The Principles of Nursing Practice Framework (PNP)
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The Principles of Nursing Practice Framework is a teaching and learning framework designed to cause you to think about the underlying principles that are important for nursing care. The framework identifies principles that should be considered every time a nursing care strategy (nursing skill) is undertaken. Consideration of these principles requires you to think deeply about the actions/behaviours you undertake. This in turn will promote safe and competent practice.
For each of your patients you would have undertaken an assessment (using the domains of health, activities of living, interview schedules and inquired into your patient’s health status). From this you should have identified the patient’s problems, needs and developed a plan of care for them.
Within the plan of care you would have identified a set of nursing strategies – nursing care activities that would meet the goals of care.
The PNP framework is a tool to analyse your knowledge of these nursing strategies. For example, the nursing strategy, assessment of vital signs – blood pressure measurement.
The actions/behaviours you undertake to measure the blood pressure need to be thought about based on principles. Using the same example, measuring blood pressure, the principle of accuracy would be considered in relation to the position of the arm. That is accuracy of method. The behaviour you would undertake would be to rest the arm on a pillow so that it is level with the heart. The rationale is that raising the arm above the level of the heart can result in an inaccurate measurement.
The principle – evidence can also be discussed here when you would discuss the evidence that is available to support this behaviour and rationale. Alternatively the principle of evidence may be considered when you have a set of blood pressure measurements for a patient and you are required to undertake another nursing strategy (such as administration of medication).
Before developing a PNP framework you are encouraged to define the principles from as many perspectives as possible so that you develop a clear understanding of these words.
You should read the text books to get as much knowledge as possible of the nursing intervention (skill) and the rationales (reasons) for the actions/behaviours you are required to undertake. Then consider each principle in turn for the actions/behaviours listed. Every principle may not be identifiable every time and there will be different ways of discussing the principles dependent on the actions/behaviours required and the rationales for these actions/behaviours.
The PNP framework will support you to develop a systematic way of thinking that can be applied to more complex nursing strategies in the future. That is you will be able to implement complex care and ensure safe practice by considering principles of practice.
Your analysis of the skill requires you to describe relevant nursing behaviours and related rationale/s. You must ensure that your presentation style illustrates clearly that a particular rationale relates to a particular nursing behaviour. This may be achieved through careful phrasing of your work or you may use headings and subheadings. The reader/marker will not assume any relationship between nursing behaviours and rationale – this relationship must be implicit in your writing and presentation.
Patient Client Identification:
Need/Problem:
Nursing Care Goal:
Nursing Care Strategy:
Principles
Actions/Behaviours/
Rationale
Accuracy
Assessment
Communication
Documentation
Equity
Evaluation
Evidence
Outcomes
Safety
Teaching
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