Patient Assignment Methods PDF

# **Patient Assignment** ## **Definition:** Assignment refers to a written delegation of duties for the care of a group of patients by trained employees assigned to the unit, based on their knowledge, skills, job description, and the patients' nursing needs. ## **Purposes of assignment:** 1. T...

# **Patient Assignment** ## **Definition:** Assignment refers to a written delegation of duties for the care of a group of patients by trained employees assigned to the unit, based on their knowledge, skills, job description, and the patients' nursing needs. ## **Purposes of assignment:** 1. To delegate the work to be done by the nursing personnel employed in the unit based on the administrative policies, order of authorities, and job description. 2. To suggest the appropriate method for delivering nursing care with maximum efficiency and minimum effort. 3. To gain the cooperation of workers in the acceptance of the work to be done. ## **Principles underlying patient assignment:** 1. Assignment must be made by the first lines manager (head nurse, nurse in-charge). 2. It is based on nursing needs of patients and the approximate time required in order to fulfill those needs. 3. It is planned for at least one week to assure continuity of care. 4. It considers the capabilities of staff, skill level, and experience. 5. It considers all indirect unit activities. 6. It considers that each task is the responsibility of one nurse. ## **Characteristics of a good assignment:** 1. It is definite and clearly understood. 2. It is related to the previous experiences of the workers. 3. It should be written. 4. It should be interesting for the workers. 5. It should be given in such a way that workers are guided in their activities and difficulties are minimized. ## **Methods of patient care assignment:** ### **The Traditional methods:** * Case method * Functional method * Team method * Primary nursing method * Modular nursing ### **The Alternative Method:** 1. **The case method:** - In this method one professional nurse assumes total responsibility for providing complete care for one or more patients while she is on duty, with no guarantee of having the same patients the next day. - The head nurse supervises and evaluates all the care given on her unit. - The case method stresses adherence to physicians' orders. #### **Advantages:** * Individualized care. * Patient satisfaction. * Facilitates close relationship of nurses with patient and families. #### **Disadvantages:** * This method will increase workload when there is a shortage in the staff (i.e. It will force the work regardless of the patients' needs and personnel abilities). * Little continuity of care -- exist from shift to shift except in following procedures. * Difficult for the head nurse to supervise. * More equipment and supplies are needed patients. 2. **Functional nursing:** - This is the oldest nursing practice modality. It can best be described as a task-oriented method in which particular nursing function is assigned to each staff member. One registered nurse is responsible for administering medications, one for treatments. One licensed practical nurse is assigned to admission and discharge. Another gives bed baths. Nurses' aide makes beds, passes meal trays, and so on. - No nurse is responsible for giving total care to any one patient. The method divides the task to be done, with each person being responsible to the nurse manager. - This method is efficient and may be best system when the nurse manager is confronted with a large patient load and a shortage of professional nurses. #### **Advantages:** * Efficient when there is a shortage in the staff or there is limited number of professional nurses. * Each staff nurse is likely to become skillful in performing the one or two tasks which leads to increasing speed and efficiency. * Less equipment needed. * Less cost. * Useful in emergency situations, #### **Disadvantages:** * The segmentation of patient care among several nurses will result in neglecting. The humanity of the patient and the individual needs of the patient will be lost in an effort to get the work done. * Lack of communication among the different persons who care for the patient. * When responsibility for a patient's care is divided among several nurses, it is easy for each to deny responsibility for care omissions and mistakes. 3. **Team method:** - It is a method that binds professional, technical, and ancillary nursing personnel into small teams. It combines the superior knowledge and skills of the professional workers with technical or ancillary workers. - Assignment of patients is made to a team consisting of a registered nurse as a team leader, other registered staff nurse, practical nurses, and aides as team members. - The team leader has the responsibility for coordinating the total care of a block of patients and is the leadership figure. - The intent of team nursing is to provide patient-centered care. The patients' nursing care needs are identified and met through nursing diagnosis and prescription. Ward clerks and unit managers perform the non-nursing functions of the unit. - The process requires planning to meet the objective of taking nursing personnel to the bedside so that they can focus upon the nursing care of patients. - Implementing team nursing requires study of the literature on team planning and the development of a priority to motivate the team to work together cooperatively to achieve a maximum level of care. - Through the team plan the contributions of all members in improving patient care are recognized. Priority is given to strengthening members' weaknesses. - Patient-centered care requires effective supervision and recognition that personnel are the means by which the objectives are met in a cooperative effort between team leaders and team members. - Through supervision, the team leader identifies nursing care goals, identifies team members' needs, focuses on fulfilling goals, motivates team members to grow as workers and citizens, and guides team members to help set and meet high standards of patient care. #### **Advantages:** * Availability of professional nurses' skills for a large number of patients. * Continuous supervision of less trained personnel, thus providing better patient care. * Increase in number and duration of professional nurse-patient interaction #### **For nursing personnel:** * Help in developing leadership skills. * Great opportunity of initiative and shared responsibility. * Maximal use of individual abilities. * Reduction of time spent in performing non-nursing activities. #### **Disadvantages:** * The team method of assignment cannot be used effectively in such a unit until the personnel were trained for the roles of team leader and team members through some sort of in-service education program. ## **Importance of interns' cooperation in assignment:** * Interns are motivated by giving the assignment in such a way that staff are guided in their activities and difficulties are minimized. * Promotes competence and development of the staff interns through work assignment rotation. * Praise the good work of interns in front of the rest of the staff