exam 1: nursing care delivery systems and staffing issues Flashcards
critical pathways
expected outcomes and care strategies developed by the collaborative practice team
total patient care
–> original model of care delivery
- RN responsible for all care for 1+ patients
- Disadv: RNs spend more time doing tasks that could have been done by less skilled
functional nursing
–> needs of a group of patients separated into tasks
- Skill is used to best advantage
- Disadv: problems with continuity, followup
MORE IN LONGER TERM FACILITIES
team nursing
–> team of personnel provides total patient care under direction of leader
- holistic, care conference
- open communication
primary nursing
–> Marie Manthey: place RN back at the bedside
- Nursing knowledge based practice NOT just task focused
- Patient load of primary patients for ENTIRE duration
MOSTLY IN HOME HEALTH OR HOSPICE
practice partnerships
–> Marie Manthey: RN and aid agree to be practice partners
- same schedule with same patients, synergistic energy
- less expensive, work load more satisfying
case management
–> became a thing when cost based to prospective payment model was switched
- ID and coordinate implementation of services for patient outcomes
- Acuity, cost, cases, insurance, complications
- ID appropriate services
synergy model of care
–> assignment based on needs and characteristics (match nurse to pt)
- useful to nurse to specialize skill
= hard to always match every shift
MAGNET HOSPITALS
patient centered care
–> all pt services are unit based, all work for that unit
- focus: efficiency and cost control
- unit has more responsibilities
MORE IN CRITICAL CARE/ICU
patient centered medical home
–> 1 provider oversees patient care
- expensive bc difficult to find provider that will take on all responsibilities, nurse not paid well, faulty communication
what drives the decision of what delivery system is chosen?
client needs
what is the role of nursing care committees in Illinois?
Every type of nurse needs to be represented, nurses make recommendations
- At least half 55% needs to be bedside nurses
- Plan has to be review 6x a year
why are mandated ratios problematic?
- Illinois better overall performance than Cali
- Lose flexibility with mandated ratios
what is the purpose of patient classification systems (pcs)
determine workload requirements and staffing needs objectively
full time equivalents (FTEs)
number of hours considered full time
- if work week = 40hrs, nurse who works 40hrs = 1FTE
- if CNA works 20hrs, = .5FTE
