Understanding Nursing Care Delivery Models and the Nursing Process

1. Nursing

2. Nursing Care Delivery Models • Nursing teams • Registered nurses (RNs) • Licensed practical nurses (LPNs) • Licensed vocational nurses (LVNs) • Nurse assistants

3. Nursing Care Delivery Models • Nursing care delivery models • Functional nursing • Team nursing • Primary nursing • Patient-focused care

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. The Nursing Process • The nursing process • Step 1 - Assessment • Step 2 - Nursing diagnosis • Step 3 - Planning • Step 4 - Implementation • Step 5 - Evaluation

13. The Nursing Process • Step 1 - Assessment • Collecting information • Communicating information

14. The Nursing Process • Collecting information • Review medical record • Take medical history • Perform physical exam • Observe patient

15. The Nursing Process • Observations • Objective • Subjective

16. The Nursing Process • Objective observations or signs can be measured or seen • Sight • Hearing • Touch • Smell

17. The Nursing Process • Subjective observations or symptoms are comments made by the patient

18. The Nursing Process • Communicating information • Documenting in patient’s medical record • Immediate problems

19. The Nursing Process • Step 2 – Nursing diagnosis • Statement of the patient’s problem • Cause of the problem

20. The Nursing Process • Step 3 - Planning • Creating a patient care plan • Nursing diagnoses • Goals for patient • Nursing interventions

21. The Nursing Process • Nursing diagnoses • Goals

22. The Nursing Process • Nursing interventions • Help the patient reach goals

23. The Nursing Process • Changes to interventions and goals • Unable to achieve desired level of ability • Has achieved a new level of ability

24. The Nursing Process • Changes to diagnoses • Patient reaches goal • New problem develops

25. The Nursing Process • Conference • Create patient care plan • All members of patient’s nursing team • Physician • Patient and family

26. The Nursing Process • Step 4 - Implementation • Carrying out nursing interventions • Provide care to patient

27. The Nursing Process • Step 5 - Evaluation • Determining whether patient has reached goals

28. The Nursing Process • Nursing process • Role of a nurse assistant