Chapter 15

Question 1

what is the nursing care delivery model

Answer 1

the method used to provide care to patients

Question 2

what is the total patient care method (patient allocation method)

Answer 2

one nurse provides total care to one or two critically ill patients, or to a group of patients, over the course of a shift

Question 3

which care method is often used for nursing students

Answer 3

total patient care method

Question 4

what is the nurse managers role in a total patient care model (3)

Answer 4

• consider expense of the system
• weight the expertise of the RN/RPN with the LPN/UCP
• decide which type of nurse can be deployed

Question 5

role of the staff nurse in the total patient care method (2)

Answer 5

• complete all functions of care
• have greater autonomy and control of care provided

Question 6

what is functional nursing

Answer 6

• ## regulated and unregulated members perform specific tasks for a large group of people

Question 7

how are assignments made in functional nursing

Answer 7

tasks are determined by scope of practice and complexity of care

Question 8

advantages of functional nursing (3)

Answer 8

• nurses become efficient at specific tasks
• more work can be done in a shorter period of time
• organization benefits financially

Question 9

disadvantages of functional nursing (5)

Answer 9

• psychological and emotional needs of patients may not be met
• patients and families may get confused about who is treating them
• limited communication with the patient about their progress
• patient’s response to care may be difficult to assess
• critical changes in the patient may go unnoticed

Question 10

role of the nurse manager in functional team nursing (4)

Answer 10

• be sensitive to quality of care being delivered and budget
• achieve patient outcomes
• rotate staff assignments to mitigate boredom
• staff meetings so staff can express concerns

Question 11

role of the staff nurse with functional nursing

Answer 11

• become efficient in tasks assigned to you

Question 12

what care delivery model can be seen as autocratic

Answer 12

functional nursing

Question 13

what is team nursing (2)

Answer 13

• “care through others”
• nurse team leader is responsible for coordination

Question 14

which care delivery model is still in use now when there are nursing shortage and changes in staff mix

Answer 14

team nursing

Question 15

advantages of team nursing (4)

Answer 15

• improved patient satisfaction
• improved nurse decision making
• cost-effectiveness
• maximized team collaboration

Question 16

disadvantage of team nursing

Answer 16

• poor communication from team leader can lead to failure

Question 17

role of the nurse manager in team nursing (2)

Answer 17

• determine which nurses can be the team leader
• provide adequate staff mix and orient team members

Question 18

role of the charge nurse in team nursing

Answer 18

• act as a liaison between team leaders and other HCP

Question 19

role of the team leader in team nursing (4)

Answer 19

• plan and delegate care
• follow up with members to evaluate quality
• update nursing care plans
• be knowledgeable about the staff’s scopes of practice and skill levels

Question 20

what is primary nursing (2)

Answer 20

• one nurse functions autonomously as the patient’s primary nurse throughout the hospital stay
• primary nurse is responsible for managing all aspects of care even when off duty

Question 21

advantages of primary nursing (4)

Answer 21

• high quality of care
• patient satisfaction
• high degree of professionalism
• decrease in unregulated personal

Question 22

disadvantage of primary nursing (3)

Answer 22

• nurse may not have the experience or education to provide total care
• communication gaps when the primary nurse isn’t there
• unsuitable in the event of staff shortages

Question 23

role of the nurse manager in primary nursing (2)

Answer 23

• determine desire to be primary nurses and provide education
• clearly define roles

Question 24

what is the partnership model

Answer 24

RN is paired with another nurse

Question 25

what is case management

Answer 25

the process of coordinating health care by planning, facilitating, and evaluating interventions to achieve cost containment and quality outcomes

Question 26

what is the overall goal of the care management model

Answer 26

manage individuals at their maximum level of comfort, functionality, and independence while at the lowest and most appropriate level of intensity of service

Question 27

what are the 6 core standards of the case manager within the case management model

Answer 27

1. client identification and eligibility for case management services 2. assessment 3. planning 4. implementation 5. evaluation 6. transition

Question 28

goal of case managers within the case management model

Answer 28

provide cost effective care by integrating financial thinking into clinical services

Question 29

what is it called when a patient's progress deviates from the normal path in the case of a clinical pathway

Answer 29

variance

Question 30

what is a negative variance

Answer 30

an action in care cannot take place

Question 31

what is a positive variance

Answer 31

an outcome is achieved before it is expected

Question 32

role of the nurse manager in the case management model

Answer 32

- assess if resources are utilized properly - care is being delivered in the right setting - case managers are handling their caseload - evaluate patient satisfaction

Question 33

advantages of the case management model (5)

Answer 33

- well-coordinated multidisciplinary care - decrease length of stay - use services efficiently - break down invisible barriers - increased nurse satisfaction

Question 34

in the synergy model, what are considered drivers of the necessary competencies for nurses

Answer 34

patient characteristics

Question 35

what must happen to create the "synergy" between patient needs and nurse competencies

Answer 35

identification of priority patient needs and the numbers and types of nurses

Question 36

what are 8 patient characteristics of the synergy model

Answer 36

1. resiliency 2. vulnerability 3. stability 4. complexity 5. resource availability 6. participation in care 7. participation in decision making 8. predictability

Question 37

8 nursing competencies in the synergy model

Answer 37

1. clinical judgement 2. advocacy and moral employer 3. caring practices 4. facilitation of learning 5. collaboration 6. systems thinking 7. response to diversity 8. clinical requirement