Chapter 13

Patient focused care

A model in which staff functions become centralized on a unit to reduce the number of staff required; emphasized quality, cost, & value.

Differentiated nursing practice

A model of care that recognizes the differences in the level of education and competency of each registered nurse. The differentiation is based on education, position, & clinical expertise.

Disease management

Continuous, coordinated processes to manage the progression of care over the course of a disease.

tips for selecting a care delivery model

Look at the organization and the population being served when selecting a care delivery model. Consider the organizational structure and processes when selecting the care delivery model. There are advantages and disadvantages to any model, there's no ideal approach. Know that every model has specific expectations for both managers and staff. Determine if there's experienced nurses who provide clinical leadership in specific settings.

the roles of the nurse manager & staff nurse vary with each nursing care delivery model.

Regardless of the model the nurse manager must have strong leadership & management skills for the model to be effective. Numerous issues must be considered when a care delivery model is implemented. Without a competent manager, none of the models would be effective.

Magnet recognition program

The only national designation built on and evolving through research. This program is designed to acknowledge nursing excellence. Designed for healthcare organizations to achieve recognition of excellent nursing care through a self-nominating self-appraisal process.

Staff mix

The proportion of RNs to LPNs/LVNs to UAPs in a specific setting.

the nurse manager and charge nurse are responsible for directing patient care regardless of the delivery system. key leadership and management concepts for directing patient care include the following

accountability delegation critical thinking communications promotion of autonomy collaboration

models

all nursing roles complement each other emerging models of professional nursing practice continue to evolve

disease management programs

assist those with chronic illness to manage their self-care to achieve their optimal health

concept of differentiated practice

emphasizes two levels of nursing practice: technical and professional each level has specific roles and responsibilities that depend on the nurses educational preparation, experience, and clinical expertise

nurse case manager

plays vital role in management of care

in the primary nursing method, a primary nurse provides total patient and directs patient care from admission to discharge

the nurse manager functions as role model, advocate, coach, consultant, budget controller, and unit quality manager. the partnership model or co-primary nursing model, pairs an RN with a technical assistant the patient focused care unit employs a primary nurse and multi-skilled team members

the nursing case management system is outcome based and is facilitated by a case manager who directs unit based care using a critical path

the nurse manager in this care delivery system faces increased demands to move the patient through the system quickly as possible. managed care is a way of organizing patient care delivery with cost savings as the main goal

in the team method a small team provides care to a small group of patients

the nurse manager in this model needs strong management critical thinking and leadership. the modular method is a modification of team nursing that focuses on the geographic location of patient rooms and assignments of staff members

the functional model of nursing emphasizes task oriented care for a large group of patients

the nurse manager is responsible for achieving patient outcomes whereas staff members are responsible only for their specific task. the functional model is most often used in subacute care facilities

the case method focuses on total patient care for a specific time period.

the nurse manager must consider the expense of this system and identify all staff members level of education & communication skills.

a care delivery model is the method nurses use to provide care to patients.

there are 5 models of patient care delivery, each with its advantages & disadvantages