Nurses emPOWERed for professional practice. Perceived barriers and facilitators affecting the implementation of Professional Practice Model for nurses: a qualitative study.

Abstract

Background: In response to the increasing complexity of care a professional work environment for nurses is required to maintain high-quality of care. Implementing a Professional Practice Model (PPM) can facilitate to establish a professional work environment and the positioning of nursing in the organisation. This study is focusing on implementation strategies of a PPM. Aim: To explore the experienced barriers and facilitators affecting the implementation of a PPM for nurses in Dutch hospitals. Method: This general qualitative study was conducted in 22 Dutch hospitals. Data were collected between February 2017 and April 2017. We used purposive reputation- and convenience sampling for 22 semi-structured interviews with 24 participants. The interviews were audiotaped, transcribed and subjected to qualitative content analysis. Results: Three themes related to perceived facilitators and barriers were identified: creating the desired future at the strategic level, connecting services at the tactic level, and leadership for excellence in nursing care at the operational level, linked by one overall theme; ‘leadership from bed to board’. The main themes are strongly related to each other and have a major impact on the professionalisation of the nursing profession. Conclusion and implications: Taking responsibility and leadership at all levels in the organisation appear to be important in the nursing professionalisation. Decisions should be made about the governance structure facilitated by a clear vision. At the tactic level, a position, embedded in the organisation structure, where it connects all levels and disciplines in the organisation is recommended to ensure leadership of the nursing profession. Head nurses have roles crucial to the success, which urges for sufficient competencies.