Delivering Care

Question 0

What do the models of care describe?

Answer 0

1. Which worker will perform each task
2. Person responsible for each tasks
3. The authority to make decisions

Question 1

Why do we discuss models of care?

Answer 1

1. Provide structure
2. Plan efficient proficient care
3. Nursing personnel is the largest percent of operating costs so target budget cuts
4. Models are influenced by social change

Question 2

Traditional models of care include

Answer 2

1. Total patient care or care models
2. Functional model or something task nursing
3. Team model
4. Modular model
5. Primary model

Question 3

Total patient care model

Answer 3

Takes care of one patient and all of their needs

Question 4

Characteristics of total patient care or case model

Answer 4

1. Florence nightingale
2. Oldest method of organizing pt care
3. Responsible: planning, organizing, all care
4. Care provided in the home including cooking and cleaning
5. During the Great Depression- unable to afford home are and began using hospitals.
6. Today it is the ICU, PACU,CCU
7. Reality shock after graduation

Question 5

Advantages of total patient care model or case model

Answer 5

1. Autonomy and responsibility
2. Holistic and u fragmented care
3. Required skilled nursing
4. Patient needs were quickly met
5. Close relationship between patient and RN

Question 6

Disadvantages of total patient care or case model

Answer 6

1. Inexperienced nurses or not adequately prepared

2. Cost! Ran are expensive

Question 7

Functional model or task nursing

Answer 7

Nurses are assigned to tasks not to patients

Question 8

Characteristics of functional model or task nursing

Answer 8

Evolved during the Great Depression when RNs went from private nursing to becoming employees of a hospital
WW2 broke out and hospitals were short staffed
Unskilled workers were to perform routine simple tasks such as BP and bathing- cna or lpn
RN became the manager of care rather than the direct care provider

Question 9

What are advantages of functional model or task nursing

Answer 9

1. Efficient way to deliver care
2. Accomplish a lot of tasks in a small amount of time
3. Staff only did what they were capable of doing and nothing was added that you couldn’t do taut could be done by an assistant
4. Care was provided by minimal number of RNs

Question 10

Disadvantages of functional or task nursing

Answer 10

1. RN time to supervise assistants
2. Care became fragmented with little holistic understanding of patients
3. Patients did not have one identifiable nurse and nurse had no accountability to the pt to the staff doing the work
4. Narrow scope of practice
5. Lead to patient and hear dissatisfaction
6. Focus was on the task not the overall result

Question 11

What is team model characteristics

Answer 11

1. Evolved in the 1950s to improve or satisfaction
2. Goal to reduce the fragmented care
3. Ancillary personnel provide care under the direction of the RN
4. RN functions as a team leader and coordinates a small group
5. RN is responsible for know the condition and needs of all patients assigned to the team
6. Duties of the team leader are planning care. Assigning duties, directing and assisting team members and giving direct care and teaching and coordinating patient activities

Question 12

Advantages of team model

Answer 12

1. Each team member capabilities are maximized so satisfaction was high
2. Each member participates in decision making and problem solving
3. Patients have one team leader with access to other providers
4. Requires excellent communication

Question 13

Disadvantages of team model

Answer 13

1. Inadequate time for team care planning and communication
2. Requires a team spirit and commitment to success
3. RN may be a team leader one day and a team member the next day thus lacks continuity
4. Care fragmented with only 8-12 hour accountability
   5 assignment unequal if based on acuity
5. Team leader if they are not a excellent practitioner with good management leadership skills most haven’t yet developed these skills

Question 14

Modular model

Answer 14

Care given according to geographic areas BEEBE

Question 15

Characteristics of modular modular model

Answer 15

1. Modification of team nursing
2. Patient unit is divided into modules or units with the RN as team leader
3. Same team care giver is assigned consistently to the fame geographic area
4. Concept evolved to increase RN involvement care

Question 16

Advantages of modular model

Answer 16

1. Continuity of care is improved
2. RN had more time for planning and coordinating care
3. Geographic closeness and efficient communication

Question 17

Disadvantages to modular model

Answer 17

1. Increase cost to stock each module

2. Long corridors are not conducive to modular nursing

Question 18

Primary model

Answer 18

One nurse cares for a group of patients within a 24 hour accountability

Question 19

Characteristics of primary model

Answer 19

1. Evolved in the 1980s to improve RN autonomy
2. RN primary nurse assumes 24 hour responsibility for planning directing and evaluations care
3. Common use areas are hospice long term and home health
4. Primary nurse has 24 hour accountability associated nurse would be there when the RN wasn’t there
5. Fully staffed by RN no cna

Question 20

Advantages of primary model

Answer 20

1. High qyality, holistic patient care
2. Establish good rapport and increased job satisfaction
3. Decentralization of nursing care decisions authority and responsibility to staff nurse

Question 21

Disadvantages of primary model

Answer 21

1. Not cost effective
2. Must be able to practice with a high degree or responsibility and accountability
3. RN must accept 24 hour responsibility

Question 22

Integrated modems of care includes:

Answer 22

1. Case management

2. Practice partnership model or co primary

Question 23

Case management

Answer 23

A strategy to improve patient care and reduce hospital costs through coordination of care

Question 24

Characteristics of case management

Answer 24

1. First introduced by insurance companies in the 1970s
2. Hospitald adopted the model in the 1980s
   organize patient care by the drgs and focus meeting outcomes with specific time frames
   Follow Pts progress from admission to discharge
   A strategy to improve or care and reduce hospital costs through coordination of care
   Coordinating patient care and establishing goals of patient care
   Doesn’t provide direct care but supervises the care
   Includes identifying core donating monitoring and outcomes
   10-15 patients per manager
   Used critic pathways and MAP

Question 25

Practiced partnership model or co primary nursing characteristics

Answer 25

Introduced in 1989
RN partnered with LPN
Worked together with same schedule and same group of patients

Question 26

Advantages of practiced partnership model

Answer 26

More cost effective than primary nursing

Encourage training and growth of he lpn

Question 27

Disadvantages of the practiced partnership model

Answer 27

RN may have difficulty delegating to a partner

Consistent partnerships are difficult to maintain due to varied schedules

Question 28

Critical pathways characteristics

Answer 28

Outline a predetermined written plan of care for a particular health problem
Specific desired outcomes and transdiciplinary intervention
Assess a common medical diagnosis
Dictate the type and amount of care given and thus financial implications