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Hamric Integrative Model: Purpose and Structure

Abstract

Numerous conceptual frameworks offer guidelines for Advanced Practice Nursing (APN). The key tenets and theoretical expositions of the Hamric model have been discussed in the paper. An integrative framework for advanced practice nursing is a science and research-based model that provides a framework for competencies and roles of practicing nurses. This model is an instrumental tool for APNs in the course of delivering care to patients. An integrated review of literature in the paper examines the purpose of the Hamric model in assisting and organizing belief systems and knowledge on Advanced Practice Nursing. Moreover, a number of evidences illustrate the purpose of the Hamric Model in providing a structure for research on APN. The model offers a coherent structure in which vital concepts in advanced practice nursing are identified and linked to each another.

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Introduction

Hamric model was formulated by Ann Hamric in 1996. It conceptualizes the nature of nursing practice as an independent profession. Hamric targeted to develop a model that would apply to the roles of Advanced Practice Nurses (APNs). Therefore, it is worth noting that the Hamric integrative model lays a lot of emphasis on the competencies and roles of Advanced Practice Nursing. Hamric also identified a criterion for defining the characteristics of APNs (Rounds, Zych & Mallary, 2013). She came up with a primary criterion of examining the level of education, certification in a nursing specialty and clinical practice of practicing nurses (Hamric, Spross & Hanson, 2005). Hamric model recognizes numerous core competencies which include research skills, direct clinical practice, professional leadership, ethical decision-making, collaboration and coaching (Oberle & Allen, 2001). This model has been refined several times. Hence, it entails the primary criteria for APNs and seven key competencies (Rounds et al., 2013). The model stipulates that contextual and environmental factors usually influence the performance of APNs. Therefore, there is need to regulate it. It is against this backdrop that this paper examines the effectiveness of Hamric model in meeting its set objectives.

The purpose of Hamric integrative model

The model can indeed assist a professional nurse to organize beliefs and knowledge about advance nursing practice. For instance, it effectively serves the purpose of facilitating understand and gaining additional knowledge about Advanced Practice Nursing (APN). Following the numerous revisions that have been done on the model, most of the crucial characteristics of APN are clearly depicted. Fawcett, Newman and McAllister (2004) posit that the model is inherently refined and elaborated and as a result, it forms a firm foundation for advanced practice nursing. In other words, it acts as a framework for organizing beliefs and knowledge regarding APN (Oberle & Allen, 2001). Furthermore, it provides a base for knowledge development in future through empirical and qualitative research activities. The model has achieved this purpose by outlining and defining the roles of practicing nurses. This has fostered development of autonomous professional practices among nurses (Rounds et al., 2013).

From the peer review literature, it is possible to attest that this model has positioned nursing practice as an independent profession (Oberle & Allen, 2001). Moreover, it is beyond reasonable doubt that the other theories have been very influential in the formulation of this model. According to Hamric et al (2005), it is vivid that Hamric model has borrowed some ideas from other models and theories. For instance, upon careful analysis of the model, it is possible to discern that the model is structured in manner similar to Maslow’s hierarchy of needs (Rounds et al., 2013). This contributes to an individual’s belief and understanding that goals can be best attained when challenges are handled in a systematic manner. For instance, a practicing nurse must attain education up to the graduate level and get certified before initiating the practice as a professional.

It is important to note that Hamric’s primary criteria of APN are targeted towards the core goal of nursing and the overall health of patients (Hamric et al., 2005). As a matter of fact, there is a direct relationship between nurses and patients bearing in mind that each one of them depends on one another. As much as nurses are trained to care for patients, there is a general belief that knowledge, skills and experiences often change progressively. This explains why the model aims to improve the central competencies of APN (Oberle & Allen, 2001). The core competencies are meant to assist practicing nurses to advance their knowledge through continuous consultation, guidance, research, coaching, leadership and collaboration (Rounds et al., 2013).

It is obvious that this model can be used for personal reference by anyone interested to gain additional knowledge and understanding of advanced practice nursing. From an objective point of view, the model allows an individual to identify and examine some of the environmental and contextual factors that affect nursing performance (Oberle & Allen, 2001). These may include health policies, organizational culture and structure, outcome of evaluation and performance among other critical environmental elements.

The purpose of Hamric Model

It is irrefutable that the model provides a structure for research on advance practice nursing. This conceptual model plays a vital role in guiding nursing practice. It also explains academic curricular for APNs as well as the overall development in each specialty (Hamric et al., 2005). It is evident from research studies that there has been continuous evolution of APN’s roles and practices. In addition, this model has been very influential in the development of nursing practice. Therefore, it is undeniable that the model provides the much-needed background for research and development of APNs (Rounds et al., 2013). It is worth mentioning that a number of other conceptual models have shaped APN in a positive manner. However, pieces of evidence from literature have confirmed that Hamric model is quite categorical in addressing research matters unlike other models. Fawcett et al (2004) elucidate that this models embraces variation in nursing practice. Oberle and Allen (2001) emphasize that the resiliency in Hamric model has been exemplified by its progressive influence on advanced nursing practice.

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This model possesses a foundational approach to advance both the general and specific aspects of nursing practice. It has a structural base which is synonymous to the Maslow’s theory of self-actualization (Hamric et al., 2005). For instance, the model centralizes everything on education. The latter is a basic necessity for APN. In the structure, the model emphasizes the importance of certification which usually comes after educational excellence. Thereafter, the model focuses on experiences that are built on core competencies in the delivery of nursing care. It is crucial to note that the revision of the model signifies the fact that its structure is dynamic in nature (Hamric et al., 2005).

Research studies have documented that potential transformations in the advanced practice nursing are inevitable (Oberle & Allen, 2001). The latter is a key indicator in developing positive initiatives. Besides, this model has provoked the spirit of inquiry thereby facilitating a more theoretical understanding of the framework. Oberle and Allen (2001) attest to the fact that this model is a research platform for advanced practice nursing. Hamric et al (2005) conceptualize that advanced practice nursing usually entails the application of a wide range of theories, practice and research-based competencies to provide care to patients. In the structure, important competencies such as collaboration and consultation are instrumental for aiding further research.

The purpose of the model in providing a coherent structure

It is vital to mention that there are a number of crucial concepts in advanced practice nursing which can be identified and related to one another. This model encompasses a coherent structure whereby successive and related concepts are identified. In addition, the model starts with the basic competencies that are patient-focused. After integrative review of literature, Fawcett et al (2004) confirm that the core competencies comprise of generic features of nursing practice. These include making ethical judgments and decisions, creative thinking, professional leadership, research, coaching and mentoring. Hamric et al (2005) observe that the generic features of APN are consistent and interrelated. For instance, there are those that are made up of direct nursing practice. Hence, they are also referred to as central competencies. These include application of knowledge in practice, analytical and critical thinking as well as clinical inquiry and professional leadership (Hamric et al., 2005). However, the remaining features are directly related to the central competencies. These include evidence-based practice, guidance, leadership and coaching. The way these concepts are structured depicts coherence in the structure of Hamric model.

Further review of literature has shown that the seven competences determine the overall state of patient wellness. Oberle and Allen (2001) observe that these competencies affect patients’ wellbeing in differing magnitudes. Fawcett et al (2004) explicate that the model takes a circular structure to signify the rounded nature of advanced nursing practice. It is important to note that the circle is stable and flexible. Therefore, it can accommodate changes in future.

Conclusion

Hamric Integrative model was synthesized in 1996 by Ann Hamric. The model provides a conceptual framework for advanced nursing practice. It outlines some of the crucial roles and competencies of nursing practice. Evidences from literature indicate that the models have structures that depict the generic characteristics of advanced nursing practice. In the model, seven core competencies are interrelated. These include collaboration, direct practice, evidence-based practice, consultation, ethical decision-making, guidance and coaching as well as professional leadership. Other components of the model include the primary criteria that entails the level of education, certification and patient-based practice. From the discussion above, it is evident that most of the competencies outlined are dependent on contextual and environmental factors. Therefore, the competencies must be managed in order to enhance advance nursing practice. This model is research-based hence; it serves the purpose of helping an individual to organize beliefs and knowledge about advance nursing practice. Moreover, it acts as a foundation for further research on advanced nursing practice. Besides, the model offers a structure where concepts that are crucial in advanced nursing are identified and studies alongside each other.

References

Fawcett, J., Newman, D., & McAllister, M. (2004). Advanced practice nursing and conceptual models of nursing. Nursing Science Quarterly, 17(2), 135-138.

Hamric, A., Spross, J., & Hanson, C. (2005). Advanced Practice Nursing: An integrative approach. St. Loius: Elsevier.

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Oberle, K., & Allen, M. (2001). The nature of advanced practice nursing. Nursing Outlook, 49 (3), 148-153.

Rounds, L. R., Zych, J. J., & Mallary, L. L. (2013). The consensus model for regulation of APRNs: Implications for nurse practitioners. Journal of the American Association of Nurse Practitioners, 25(4), 180-185.

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