The AACN Synergy Model and Patient Care

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When the American Association of Critical Care Nurses (AACN) developed a program to bridge the gap between critically injured patients and nurses, the organization outlined defined plans for critical-care settings.

Nurse greeting with patient in wheelchair

Today, the AACN’s Synergy Model for Patient Care has been so successful it has been adopted worldwide for uses in all aspects of nursing, from the classroom to the operating room. The model categorizes patients based on abilities and nurses on competencies to create successful nurse-patient relationships. The ultimate goal is patient satisfaction within the desired degree of wellness.

Healthcare leaders praise the Synergy Model for its simplicity, ease of use, and practical applications. In educational settings, the model has been lauded as “a blueprint for the nurse educator and learner to facilitate acquisition of knowledge, skills, and values across a nursing career,” researcher Deborah Green said in the Journal for Nurses in Staff Development.

Major universities have adopted the Synergy Model as a conceptual framework for nurse education. The Synergy Model empowers nurse to become leaders and learn more about the needs of the individual patients.

“Too often, a mismatch occurs between educators, learners, and the system in which they practice. A synergy model provides a way to close this gap and enhance the connection between the three entities,” Green said.

In creating the model, AACN members started the process by speculating that positive outcomes derive from three sources: the patient (and the patient’s family), the nurse, and the healthcare system. Overall the model is based on assumptions made by healthcare providers.

Initial Assumptions in Patient Health

The Synergy Model begins with expectations and assumptions as a starting point for foundational patient care, based on underlying tenets. The AACN describes them as follows:

  1. Patients are biological, psychological, social, and spiritual people who need medical care during particular healthcare incidents. All aspects of the patient (body, mind, and spirit) must be considered.
  2. The patient, family, and community contribute to providing a framework for the nurse-patient relationship.
  3. Both patients and nurses must be viewed as whole individuals rather than through their separate characteristics. Each of their characteristics must not be viewed in isolation, but rather in their entirety.
  4. The ultimate goal of nursing is to restore patients to their individual definition of wellness.

Patient and Nurse Relationships in the Synergy Model

When determining the right fit for nurse-patient partnerships, the first steps include determining patient acuity, or the intensity of required nursing care, and nurse competencies. The melding of the two can create positive outcomes for the patient, the AACN said. The organization noted, “Death can be an acceptable outcome, in which the goal of nursing care is to move a patient toward a peaceful death.”

Patients are defined based on the following characteristics presented during phases of their illness. Each of the characteristics is rated on a one, three, and five scale, with one as minimal, three as moderate, and five as maximum.

“The patient side of the model provides a means of describing patients and their families in a way that resonates with nurses and other caregivers. It provides the opportunity to build a common language for caregivers as they describe patient needs,” researchers in Nurse Economics said.

The AACN rates patients based on the following characteristics:

  1. Resiliency – The patient’s ability to bounce back from an illness or injury. This is based on age, overall health, and comorbid (or simultaneous) medical conditions. One is considered minimally resilient (unable to cope). Three is moderately resilient (able to mount a moderate response). Five is highly resilient (strong endurance).
  2. Vulnerability – Susceptibility to stressors that can endanger patient outcomes. This ranges from medically fragile to fully recovering.
  3. Stability – Ability to maintain steady equilibrium, ranging from a high risk of death to a low risk of death.
  4. Complexity – Intricate entanglement of psychological and emotional states, including family relations and environmental factors. This ranges from complicated lifestyles and family relations to straightforward interactions.
  5. Resource Availability – Availability of support, including supportive relationships, financial stability, and psychological care, ranging from few resources to abundant resources.
  6. Participation in Care – Accessibility, availability, and willingness by the patient and family to assist in care, ranging from no participation to full participation.
  7. Participation in Decision Making — Accessibility, availability, and willingness by the patient and family to understand the information provided, ranging from no participation to full participation.
  8. Predictability – Expectations of a certain course of action, ranging from not predictable to highly predictable.

At the same time, nurses are rated by competencies considered essential to quality patient care, based on an equal rating of one, three and five and ranging from full proficiency to novice experience. The idea is to pair nurses with patients to ensure the best outcomes. The following are nurse competency ratings:

  1. Clinical Judgment – Assessing a situation based on education and experience.
  2. Advocacy – Working on another person’s behalf.
  3. Care Practices – Using caring behaviors based on individual patient needs.
  4. Collaboration – Working with others to promote wellbeing.
  5. Systems Thinking – Using tools and knowledge from across the healthcare system.
  6. Response to Diversity – Recognizing and appreciating differences for appropriate care.
  7. Facilitator of Learning – Using knowledge to educate patients, families, caregivers, and other healthcare providers.

The Synergy Model and Nurse Education

While the Synergy Model was initially developed for use in critical-care settings, nurses across the healthcare spectrum have adopted the program. Nurse educators have found it useful when applied to students and learning, in both the classroom and clinical settings. Universities such as Duquesneuse the Synergy Model because it provides robust educational experiences.

Duquesne University Online Bachelor of Science in Nursing (RN-BSN) program

Students enrolled in Duquesne University’s online RN-BNS program learn the essentials of the Synergy Model through practical use in academic and clinical settings. Duquesne University’s online RN-BSN program allows RNs to complete their coursework in a flexible setting. The program’s academic advisors and faculty mentors are available to help students succeed.