When the AACN Synergy Model for Patient Care debuted, it embodied a fundamental shift in thinking about nursing skills and how to assess them through certification. Today, the Synergy Model continues to serve as the basis for AACN certification programs, and it establishes the standard for entry-level progressive care (PCU) and critical care (ICU) nurse competency. The competencies are described in “AACN Competence Framework for Progressive and Critical Care: Initial Competency 2022” and its toolkit. Throughout the nursing profession, the Synergy Model use has expanded to other nursing applications in a variety of organizational types.
What is the Synergy Model?
The Synergy Model is a conceptual framework that aligns patient needs with nurse competencies. Developed in 1996, the Synergy Model shifted the assessment of nursing skills from the then-prevalent body systems/medical model,which didn’t consistently match actual practice,to a “nurse competencies” framework.
The central idea of the model is that a patient's needs drive the nurse competencies required for patient care. When nurse competencies stem from patient needs, and the characteristics of the nurse and patient match, synergy occurs. This synergy enables optimal outcomes.
The model identifies eight patient characteristics and eight nurse competencies. More detailed information about these needs and competencies is available here.
Where is the Synergy Model used?
The Synergy Model is the keystone of AACN certifications and AACN’s competence framework, and has been used as a professional practice model, a foundation for nursing school curricula and a model for professional advancement.
How is the Synergy Model used as the standard for initial ICU and PCU competency?
Measurable performance outcomes (POs) for each of the eight Synergy Nurse Competencies (SNCs) were developed and underwent content validity testing with greater than 80% agreement for each of the POs.
- Preceptors use these POs to assess and evaluate an orientee nurse’s progress toward competency.
- Overall competency is addressed by partnering evaluation of the SNCs with evaluation of a succinct list of knowledge, skills and abilities (KSAs) specific to the practice area.
- When all POs for each SNC are consistently displayed and KSAs are met, the nurse is deemed competent and ready to transition from orientation to more independent assignments.
How is the Synergy Model integrated into AACN certification programs?
The Synergy Model influences AACN certifications in three ways.
- Developing Nurse Competencies
AACN Certification Corporation uses the nurse competencies of the Synergy Model as the conceptual framework for the research — called job analyses or "studies of practice"— underpinning development of its certification exams. The organization conducts national job analysis surveys at least every five years to ensure its certification exams reflect current nursing practice. The nurse competencies in the model guide the questions on these surveys, and the results serve as the foundation for certification test plans. You can access the job analysis report from each AACN certification. - Developing Certification Test Plans
Test plans for AACN Certification Corporation exams are organized by the nurse competencies in the Synergy Model and can be accessed in the exam handbook for each certification program. When preparing for an AACN certification exam, you are not expected to memorize all components of the model. However, you may benefit from studying the nurse competencies of the model and are encouraged to use your certification's test plan as a primary study resource. - Supporting Certification Renewal
Renewal of many AACN Certification Corporation credentials requires earning Continuing Education Recognition Points (CERPs) in categories corresponding to the eight nurse competencies in the Synergy Model. For example, one category focuses on collaboration and systems thinking, encompassing topics such as communication and healthy work environments. When it's time to renew your certification, you may find it beneficial to familiarize yourself with these nurse competencies. Access details about CERP categories in the CCRN/PCCN Renewal brochure.
Where can I find Synergy Model source materials and references for research projects?
Over the years, a number of national nursing experts have authored materials that describe and expand on the AACN Synergy Model for Patient Care.
- “Synergy: The Unique Relationship Between Nurses and Patients” — Edited by Martha A.Q. Curley in 2007, remains a seminal publication on the Synergy Model that provides foundational insights into its principles and applications.
- "Synergy for Clinical Excellence - The AACN Synergy Model for Patient Care," 2nd ed. — Sonya Hardin and Roberta Kaplow's 2017 book provides a detailed analysis with case examples for each of the Synergy Model's eight patient characteristics and eight nurse competencies, as well as examples of the model's broader applications.
- Critical Care Nurse and the American Journal of Critical Care — These two AACN peer-reviewed journals have published numerous articles on applications of the Synergy Model since 1996.
How has the Synergy Model been used in developing frameworks for nursing practice?
The Synergy Model emphasizes the importance of alignment between patient needs and nurse competencies in achieving optimal outcomes and nurse satisfaction. With its focus on context and the patient/nurse relationship, the model lends itself to broader application within the world of nursing practice.
Hardin and Kaplow dedicate an entire section of their book "Synergy for Clinical Excellence - The AACN Synergy Model for Patient Care," 2nd ed. to various applications of the model within nursing practice, in situations from the bedside to the boardroom, and from academic education to professional development.
Many organizations across the United States draw on the Synergy Model as a basis for their work. For example, the Department of Nursing at the University of California, San Francisco Medical Center and Baylor Health Care System use it as their professional practice model. Duquesne University employs it as their model for nursing education and publishes their Synergy Model-based graduate curriculum model online.
Can the Synergy Model be used to develop viable staffing models?
As a guiding framework, the Synergy Model matches nurse knowledge, skills and abilities with patient needs. Matching nurse competencies with patient needs promotes optimal outcomes and nurse well-being. Using this framework enables organizations to implement the "Appropriate Staffing" standard of the "AACN Standards for Establishing and Sustaining Healthy Work Environments."
Appropriate staffing ensures an effective alignment between the unique characteristics of both the nurse and the patient. The Synergy Model moves staffing practices beyond potential mismatches that result from rigid solutions — such as fixed staffing ratios — toward staffing plans that acknowledge the dynamic variability among acutely and critically ill patients.
For additional information on appropriate staffing, visit our Staffing Resources.