Strong Memorial Hospital’s Model of Advanced Practice Nursing: A Game-Changer in Healthcare
APRNs at Strong Memorial Hospital, Rochester, New York developed a model of advanced practice nursing (Ackerman et al., 1996, 2000; Mick & Ackerman, 2000). The model evolved from the delineation of the domains and competencies of the acute care NP (ACNP) role, conceptualized as a role that “combines the clinical skills of the NP with the systems acumen, educational commitment, and leadership ability of the CNS” (Ackerman et al., 1996, p. 69). The five domains are direct comprehensive patient care, support of systems, education, research, and publication and professional leadership. All domains have direct and indirect activities associated with them. In addition, three unifying threads influence each domain: collaboration, scholarship, and empowerment, which are illustrated as circular and continuous threads (Ackerman et al., 1996; Fig. 2.7). These threads are operationalized in each practice domain. Ackerman et al. (2000) noted that the model is based on an understanding of the role development of APRNs; the concept of novice (APRN) to expert (APRN) is foundational to the Strong model.
Direct Comprehensive Patient Care: A New Standard
Direct comprehensive care at Strong Memorial Hospital includes a wide range of assessments and interventions performed by APRNs. This encompasses history taking, physical assessments, requesting and/or performing diagnostic studies, performing invasive procedures, interpreting clinical and laboratory data, prescribing medications and other therapies, and managing the care of complex, critically ill patients. This domain emphasizes the APRN’s role in providing high-level, direct patient care, distinguishing them as pivotal figures in the healthcare team.
Table: Core Domains and Competencies of Strong Memorial Hospital’s Advanced Practice Nursing Model
| Domain | Key Responsibilities |
|---|---|
| Direct Comprehensive Patient Care | History taking, physical assessments, diagnostic studies, invasive procedures, interpreting data, prescribing treatments, and case management of critically ill patients. |
| Support of Systems | Indirect patient care, strategic planning, quality improvement initiatives, establishing standards of practice, precepting students, and promoting APRN practice. |
| Education | Evaluating educational programs, providing formal and informal education to staff, educating patients and families, and disseminating educational resources. |
| Research | Conducting and utilizing research, contributing to evidence-based practice. |
| Publication and Professional Leadership | Disseminating knowledge, participating in professional organizations, influencing health policy, and publishing in professional journals. |
Support of Systems: Enhancing Clinical Quality
In the support of systems domain, APRNs at Strong Memorial Hospital engage in indirect patient care activities that enhance the overall clinical environment. This includes consultation, participating in or leading strategic planning, driving quality improvement initiatives, establishing and evaluating standards of practice, precepting students, and promoting the role and practice of APRNs. This domain ensures that APRNs not only provide exceptional direct care but also contribute to the system’s overall effectiveness and efficiency.
Education: Empowering the Next Generation
Education is a critical component of the Strong Memorial Hospital model. APRNs are deeply involved in evaluating educational programs, providing both formal and informal education to staff, educating patients and their families, and identifying and disseminating essential educational resources. This domain ensures that knowledge is continuously shared and that both current and future healthcare providers are equipped with the necessary skills and knowledge.
Research: Driving Evidence-Based Practice
The research domain in Strong Memorial Hospital’s model underscores the importance of both conducting and utilizing research to inform clinical practice. APRNs are encouraged to engage in research activities that contribute to evidence-based practice, thereby ensuring that patient care is grounded in the latest scientific evidence. This commitment to research enhances the quality of care and positions APRNs as leaders in clinical innovation.
Publication and Professional Leadership: Shaping the Future of Healthcare
APRNs at Strong Memorial Hospital are also leaders in the dissemination of knowledge and professional development. This includes publishing research, participating in professional organizations, influencing health and public policy, and leading initiatives within the healthcare system. The publication and professional leadership domain ensures that APRNs are not only practitioners but also thought leaders who shape the future of healthcare.
Collaboration, Scholarship, and Empowerment: The Unifying Threads
The unifying threads of collaboration, scholarship, and empowerment are what truly set Strong Memorial Hospital’s model apart. Collaboration ensures that all members of the healthcare team work together effectively, valuing each other’s contributions. Scholarship emphasizes the importance of continuous learning and inquiry, encouraging APRNs to question existing practices and develop innovative solutions. Empowerment ensures that nurses have the authority to influence nursing practice and are provided with opportunities to advance and improve.
FAQs about Strong Memorial Hospital’s Model of Advanced Practice Nursing
Q1: What makes Strong Memorial Hospital’s model unique?
A1: The model is unique due to its comprehensive approach, integrating direct patient care with system support, education, research, and leadership, all underpinned by collaboration, scholarship, and empowerment.
Q2: How does the Strong model compare to other advanced practice nursing models?
A2: Unlike other models that may emphasize direct care as the central competency, Strong’s model treats all domains—direct care, support of systems, education, research, and leadership—as mutually exclusive and exhaustive, each contributing equally to the overall practice.
Q3: How does the Strong Memorial Hospital model support APRN role development?
A3: The model supports role development by incorporating the concept of moving from novice to expert APRN, providing a structured framework that guides APRNs through their professional growth.
Q4: What role does research play in the Strong Memorial Hospital model?
A4: Research is integral to the model, with APRNs actively engaged in both conducting and applying research to ensure that clinical practice is evidence-based and innovative.
Q5: How does the Strong model impact patient care?
A5: The model enhances patient care by ensuring that APRNs are not only skilled clinicians but also leaders in quality improvement, education, and research, thereby providing comprehensive, informed, and high-quality care.
The Strong Memorial Hospital’s Model of Advanced Practice Nursing represents a significant advancement in the field of nursing. By balancing direct patient care with system support, education, research, and leadership, this model provides a robust framework for APRNs to deliver exceptional care while also contributing to the broader healthcare environment. Through collaboration, scholarship, and empowerment, the Strong model ensures that APRNs are well-equipped to meet the challenges of modern healthcare and to continue driving the profession forward.