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Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care

2006; American Association of Critical-Care Nurses; Volume: 26; Issue: 2 Linguagem: Inglês

10.4037/ccn2006.26.2.139

1940-8250

Melanie Cline, Mary Nottingham, Such Lockhart,

Nursing Diagnosis and Documentation

Sonya R. Hardin, Roberta Kaplow. Sudbury, Mass: Jones and Bartlett; 2005. Paperback, 237 pages. ISBN: 0-7637-2601-X.In Synergy for Clinical Excellence, Hardin and Kaplow have developed a useful reference for nurses interested in gaining a deeper understanding of the American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care in order to use it in clinical practice. The introduction offers a historical review of how AACN developed the model as the conceptual framework for certified practice in critical care nursing. The text is organized around the basic tenets of the model—the patient and nurse characteristics—concluding with sample questions for those seeking critical care certification.The reader will appreciate the thorough review of literature provided for each of the 8 patient characteristics. The text provides a deeper understanding of each characteristic, enhancing clarity and facilitating a more consistent application of the model. AACN’s definitions are discussed in detail and illustrated with a case study in which the patient’s needs are categorized by level (low, medium, high) and nursing actions suggested to address each need and improve outcomes.The book continues with a thorough introduction to the 8 nurse characteristics that are embedded in both the Synergy Model and in everyday nursing practice. Nurses at the bedside will find the definitions, descriptions, and illustrations helpful in understanding and articulating a nurse’s unique role in relation to the model. Once again, case studies facilitate a contextual understanding that will help clinicians to identify these characteristics within their own practice. Clinicians will also be able to identify the developmental levels of practice based on Benner’s work (level 1, advanced beginner; level 3, competent; level 5, expert) for each characteristic.Nurses preparing for adult, pediatric, or neonatal CCRN certification will find more than 100 pages of study questions very useful. Each question is based on the Synergy Model and includes a detailed rationale for the correct answer providing context and demonstrating the relationship between the model’s patient and nurse characteristics.Clarian Health Partners is the first healthcare system to adopt the AACN Synergy Model for Patient Care as the basis for care delivery and professional advancement. Hardin and Kaplow’s book has proven useful as an introductory guide and reference for clinical nurses to acquire a basic understanding of the model. The text is clear and direct, offering a quick and easy read along with excellent real-life examples of the model’s application to clinical practice.Designing nursing curricula and program outcomes aimed to prepare future nurses in meeting the health-care needs of a global community are essential responsibilities of nursing faculty. A conceptual framework to organize and guide nursing curricula is vital in fulfilling those responsibilities. The AACN Synergy Model for Patient Care, as described by Hardin and Kaplow, offers that framework because of its basic premise. Namely, that patient outcomes are optimized when patient needs and nurse characteristics match. For this reason, Duquesne University School of Nursing has adopted the model for both undergraduate and graduate nursing curricula.According to the authors, the model was originally designed as a framework (blueprint) for specialty certification in clinical practice. They suggest using the book to learn how to apply the model in clinical practice and to prepare for CCRN certification. The authors further suggest using the model as a nursing education and research resource. It can also be used in nursing theory courses and in designing nursing curricula.The book’s structure and content facilitates its intended uses. It is organized into 4 sections that are further subdivided into chapters. Section I (Introduction) describes the historical evolution of the model since its inception over a decade ago and introduces its key components. This section expands on the model’s value in providing a “new paradigm for clinical practice” that focuses on meeting patient needs and influencing patient outcomes. Attention is given to 8 patient characteristics (needs), 8 nurse characteristics (competencies) and key assumptions. Relationships among patient characteristics, nurse competencies, and patient, nurse, and healthcare system outcomes are illustrated and briefly addressed. Further explanation could strengthen the model’s utilization in nursing research.The chapters in Section II further develop each patient characteristic and use case studies to aid application to practice. A similar approach is employed in Section III for the nurse characteristics. The nurse characteristics are competencies that can guide learning experiences and serve as the outcomes graduates need to attain at the conclusion of an undergraduate or graduate degree program.Section IV includes 150 scenario-based multiple-choice questions based on the model. Various clinical contexts are used, including acute and critically ill adults, pediatric, neonatal, advanced practice, and progressive care. The rationale for each correct response provides immediate feedback and challenges readers to integrate the model in practice. This chapter seems equally helpful for faculty designing examinations within a curriculum based on the model and nurses preparing for certification. A glossary of key terms concludes the book and provides a quick reference.In summary, Hardin and Kaplow have developed a practical, reader-friendly resource for nurses in clinical practice, education, and research to understand the AACN Synergy Model for Patient Care and integrate it in their practice.