy Work Environments Best Practice
Guidelines

• Six Best Practice Guidelines
• Developing and Sustaining Nursing Leadership
• Collaborative Practice Among Nursing Teams
• Embracing Cultural Diversity in Health Care
  Developing Cultural Competence
• Professionalism in Nursing
• Developing and Sustaining Effective Staffing and
  Workload Practices
• Workplace Health, Safety and Well-being of the
  Nurse

5
Organizing Framework for the Healthy Work
Environments Best Practice Guidelines Project
Physical/Structural Policy Components
Cognitive/Psycho/Social/Cultural/ Components
Professional/Occupational Components
6
Professional/Occupational Components
HWE
Individual Nurse Factors
Professionalism in Nursing
Organizational
Factors
External Occupational Factors
7
Professionalism in Nursing

• Goals of the Professional Practice BPG
• To identify the concept of professionalism as a
  guiding tenant that enhances outcomes for nurses,
  patients, organizations and systems
• To define the attributes of professionalism
• To identify and discuss the evidence related to
  each attribute of professionalism
• To provide strategies for success

8
Definition of Professional Practice

• Professional Practice is patient and client
  -centered care, founded on knowledge and values,
  interdisciplinary approaches, compassionate and
  ethical.
• A Professional Practice environment supports an
  environment where a nurse has the autonomy to
  make decisions within her scope of practice.
• Where nurses have a voice and influence
  practice and organization decisions, where
  clinical practice is evidence based.

9
ContinuedDefinition of Professional Practice

• Full scope of practice, knowledge, appropriate
  resources and values to deliver safe, innovative
  and evidence-based, effective patient and family
  centered care in collaboration with the
  inter-professional team, the community and
  significant stakeholders.
• A Professional Practice practitioner positively
  influences patient care, community health, health
  and social policies at the local, provincial,
  national and international level.

10
Attributes of Professionalism

• Knowledge
• Definition Understanding of or information about
  a subject, which has been obtained by experience
  or study
• Practical and theoretical knowledge
• Application of Knowledge
• Evidence-based care
• Knowledge synthesis
• Communication of knowledge

11
Application..

• Knowledge
• Art and Science of Nursing
• Personal, ethical and sociopolitical knowledge
• Transition to practice environment,
• Ongoing development (complexity. technology) i.e.
  Career advancement models
• Protected time
• Educator roles
• Advance practice roles/resources
• Access to the literature,
• Vehicles for translation of knowledge/evidence/pol
  icy to practice, i.e. best practice guidelines,
  benchmarks,
• Collaboration with academic centers

12
Attributes of Professionalism

• Spirit of Inquiry
• Definition An inquisitive, inquiring approach
  to ones own practice
• Open-minded, desire to explore new knowledge
• Asking questions, generating knowledge
• Defining patterns of responses from clients,
  stakeholders
• Commitment to lifelong learning

13
Application..

• Spirit of Inquiry
• An inquisitive, inquiring approach to ones own
  practice
• Role models who are open minded
• Conferences,
• Opportunities for dialogue
• Access to education programs
• Academic partners, i.e. universities, colleges
• Knowledge brokers and knowledge translation
• Evidence based practice
• Access to libraries, literature, i.e. systematic
  reviews

14
Attributes of Professionalism

• Accountability
• Definition Responsibility for ones conduct
• Self regulation
• Using legislation, standards of practice and a
  code of ethics to guide ones scope of practice
• Engage in advancing quality of care
• Recognizing personal capabilities, knowledge
  base, areas to improve

15
Application..

• Accountability
• Means responsibility for ones conduct
• Direct access to leaders
• Trust
• Leadership models
• Use of legislation, standards of practice,
• Self-governance, i.e. College of Nurses
• Work to achieve optimal desired outcomes,
• Patient safety
• Focus on learning versus blame
• Disclosure
• Opportunity to participate in improvement
  initiatives

16
Attributes of Professionalism

• Autonomy
• Definition Right of self-government personal
  freedom
• Working independently, exercising decision-making
  within ones scope of practice
• Recognizing relational autonomy
• Aware of barriers that interfere with ones
  autonomy, seek remedies

17
Application..

• Autonomy
• Respect for the role of nursing within the team
• Inter-professional practice
• Embrace formal and informal leadership roles
• Implement the full scope of decision making
  within nursing role
• Seek to address organizational barriers impeding
  optimal nursing care

18
Attributes of Professionalism

• Advocacy
• Definition Person who supports or speaks out for
  a cause, policy
• Understanding the clients perspective
• Being involved in professional practice
  initiatives
• Knowledgeable about policies that impact delivery
  of health care

19
Application..

• Advocacy
• Advocate for the client, team, organization,
  system and processes
• Opportunity to sit on committees, i.e.
  professional practice initiatives, community
  groups
• Champion evidence based practice
• Establish working relationships with key
  stakeholders
• Be an informed citizen/constituent, recognizing
  that health is political
• Practice related issues/identify needs and gaps

20
Attributes of Professionalism

• Innovation and Visionary
• Definition bring in new methods imaginative
  insight
• Fostering a culture of innovation
• Showing initiative for new ideas and taking
  action
• Influence future of nursing and delivery of care
  and the health care system

21
Application..

• Innovation and Visionary
• Provide opportunity for thinking and idea
  generation
• Foster a culture of innovation (opportunity and
  recognition)
• Clinical progression models
• Unit leadership models that involve staff
• Participate in regional, provincial and national
  forums to shape future of health care and nursing
  profession

22
Attributes of Professionalism

• Collegiality and Collaboration
• Definition Shared power is vested among
  colleagues work jointly with
• Develop collaborative partnerships
• Recognition of interdependence
• Acting as a mentor to nurses, students and
  colleagues

23
Application..

• Collegiality and Collaboration
• Inter and intra-professional
• Team building
• Approaches to conflict management
• Respect in the workplace programs
• Individuals/communities active partners in
  defining their own health needs

24
Attributes of Professionalism

• Ethics and Values
• Definition System of valued behaviours and
  beliefs for determining right or wrong
• Knowledgeable about ethical values, concepts
• Apply knowledge of nursing ethics to make
  decisions
• Develop and maintain practice environment that
  supports nurses and respects their ethical
  responsibilities
• Engage in critical thinking about ethical issues
  in clinical and professional practice

25
Application.

• Ethics and Values
• Role models
• Ethics resources
• Ethicists
• Committees
• Rounds
• Address moral distress within work environment
• Transparent culture
• Zero tolerance for abuse
• Diversity

26
Professionalism in NursingPutting it all
together

• Knowledge
• Spirit of Inquiry
• Accountability
• Autonomy
• Advocacy
• Innovation and Visionary
• Collegiality and Collaboration
• Ethics and Values

27

• Discussion
• Questions?

28

• Thank you!