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Professional Practice Model

Our professional practice model (PPM) depicts how Dartmouth-Hitchcock nurses practice, collaborate, communicate and develop professionally to provide the highest quality of care to our patients, families and communities. Our PPM illustrates the alignment and integration of nursing practice with Dartmouth-Hitchcock’s mission, vision and values.

As Dartmouth-Hitchcock Registered Nurses, we stand shoulder to shoulder with our patients, families and colleagues, uniting our system in the best interest of populations served. As practitioners, leaders/decision-makers, scientists and transferors, we make decisions and change outcomes.

Professional Role Clarity

As members of the profession of nursing, we adopt the tenets of practitioner, leader/decision maker, scientist and transferor as foundational to our practice. This integrated set of tenets transcends functional roles (e.g. direct care RN, manager, CNO, APRN, educator, clinical specialist, etc.) to bring meaning and significance to our professional practice across our health care delivery system.


Society grants us professional privilege with the understanding and expectation that we are guided by standards (state boards of nursing, nursing scope and standards, specialty standards). Monitoring and measuring our practice and outcomes are key components of our professional role responsibility.


We make decisions about care delivery to individuals or groups of patients with consideration for individual needs and preferences, based on nursing theory, science and evidence. We partner and collaborate with the other professional disciplines in health care to ensure safe passage of patients and families within our communities.


The science of nursing is based on the nursing process, an analytical framework of critical thinking, comprised of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. As nurse scientists, we create new knowledge through robust nursing research. We access, evaluate and apply the most current evidence in our continual quest to improve outcomes.


Professional nurses possess a specialized body of knowledge which they freely convey to patients, families, the community and colleagues. Our commitment to caring includes the D-H professional nurses’ continuous engagement in the “transmission and exchange of pertinent information that supports decisions required to manage the patient condition” (O’Rourke, 2011).


Our PPM was developed in the spring of 2015 by Registered Nurses serving in various roles across our system under the guidance of Dr. Maria O’Rourke. Dr. O'Rourke's life work has been to improve patient care through the alignment of care delivery with the standardization of nursing practice. Research indicates that organizations that deliver high-quality care have professionals who minimize variation in their practice and operate with a synergistic understanding of their professional role.