Nursing-care-delivery-system.pdf

Nursing care delivery systems  Out line: Definition of nursing delivery system Purpose of nursing delivery system The 5 C’s of Caring Principles of nursing delivery system Models of nursing delivery system Professional Practice Environment (PPE). Variables of Profes...

Nursing care delivery systems  Out line: Definition of nursing delivery system Purpose of nursing delivery system The 5 C’s of Caring Principles of nursing delivery system Models of nursing delivery system Professional Practice Environment (PPE). Variables of Professional Practice Environment. Factors influencing nursing care delivery system. Roles of a Nurse. Nursing Care Delivery System: The nursing care delivery system means :“the process of delivering care to the client by combining various aspects of nursing service which will fit to various patient care settings to produce a common outcome of delivering quality care and meeting the needs of clients” Nursing Care Delivery System The purpose of nursing care delivery system is: to provide structure that enables nurses to deliver nursing care to specified group of patients and meet their need. The 5 C’s of Caring: Commitment: The life of a nurse can be challenging at times, commitment to patients cannot be sacrificed. Nursing staff members must continually dedicate themselves to putting their best foot forward. Conscience: Delivering the best possible care to patients involves a resilient sense of moral responsibility born of a strong conscience. Conscience helps guide your actions even when focus on stress or personal matters. The 5 C’s of Caring: Competence: There are a number of ways nurses can demonstrate competence in the workplace. Consistently arriving to work on time and presenting yourself in a professional manner is one way. Another is to hold yourself to a high standard of excellence when fulfilling daily tasks, regardless of the behavior of others or the circumstances.  Cont… Compassion: Having compassion is essential for anyone in the health care profession as it takes compassion to give patients a positive experience. Compassionate nurses empathize with their patients and provide kind and considerate treatment at all times. Confidence: Confidence is the aspect of caring that ties the other 4 of the 5 C’s together. It takes confidence in personal skills and knowledge to act with commitment, follow conscience, consistently act in a competent manner, and express compassion, even in the most difficult of situations.  Principles of nursing care delivery system: - Holistic approach is used to identify nursing care - physical needs - mental and social needs - spiritual needs -Nursing care is based on a helping relationship - It is the unique function of the nurse to provide nursing care according to client needs. -The aspect of patient care has to be initiated and controlled by nurse. - Before planning care organizational policies to be considered. Models of Nursing Care Delivery System: 1. Functional nursing 2. Team nursing 3. Primary nursing 4.Total patient care 5. Case management 1. Functional Nursing: -is a method of providing patient care by which each licensed and unlicensed staff members perform specific tasks for a large For example, there is a medicine nurse whose group of patients. sole responsibility is administering -1930 USA medications. -Its also called task nursing It required only one RN Functional Nursing (Cont…) Advantages Disadvantages - The staff become efficient and - Lack of holistic care or effective as well as strength at increase in fragmentation of performing their tasks care - Problem with follow-up - Most lowest cost model. nurse-patient relationship - Save time -staff may have very little - useful in emergency motivation to develop self 2. Team Nursing: - A nursing team made up of professional nurses, nursing auxiliaries and nursing aids. They can work together co- operatively under a well qualified team leader to provide a range of nursing services which may vary from the simple to the most complex nursing functions. - 1950 - most function of team nursing : ( nursing aides , trained nursing personnel , a nurse with professional nursing education background ). Team nursing Cont … Advantage Disadvantage - high quality , - Fragment of care comprehensive care with a high proportion of - The time needed for the ancillary staff team leader to communicate, supervise, - Use of different levels and coordinate team of member nursing staff or nursing personnel - High cost (need more than RN) - Team nursing help to - No client care may be given by team save steps and time member during patient care 3. Primary Nursing: - Primary nursing concept was to promote individualized nursing care and to make qualified registered nurses assume responsibilities for nursing care provided to patients. - Comprehensive, continuous and coordinated nursing process for meeting the total needs of each patient. -One registered nurse is responsible for patient care over 24 hours period, 7 days week from the time the patient is admitted to the hospital to the discharge Primary nursing cont... Advantage Disadvantage - Continuity of care - Improper implementation - Patients satisfaction - Incompetence primary - Provide high quality nurse patient care to identify patient’s need or - Most Cost-effective condition change model - Increased communication with - Need time for physician and other health care coordination provider 4. Total Patient Care Nursing: - where one nurse provides total care to a single patient or a group of patients during his/her shift. During that shift, all the patient needs are addressed by the nurse, and in some cases, the nurse issues care until the end of the patient's medical needs. - It is the oldest model -This Model is used in Critical care units (ICU or CCU), any area where one nurse care for patients total need. Cont… Advantage - Comprehensive care Disadvantage - Costly - Meet all the patient’s needs - Need for nurse to have the - Self improvement expertise to meet all the care - is the one-on-one needs of the patient attention and monitoring a skilled nursing professional provides 5. Case Management: - process of monitoring an individual patient's health care by the case manager, for the purpose of maximizing positive outcomes and containing costs. - 1991 ANA defines it healthcare delivery process whose goals are to provide healthcare , decrease fragmentation, enhance client quality of life. - Planning, implementing, coordinating and evaluating for patient throughout the period of illness plans are made in advance for the next needed step. Requirements of Nursing Case Management: - Collaboration with members of health care team. - Identification of expected patients’ outcome. - Promotion of professional practice. - Use principle of continuous quality improvement.  What is the deference between case management and primary nursing? 1. The primary focus in case management is planning, coordinating, and evaluating care. In primary care, the primary focus is delivering care. 2. There is more collaboration and less control of the patient care. Factors influencing nursing care delivery system: Availability of adequate staff in units. Patient census. staff deficiency. Availability of skilled staff. Patient preference for care. Cont… Opportunities for continuing and in-service education for the staff. Socioeconomic condition of the patient. Budget of the organization. Patient and community needs. Professional Practice Environment (PPE)  Professional Practice Environment: A professional practice environment as "a system that supports registered nurse control over the delivery of nursing care and the environment in which care is provided." Two concepts frequently cited as attributes of professional practice environments are autonomy and control over practice. Professional Practice environment: Two basic concepts attributes of professional practice environment are: 1. Autonomy. 2. Control over practice. Autonomy: The extent to which employees act independently of a supervisor and exert control over their work. Control Over Practice The extent to which nurses have the resources and supports to provide autonomous practice. Variables of Professional Practice Environment: 1. Decentralization: The delegation of authority for decision making to operational level. 2. Autonomy: The freedom to exercise skills and expertise without control of an external agent. Cont… 3. Job satisfaction: The degree to which an employee holds the positive attitude toward his or her place of employment. 4. Organizational commitment: Believing in an organization's values and goals and the willingness to work diligently on the organizations behalf.  Roles of a Nurse: The primary role of a nurse is to advocate and care for individuals and support them through health and illness. However, there are various other responsibilities of a nurse that form a part of the role of a nurse, including to: Record medical history and symptoms. Collaborate with teams to plan for patient care. Advocate for the health and wellbeing of patients. Monitor patient health and record signs. Cont… Administer medications and treatments. Operate medical equipment. Perform diagnostic tests. Educate patients about management of illnesses. Provide support and advice to patients.  Patient care: A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat health conditions. To do this, they need to observe and monitor the patient, recording any relevant information to aid in treatment decision-making. Cont… Throughout the treatment process, the nurse follows the progress of the patient and acts accordingly with the patient’s best interests in mind. The care provided by a nurse extends beyond the administration of medications and other therapies. They are responsible for the holistic care of patients, which encompasses the psychosocial, developmental, cultural, and spiritual needs of the individual.  Patient advocacy: The role of the nurse is to advocate for the best interests of the patient and to maintain the patient’s dignity throughout treatment and care. This may include making suggestions in the treatment plan of patients, in collaboration with other health professionals.  Planning of care: A nurse is directly involved in the decision-making process for the treatment of patients. It is important that they are able to think critically when assessing patient signs and identifying potential problems so that they can make the appropriate recommendations and actions. Cont… As other health professionals, such as doctors or specialists, are usually in charge of making the final treatment decisions, nurses should be able to communicate information regarding patient health effectively. Nurses are the most familiar with the individual patient situation as they monitor their signs and symptoms on an ongoing basis and should collaborate with other members of the medical team to promote the best patient health outcomes.  Patient Education and Support: Nurses are also responsible for ensuring that patients are able to understand their health, illnesses, medications, and treatments to the best of their ability. This is of the essence when patients are discharged from hospital and need to take control of their own treatments. A nurse should take the time to explain to the patient and their family or caregiver what to do and what to expect when they leave the hospital or medical clinic. They should also make sure that the patient feels supported and knows where to seek additional information.