Nursing

Nursing Care Delivery Models

• Nursing teams

• Registered nurses (RNs)

• Licensed practical nurses (LPNs)

• Licensed vocational nurses (LVNs)

• Nurse assistants

Nursing Care Delivery Models

• Nursing care delivery models

• Functional nursing

• Team nursing

• Primary nursing

• Patient-focused care

Nursing Care Delivery Models

• Functional nursing

• One large team to care for all patients in a unit

• Each member has specific tasks that they always do

• An RN serves as nursing team supervisor

Nursing Care Delivery Models

• Functional nursing advantages• Uses each team member’s

strengths• Reduces costs

• Functional nursing disadvantages• Right mix of skills• Qualified team supervisor• Too many people providing care

to patient

Nursing Care Delivery Models

• Team nursing

• Divide into several small teams providing care for group of patients within unit

• Each member has specific tasks depending on patient’s needs

• An RN serves as nursing team manager

• Nursing team manager reports to nursing team supervisor

Nursing Care Delivery Models

• Team nursing advantages• Uses each team member’s

strengths• Closer relationships between

member and patient• Reduces costs

• Team nursing disadvantages• Members have needed skills• Members understand

responsibilities• Qualified team manager

Nursing Care Delivery Models

• Primary nursing

• One RN provides all the care to a patient for entire stay

• Members assisting RN not responsible for specific tasks

• All RNs in unit report to unit nursing team supervisor

Nursing Care Delivery Models

• Primary nursing advantages• More nursing expertise• Better continuity of care• Close relationship between RN

and patient

• Primary nursing disadvantages• Requires RNs• Uses LPNs, LVNs and nurse

assistants to lesser degree• Increases cost

Nursing Care Delivery Models

• Patient-focused care

• Similar to team nursing• Multi-skilled team members• Team provides services usually

provided by diagnostic or therapeutic departments

• Nurse assistants trained to provide these services

• RN as nursing team manager

Nursing Care Delivery Models

• Patient-focused care advantages• Use team member strengths• Better continuity of care• Close relationships• Decreases transport time• Reduces costs

• Patient-focused care disadvantages• Expensive• Members need skills• Members understand

responsibilities• Qualified team managers

The Nursing Process

• The nursing process

• Step 1 - Assessment

• Step 2 - Nursing diagnosis

• Step 3 - Planning

• Step 4 - Implementation

• Step 5 - Evaluation

The Nursing Process

• Step 1 - Assessment

• Collecting information

• Communicating information

The Nursing Process

• Collecting information

• Review medical record

• Take medical history

• Perform physical exam

• Observe patient

The Nursing Process

• Observations

• Objective

• Subjective

The Nursing Process

• Objective observations or signs can be measured or seen

• Sight

• Hearing

• Touch

• Smell

The Nursing Process

• Subjective observations or symptoms are comments made by the patient

The Nursing Process

• Communicating information

• Documenting in patient’s medical record

• Immediate problems

The Nursing Process

• Step 2 – Nursing diagnosis

• Statement of the patient’s problem

• Cause of the problem

The Nursing Process

• Step 3 - Planning

• Creating a patient care plan

• Nursing diagnoses

• Goals for patient

• Nursing interventions

The Nursing Process

• Nursing diagnoses

• Goals

The Nursing Process

• Nursing interventions

• Help the patient reach goals

The Nursing Process

• Changes to interventions and goals

• Unable to achieve desired level of ability

• Has achieved a new level of ability

The Nursing Process

• Changes to diagnoses

• Patient reaches goal

• New problem develops

The Nursing Process

• Conference

• Create patient care plan

• All members of patient’s nursing team

• Physician

• Patient and family

The Nursing Process

• Step 4 - Implementation

• Carrying out nursing interventions

• Provide care to patient

The Nursing Process

• Step 5 - Evaluation

• Determining whether patient has reached goals

The Nursing Process

• Nursing process

• Role of a nurse assistant