Organizing Patient Care Flashcards
5 Traditional means of Organizing Nursing and Patient Care
Total patient Care
Functional nursing
Team and modular nursing
Primary nursing
Case management
Another name for primary nursing
professional practice model
Another name for team nursing
partner in care or patient service partners
Total Patient Care
Oldest Mode of organizing patient care
“The case method of assignment”
patients are assigned to a caregiver and each caregiver is under a charge nurse
Advantage of total patient care organization
provides care givers with high autonomy and responsibility
assigning patients is simple and direct
Disadvantages of total patient care organization
each caregiver caring for the patient can theoretically modify the care regimen meaning if there are three shifts then the patient is getting 3 different approaches to care
if a caregiver is inexperienced of inadequately prepared this leads to issues
Functional Nursing
method of delivering nursing care and organization
started in WWII
personnel assigned to complete tasks rather than specific patients, and relatively unskilled workers gained task proficiency through repetition
RNs then became managers of care rather than direct care providers (“Care through others”)
Advantage of Functional nursing
efficiency - tasks are completed quickly with little confusion regarding responsibilities and allows minimal RN needs
Disadvantage of Functional Nursing
can lead to fragmented care and the possibility of overlooking patient priority needs
Team Nursing
personnel collaborate in providing care to a group of patients under a direction of a professional nurse
so the charge nurse is above team leaders who direct nursing staff at a specific patient
Advantage of Team Nursing
comprehensive care and extensive team communication
Disadvantage of Team Nursing
improper implementation rather than the philosophy itself
team leaders have to be excellent practitioners and have good communication, organization, management, and leadership skills
Modular Nursing
more modern
mini teams of 2-3 members with at least one member being an RN (Care Pairs)
patients are divided into modules or districts and assignments are based on the geographical location of patients
also try to assign same patients to same team as much as possible
similar to team nursing
Primary Nursing
Relationship Based Nursing
A primary nurse has 24 hour responsibility for planning the care of one or more patients from admission to discharge - during work hours the nurse provides total direct care and when not on duty associate nurses follow the primary’s care plan
the primary nurse and patient are then at the center with other personnel like other nurses physicians and such connecting to them
Disadvantage of Primary Nursing
Difficult to implement due to degree of responsibility and autonomy needed of the primary nurse
improper implementation preparation or incompetence
Benefit of Primary nursing
job satisfaction is high
skills developed well
often feel challenged and rewarded
Interprofessional or Multidisciplinary Health Care Team
complex process involving 2 or more health professionals with complementary backgrounds and skills
team members share common health goals in patient care through collaboration, communication, and shared decision making
Primary Health Care Teams (PHCTs)
interprofessional teams that include but are not limited opt physicians, NPs, nurses, physical therapists, dentists, occupational therapists, social workers who all work collaboratively to deliver coordinated patient care
Strategies for working with an interdisciplinary health care team
know your role and expertise as well as that of your team members
know the end goal / purpose of your interdisciplinary team
communicate compassionately so that all members of the interdisciplinary team feel comfortable voicing their opinions
establish a support structure whereby all members feel like they play an important role
Case Management
A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individuals and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes
professional and collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet an individual’s health needs. It uses communication and availableresources to promote health, quality, and cost-effective outcomes in support of the “Triple Aim” of improving the experience of care, improving the health of populations and reducing per capita costs of health care
What do case managers use to plan patient care
critical pathways and multidisciplinary action plans (MAPS)
Maps are combos of nursing care plans and critical pathways
Population Based Health Care and Continuous Health Improvement (Disease Management Programs)
Comprehensive integrated approach to care and reimbursement of high cost chronic illnesses
disease management = DM
case managers use this and the goal is to address illness or conditions with maximum efficiency across treatment settings regardless of typical reimbursement patterns - this will prevent cost drivers which increase costs over time since early detection and intervention are used
The focus of population based health care is…
COVERED LIVES (populations of patients rather than on the individual patient)
Disease Management programs are efficiency when what happens
cost drivers are reduced, whereas patient needs are met
