Nursing Care Delivery within Health Care System – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Nursing Care Delivery within Health Care System
There are 5 (five) patterns of nursing care delivery within health care system. These are:
- Functional nursing.
- Team nursing.
- Total patient care.onl
- Primary care nursing.
- Nursing management.
Functional Nursing
Functional nursing divides the nursing work into nursing units that are then assigned to one of the team members. In this method, each has specific duty of tasks, they are responsible for. For example, one is assigned to give all the medication, another performs all the treatments and another works at the desk transcribing physician’s order and communicating with other nursing departments about patient care issues.
This pattern is been used less often becomes its focus tends to be more on completing the task rather than caring for individual patients.
Team Nursing
Team nursing is a care delivery model that assigns nurses to teams that then are responsible for a group of patient. Team nursing is organized and directed by a nurse called the team leader. The team leader and supervisors, co-ordinates all the care provided by those on his team. The team is most commonly made up of various level of nursing staff and personnel.
All team members report the outcomes of their care to the team leader, the outcomes of their care to the team leader. The team leader is responsible for evaluating whether the goals of patient care are met.
Conferences are important part of team nursing. They may cover a variety of subjects but are planned with certain goals in mind, such as determining the best approaches to each patient’s health problems, increasing the team member’s knowledge and promoting a cooperative spirit among nursing personnel.
Total patient care
Total patient care is a system of comprehensive patient care that considers the physical, emotional, social, economical and spiritual of an individual. The nurse is responsible for the total care for the patient assignment for the shift she/he is working.
Primary Care Nursing
Primary Nursing is the care delivery system that best supports professional nursing practice. The focus is on the nurse-patient relationship, strengthens accountability for care, and facilitates patient and family involvement in the planning of care. Our care delivery system allows the Primary Nurse to establish a therapeutic relationship with each patient and family.
High quality nursing care that is individualized to a particular patient and administered compassionately, competently, and with continuity is achieved through Primary Nursing.
Nursing/Case Management
Nursing/Case management is a strategy to improve patient care and reduce hospital cost through co-ordination of care. A nurse/case manager is responsible for co-coordinating care and establishing goals from preadmission through discharge. In this model a nurse is assigned to a specific high risk patient, such as cardiac surgery patients.
The case manager has the responsibility to work with all disciplines to work with all disciplines to facilitate care. The advantage is that it ensures the higher quality compared to other models. The disadvantage is that it requires enough nurse time allocated for this activity.
Total Patient Care:
Total patient care is a system of comprehensive patient care that considers the physical, emotional, social, economical and spiritual of an individual. The nurse is responsible for the total care for the patient assignment for the shift she/he is working.
Advantage of Total Patient Care
- Total patient care is the consistency of one individual caring for patients for an entire shift.
- This enables the patient, nurse and family to develop a relationship based on trust.
- This model provides a higher number of nurse hours of care than other models.
- The nurse has more opportunity to observe and monitor progress of the patient.
Disadvantage of Total Patient Care
- It disadvantage may be that the nurse may not have the same patients from day to day and therefore looks at the patient on a shift by shift basis rather than on a continuum of care.
- The model utilizes a high level of nurse hours to deliver care, and this level of nurse intensity is not warranted.
- It is more costly than any others.
Primary Care Nursing
Primary nursing is a care delivery model that clearly describes the responsibility and accountability of the registered nurse and designates her as the primary provider of care to patients. It consists of four elements. These are –
a) Allocation and acceptance of individual responsibility for the decision making to one individual.
b) Assignment of daily care by the case method.
c) Direct person to person communication.
d) One person is operationally responsible for the quality of care administered to patient on a unit for care 24 hours a day, 7days a week. It is a method of providing comprehensive, individualized and consistent care.
The nurse has accountability and responsibility to develop a plan of care with the patient and family. There is a holistic approach to care, which facilitates continuity of care rather a shift to shift focus. Disadvantages include a high cost, a requirement of knowledgeable nurses to ensure the appropriate matching of nurse to patient etc.
Nursing/Case Management
Nursing/Case management is a strategy to improve patient care and reduce hospital cost through co-ordination of care. A nurse/case manager is responsible for co-coordinating care and establishing goals from preadmission through discharge. In this model a nurse is assigned to a specific high risk patient, such as cardiac surgery patients.
The case manager has the responsibility to work with all disciplines to work with all disciplines to facilitate care. The advantage is that it ensures the higher quality compared to other models. The disadvantage is that it requires enough nurse time allocated for this activity.