Patient Care Delivery System PDF

II. Patient Care Delivery System DR. ANNE ROSE L. CALIMLIM, MAN, RN  Patient Care Delivery System In the field of nursing, the delivery of quality care services is of paramount importance. To ensure efficient and effective healthcare provision, nursing management and leadership play a cru...

II. Patient Care Delivery System DR. ANNE ROSE L. CALIMLIM, MAN, RN  Patient Care Delivery System In the field of nursing, the delivery of quality care services is of paramount importance. To ensure efficient and effective healthcare provision, nursing management and leadership play a crucial role. One essential aspect that underpins these roles is how to delegate these tasks by using the nursing process, which guides nurses in their decision-making and care delivery. Alongside the nursing process, the patient classification system and modalities of care also play a significant role in ensuring optimal patient outcomes. A. Definition of Delegation Making or giving an assignment is not the same as delegation. In an assignment, power is not transferred. Assignments relate to situations where an RN directs another individual to do something that the person is already authorized to do. However, if the RN directed the nursing attendant to check the amount of drainage on a fresh perioperative abdominal dressing, this would be considered delegation because the RN retains responsibility for this action. Hierarchy of Nursing B. Nursing Process in the Delivery of Nursing Care Services The nursing process is a systematic framework that guides nurses in delivering high-quality care to patients. It provides a structured approach to assess, diagnose, plan, implement, and evaluate nursing interventions. A-Collecting and analyzing data. Assessment includes not only physiological data, but also psychological, sociocultural, spiritual, economic, and life-style factors as well. For example, a nurse’s assessment of a hospitalized patient in pain includes not only the physical causes and manifestations of pain, but the patient’s response—an inability to get out of bed, refusal to eat, withdrawal from family members, anger directed at hospital staff, fear, or request for more pain medication. D-The nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs. The diagnosis reflects not only that the patient is in pain, but that the pain has caused other problems such as anxiety, poor nutrition, and conflict within the family, or has the potential to cause complications. Nursing Process in the Delivery of Nursing Care Services P-Based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient that might include moving from bed to chair at least three times per day; maintaining adequate nutrition by eating smaller, more frequent meals; resolving conflict through counseling, or managing pain through adequate medication. I-Nursing care is implemented according to the care plan, so continuity of care for the patient during hospitalization and in preparation for discharge needs to be assured. Care is documented in the patient’s record. E-Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed. The Nursing Process and Delegation The nurse must then oversee the Before deciding who should care for care and determine whether client a particular client, the nurse needs care needs have been met to assess each client’s care (evaluation). It is also important for requirements, set client-specific the nurse to allow time for feedback goals, and match the skills of the during the day. This enables all person assigned with the tasks that personnel to see what has been need to be accomplished accomplished and what still needs (assessment). to be done. Thinking this through before Next, the nurse assigns the tasks to delegating helps prevent problems the appropriate person later (plan). (implementation). Importance in Nursing Management and Leadership 1. Promote standardized care: The nursing process promotes consistency and uniformity in care delivery, ensuring that all patients receive evidence-based and quality care regardless of the healthcare setting. 2. Enhance communication and collaboration: The nursing process fosters effective communication and collaboration among healthcare professionals, leading to improved interdisciplinary teamwork and patient outcomes. 3. Facilitate decision-making: By utilizing the nursing process, nurse leaders can make informed decisions based on accurate assessment, diagnosis, and evaluation of patient needs, leading to improved management of nursing care services. 4. Ensure accountability and quality improvement: The nursing process provides a framework for nurse managers to monitor and evaluate the quality of care provided, identify areas for improvement, and implement evidence-based practices.  C. Types of Patient Classification System OBCU Obstetrical Acuity Scale (OTAS)- London Health Sciences Centre 1. Acuity-based Classification: Acuity-based classification systems assess the complexity and intensity of patient care needs. They utilize standardized criteria to determine the level of nursing care required. This approach considers factors such as diagnosis, treatment, level of dependency, and required interventions. Acuity-based systems aid in accurately matching nursing resources to patient needs, ensuring appropriate staffing and skill mix.  C. Types of Patient Classification System Care Dependency Scale 2. Dependency-based Classification: Dependency-based classification systems focus on the level of patient dependency on nursing care. These systems evaluate activities of daily living (ADLs), such as mobility, hygiene, and nutrition, along with the need for assistance and supervision. By categorizing patients based on their dependency levels, nursing professionals can allocate resources efficiently and provide individualized care plans.  C. Types of Patient Classification System Overview of Triage Acuity System based on Time 3. Time-based Classification: Time-based classification systems allocate nursing resources based on the amount of time required for patient care. This approach considers the time needed for specific nursing interventions, procedures, and treatments. Time-based classification aids in workload distribution and facilitates effective time management. Importance in Nursing Management and Leadership 1. Efficient Resource Allocation: Patient classification systems enable nursing leaders to allocate resources effectively and efficiently. By accurately assessing patient needs and matching them with available resources, nursing professionals can optimize staffing levels, skill mix, and workload distribution. This ensures that each patient receives the appropriate level of care and reduces the risk of understaffing or overstaffing. 2. Improved Patient Outcomes: Effective patient classification systems contribute to improved patient outcomes. By assigning patients to appropriate care levels, nursing professionals can provide individualized care plans tailored to specific needs. This promotes patient safety, enhances quality of care, and reduces the risk of adverse events. Patient classification also aids in continuity of care during transitions between healthcare settings. 3. Enhanced Decision-making: Patient classification systems provide nursing leaders with data-driven insights for decision-making. By analyzing patient acuity, dependency, and other relevant factors, leaders can make informed decisions regarding staffing, resource allocation, and care planning. This can foster efficient decision-making and supports effective management of nursing units and departments. 4. Workforce Satisfaction: Optimal patient classification systems contribute to workforce satisfaction among nursing professionals. By ensuring appropriate workload distribution and staffing levels, nursing leaders can promote a healthy work environment. Adequate staffing reduces the risk of burnout, enhances job satisfaction, and improves retention rates. It also allows nurses to provide quality care while maintaining a better work-life balance. D. Modalities of Care 1. Functional Nursing: Functional nursing is a mode of care delivery in which tasks are divided among a group of healthcare professionals. Each team member has a specific function or responsibility, such as administering medication or monitoring vital signs. This mode promotes efficiency and specialization, as each team member becomes highly skilled in their assigned task. However, it may result in fragmented care and a lack of holistic understanding of the patient's needs. D. Modalities of Care 2. Team Nursing: Team of healthcare professionals works together to provide care for a group of patients. The team typically consists of a registered nurse, licensed practical nurses, and nursing assistants. Each team member contributes their expertise and collaborates to deliver comprehensive care. This mode promotes communication and coordination among team members, ensuring that all aspects of patient care are addressed. However, it can sometimes lead to role confusion and a lack of clear leadership. D. Modalities of Care 3. Total Patient Care Nursing: Total patient care nursing, also known as case method or bedside nursing, involves a registered nurse assuming full responsibility for the care of a specific patient. The nurse is responsible for coordinating and providing all aspects of care, including physical, emotional, and psychosocial needs. This mode allows for personalized care and a strong nurse-patient relationship. However, it requires a higher nurse-to-patient ratio and may not be feasible in all healthcare settings. D. Modalities of Care 4. Primary Nursing: Primary nursing is a mode of care delivery where a registered nurse is assigned to a small group of patients for an extended period. The primary nurse assumes responsibility for coordinating and managing all aspects of care for their assigned patients, even when not physically present. This mode promotes continuity of care and a strong nurse-patient relationship. However, it may be challenging to maintain consistency if the primary nurse is unavailable or overwhelmed with other responsibilities. D. Modalities of Care 5. Modular Nursing Modular nursing is a flexible mode of care delivery where healthcare professionals work in modules or units, focusing on specific patient populations or conditions. Each module consists of a team of nurses, collaborating with other healthcare professionals as needed. This mode allows for specialized care and expertise in specific areas. However, coordination between modules and communication among team members are crucial to ensure comprehensive care for patients. D. Modalities of Care 6. Nursing Case Management Nursing case management involves a registered nurse assuming the role of a case manager to coordinate and manage care for a specific patient or group of patients. The nurse collaborates with other healthcare professionals, such as physicians, therapists, and social workers, to ensure the delivery of appropriate and timely care. This mode focuses on coordinating resources, advocating for the patient, and ensuring continuity of care across different healthcare settings. However, it requires strong organizational and communication skills to effectively manage complex cases.