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 Health Care (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
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
"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
"Participate hospital-wide in
the development of Clinical policies and procedures using an
help us develop a language to communicate better is the perfect
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
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.