care delivery strategies Flashcards
(21 cards)
model selection
considerations to be addressed in selecting a model; organizational goals, unit objectives, patient population, staff availability, economic feasibility
care models
- case method
- functional nursing
- team nursing
- primary nursing
- case management
other care delivery strategies
- disease management programs
- differentiated practice
emerging practice models/influences
- transforming care at the bedside
- synergy model
nurse manager role
assess patient needs to determine level of care; RN care, RN-supervised care (UHCP), hiring and management of appropriate staff to provide total care in cost-effective matter
functional nursing
- specific tasks for a large group of pts; performed by regulated and unregulated members of the care team
- determined by scope of practice
- division of work
- charge nurse
advantages of functional nursing
- efficient
- assistive personnel can be trained to perform specific tasks
- cost-effective; mixing staff
- large number of tasks accomplished in a short period
- unregulated staff can be trained to perform specific task
disadvantages of functional nursing
- care is fragmented and task-oriented
- pt and family needs may be overlooked
- lapses in communication may occur
- professional nurses may find this type of nursing frustrating
functional nursing manager role
- sensitive to quality of patient care and budgetary restraints
- responsible for ensuring that patient outcomes are achieved
- focuses staff perception of independence
- rotates assignments
team nursing
charge nurse RN > team leader RN > RN/LPN/RPN/UCP > group of patients
advantages of team nursing
- cost effective
- decisions are made at the grassroots level, often by staff caring for pts
- patient satisfaction is improved
disadvantages of team nursing
- team leader must be skilled and knowledgeable
- teams need adequate staff with right skill mix
- care can be fragmented
team nursing management role
- effective management skills
- selects charge nurses
- selects team leaders
- provides adequate staff mix
- receives continuing education about leadership, delegation and team interaction
primary nursing hybrids
compare and contrast; partnership model (tag team with 2 RNs) and patient-focused care
nursing case management
- process of coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve cost containment and quality outcomes
- improve pt outcomes
- decreased length of stay
- interfacing with multiple disciplines
- care provided across the continuum of illness, often in different institutions
case manager
- can be a nurse, social worker, or professional in another discipline
- standards; client identification and eligibility, assessment, planning, implementation, evaluation, transition
clinical pathways
- provides grid for expected plan of care
- variance; if an unexpected event occurs it changes the pathway (ex. fall after surgery)
- evidence-informed practice forms these pathways
disease management
- model of care that coordinates care interventions for pts with chronic illness
- emphasis; self-care education with the goal of preventing exacerbations and complications
- best practices used for pts with chronic illnesses such as arthritis, CHF, diabetes
- outpatient follow-up
differentiated nursing practice
- BSN/BScN
- advanced practice nurse
- clinical nurse leader
synergy model
- based on pt characteristics and nurse competencies
- synergy between pt characteristic and nurse competency optimizes care
transforming care at bedside (TCAB)
- 5 premises
- improve work processes and optimizes work of nurses
- themes; reliability, vitality, patient-centered, increased value
