GNUR 383 Exam II
Considerations to be addressed when selecting a care delivery model -
ANS-Organizational mission and purpose
Unit objective
Patient population
Staff availability
Economic feasibility
Care Models: Case Method - ANS-Aka total patient care
A nurse working an 8hr shift is responsible for doing everything for the patient (vitals,
ADLs, medications, etc.)
Care Models: Functional - ANS-Aka task delivery
Each nurse is assigned one particular function for the day (e.g. admissions, discharges,
ADLs, medications)
Mostly used in clinics, outpatient settings, smaller emergency departments
Rarely seen in acute care hospitals today
Care Models: Functional: Advantages - ANS-Efficient
Assistive personnel can be trained to perform specific tasks
Cost-effective
Care Models: Functional: Disadvantages - ANS-Fragmented care; task oriented
Patient and family needs may be overlooked
Lapses in communication
Quality of care may be compromised
Holistic view of patient and family may be lacking (don't know who is the nurse because
so many people are in and out of room)
Frustrating to professional nurse
Care Models: Team Nursing - ANS-Team includes RN, care techs, charge nurse, unit
secretary, CNA, team leaders, etc.
Care Models: Team Nursing: Advantages - ANS-Cost effective
,Decisions made at the "grass roots" level, often by staff caring for the patient
Improved patient satisfaction if they know who is taking care of them
Care Models: Team Nursing: Disadvantages - ANS-Need a skilled, knowledgable team
leader
Need adequate staff with the right skill mix
Potential for fragmentation of care
Few work settings implement team nursing as originally designed
Care Models: Primary Nursing - ANS-The nurse that is signed up to care for the patient
is the primary nurse even while they are not on shift - the other nurses that care fo 4th
patient need to follow the care plan set out by the first nurse
Primary nurse is responsible for whatever the other nurses do
Primary nurse decides who is caring for the patient while the primary nurse is not on
shift
Care Models: Primary Nursing: Partnership Model - ANS-Aka co-primary nursing model
Two nurses take care fo the same patient
Two primary nurses
Care Models: Primary Nursing: Patient-focused care - ANS-Individual patient has a
disease problem
Inpatient case management
Narrowly focuses on that disease problem and let everyone else handle everything else
Not normally used on its own
Care Models: Nursing Case Management - ANS-Functions in a service line matrix but
provides a continuum of care (e.g. a diabetic case manager who patients are spread out
over the healthcare system)
The process of providing comprehensive care for those with complex healthcare
problems
, Offers improved patient outcomes, decreased length of stay, interfaces with multiple
disciplines, care provided across the continuum of illness is often in different institutions
Includes Nursing Case Managers and Nurse Navigators
Nurse Case Managers - ANS-Coordinate patient care throughout the admission process
Facilitates access to needed health resources
Monitors utilization of resources
Measures outcomes and quality
Uses critical pathways of care (MAPs)
Nurse Navigators - ANS-Provide specific services designed to improve care
Removes barriers to care
Service-ling care (e.g. oncology, cardiology)
Clinical Pathways - ANS-
Care Maps - ANS-
Transitional Care - ANS-Comprehensive discharge with instruction about medications
and warnings of health problems
Instructions about medications and warning signs
Contact with patients following discharge, emphasizing helping patients manage
medications
Assist in communication between patient and primary and secondary caregivers
Differentiated Practice: LPN/LVN - ANS-Can administer PO, IM, SL, rectal, SQ meds -
not IV meds
Can do basic patient care
Can do vitals, nursing assessment as long as an RN has done the assessment
originally and the patient is stable
Cannot take care of unstable patients
Can supervise CNAs under the direction of a RN
Considerations to be addressed when selecting a care delivery model -
ANS-Organizational mission and purpose
Unit objective
Patient population
Staff availability
Economic feasibility
Care Models: Case Method - ANS-Aka total patient care
A nurse working an 8hr shift is responsible for doing everything for the patient (vitals,
ADLs, medications, etc.)
Care Models: Functional - ANS-Aka task delivery
Each nurse is assigned one particular function for the day (e.g. admissions, discharges,
ADLs, medications)
Mostly used in clinics, outpatient settings, smaller emergency departments
Rarely seen in acute care hospitals today
Care Models: Functional: Advantages - ANS-Efficient
Assistive personnel can be trained to perform specific tasks
Cost-effective
Care Models: Functional: Disadvantages - ANS-Fragmented care; task oriented
Patient and family needs may be overlooked
Lapses in communication
Quality of care may be compromised
Holistic view of patient and family may be lacking (don't know who is the nurse because
so many people are in and out of room)
Frustrating to professional nurse
Care Models: Team Nursing - ANS-Team includes RN, care techs, charge nurse, unit
secretary, CNA, team leaders, etc.
Care Models: Team Nursing: Advantages - ANS-Cost effective
,Decisions made at the "grass roots" level, often by staff caring for the patient
Improved patient satisfaction if they know who is taking care of them
Care Models: Team Nursing: Disadvantages - ANS-Need a skilled, knowledgable team
leader
Need adequate staff with the right skill mix
Potential for fragmentation of care
Few work settings implement team nursing as originally designed
Care Models: Primary Nursing - ANS-The nurse that is signed up to care for the patient
is the primary nurse even while they are not on shift - the other nurses that care fo 4th
patient need to follow the care plan set out by the first nurse
Primary nurse is responsible for whatever the other nurses do
Primary nurse decides who is caring for the patient while the primary nurse is not on
shift
Care Models: Primary Nursing: Partnership Model - ANS-Aka co-primary nursing model
Two nurses take care fo the same patient
Two primary nurses
Care Models: Primary Nursing: Patient-focused care - ANS-Individual patient has a
disease problem
Inpatient case management
Narrowly focuses on that disease problem and let everyone else handle everything else
Not normally used on its own
Care Models: Nursing Case Management - ANS-Functions in a service line matrix but
provides a continuum of care (e.g. a diabetic case manager who patients are spread out
over the healthcare system)
The process of providing comprehensive care for those with complex healthcare
problems
, Offers improved patient outcomes, decreased length of stay, interfaces with multiple
disciplines, care provided across the continuum of illness is often in different institutions
Includes Nursing Case Managers and Nurse Navigators
Nurse Case Managers - ANS-Coordinate patient care throughout the admission process
Facilitates access to needed health resources
Monitors utilization of resources
Measures outcomes and quality
Uses critical pathways of care (MAPs)
Nurse Navigators - ANS-Provide specific services designed to improve care
Removes barriers to care
Service-ling care (e.g. oncology, cardiology)
Clinical Pathways - ANS-
Care Maps - ANS-
Transitional Care - ANS-Comprehensive discharge with instruction about medications
and warnings of health problems
Instructions about medications and warning signs
Contact with patients following discharge, emphasizing helping patients manage
medications
Assist in communication between patient and primary and secondary caregivers
Differentiated Practice: LPN/LVN - ANS-Can administer PO, IM, SL, rectal, SQ meds -
not IV meds
Can do basic patient care
Can do vitals, nursing assessment as long as an RN has done the assessment
originally and the patient is stable
Cannot take care of unstable patients
Can supervise CNAs under the direction of a RN
