Role-Based Practice

Role-Based Practice is the concept that nurses are professionally obligated to be aware of best practices in their role as a health care provider and to deliver patient care accordingly. Role-Based Practice acknowledges the crucial role that nurses have within the healthcare team and provides a framework to facilitate understanding of that role and how it impacts the delivery of evidence-based care.

In early 2010, Stanford Hospital & Clinics (SHC) was honored to work with Dr. Maria O'Rourke, the distinguished nursing expert who helped to develop the Model of Professional Practice. This model is widely acknowledged by nursing professionals as the model on which nurses should base their practice.

Dr. O'Rourke's life work has been to improve patient care through the alignment of care standards with the standardization of nursing practice. Research indicates that organizations delivering high levels of care were found to have professionals who had minimized variation in their practices and operated under a synergistic understanding of their roles and work expectations.

Dr. O'Rourke worked with SHC nurses to develop a Role-Based Practice Program specific to SHC's needs. The Professional Role-Based Practice Program is a multi-week program that is designed for nurses committed to re-examining their own practice behaviors against best practice standards for the professional nurse. It involves reading and studying the essential documents that describe the standards for a nursing professional: the ANA Standards of Practice, Code of Ethics, and the California Nurse Practice Act, among other resources. Nurses then work with an interactive tool designed to promote greater understanding of the nurse's individual practice and to align that with best practice goals.

To determine the stability of the patient condition, a role-based nurse must apply the Model of Professional Practice: the nurse as Practitioner, Leader, Scientist, and Transferor of Knowledge. A Clinician/practitioner recognizes that for each task a nurse performs, there is a corresponding professional responsibility and accountability.

In the leadership role: A nurse is a decision-maker and coordinator of care.

As a scientist: A nurse ensures his or her practice is evidence-based and that institution approved protocols are utilized.

As a transferor of knowledge: This important role is invoked when discussing the plan of care with patients, their loved ones, and with other members of the healthcare team.

Participants in the Professional Role-Based Practice Program speak enthusiastically about its impact:

  • "Empower my professional practice for better and safer patient care." "I'm going to voice my opinion and use evidence-based practice."
  • "Think more of the overall plan for patients and define goals during rounds."
  • "Put this in practice, encourage others to take advantage of what can be done to have better patient outcomes."
  • "Communicate more effectively and increase collaboration and participation."
  • "Participate hospital-wide in the development of Clinical policies and procedures using an evidence-based approach."
  • "Models that help us develop a language to communicate better is the perfect concept."

Chief Nursing Officer Nancy J. Lee, RN, MSN, says this of the Professional Role-Based Practice Program:

  • "We have a unique opportunity to take some of the best nurses in the world to even higher professional practice. I am so excited about our ability to provide even better care to our patients."

SHC continues to make Role-Based Practice the standard within the organization and supports nurses in their pursuit of this ideal with ongoing opportunities for education and collaboration.