Methods of Nursing Assignment

7/29/2019 Methods of Nursing Assignment

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RAKESH PATIDAR

PATIENT CARE ASSINGMENT


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NURSING CARE ASSIGNMENT(sometimes called.. )

Modalities of Nursing Care,

Systems of Nursing Care,

Patterns of Nursing Care


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Nursing modalities are ways care is organizedand delivered to patients. They have to do

with arranging staff members and assigningpatients. Care delivery methods take intoaccount the total number of patients andtasks needed to be accomplished as well as

how many nurses are needed. Mostimportantly, they are concerned with meetingpatient's needs and continuity of care. "Thepurpose of any delivery system is to provide

high quality care, efficiently and effectively,"according to Kaiser Permanente Institute forHealth Policy.


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Definition:

Refers to the manner in which the

total work of the nursing unit isdivided up among personnel.


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Purposes:

-To delegate the work to be done by nursingpersonnel.

-Suggest appropriate procedures for nursing

care, with maximum efficiency with

minimum effort.

-Gain the cooperation of workers in theacceptance of work to be done.

-Serve as work plan.


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Principles:

Formulate assignment of activities based on thefollowing principles:

-Use simple clear words in writing assignment.

-Fix responsibility for all duties clearly with nooverlapping.

-Provide for emergency situations and provide

for special nursing activities.- Give each person time and opportunity to plan

her work.


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-Assignment must include information from

the nursing orders as well as from thedoctor's orders.

-Arrange the various parts of the

assignment in logical order.-Ensure continuity of patient care.

-Assignment should be made in accordancewith the administrative policies.


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-Should be made by the head nurse.

-Planning for skills development-Should be in written form.

-Based on accurate assessment.-Two workers should never be assigned

to do the same work.

-It should be related to previousassignment.


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Factors to be considered in distributing

duties:

- The number, qualifications, experience, and

abilities of nurses.-The number, condition of patients (i.e. patient'sacuity)

-The availability of supplies and equipment.-Architectural features of the unit.


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Methods of assigning personnel:

There are five methods of assignment ingeneral use:

1-Case method.

2-Functional method.

3-Team nursing method.

4-Primary care method.5-Modular method.


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1-The case method:

-Is the oldest patient care delivery system.-In this system one must assume total

responsibility for the complete care of the

patient while she is on duty.-The patient has different nurse in each shift.

-Is used frequently in intensive care unit.

-As a method for teaching student nurses.-Is widely used in home health agencies.


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Patient Care

The registered nurse plans,organizes, and performs all care

Registered

Nurse8-hour shift

Registered

Nurse8-hour shift

Registered

Nurse8-hour shift

Total Patient Care (Case Method) Delivery


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Total Patient Carecontd

Advantages

High degree of autonomy

Lines of responsibility and accountability are

clear

Patient receives holistic, unfragmented care

Disadvantages

Each RN may have a different approach to care Not cost-effective

Lack of RN availability


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2-Functional nursing method:It is a task-oriented method wherein a

particular nursing function is assigned toeach staff member. The medication nurse,treatment nurse and bedside nurse are all

products of this system. For efficiency,nursing was essentially divided into tasks, amodel that proved very beneficial when

staffing was poor. The key idea was fornurses to be assigned to tasks, not topatients.


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Nurse Manager

LPNPO Meds

Treatments

RNAssessments

Care Plans

Nurse AideVital signs

Hygiene

Nurse AideHygiene

Stocking

Assigned Patient Group

Functional Nursing Care Delivery Model


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Advantages:Merits:

Each person become very efficient at specific tasks and a

great amount of work can be done in a short time (time saving).

It is easy to organize the work of the unit and staff.

The best utilization can be made of a persons aptitudes,experience and desires.

The organization benefits financially from this strategybecause patient care can be delivered to a large number ofpatients by mixing staff with a large number of unlicensedassistive personnel.

Nurses become highly competent with tasks that are

repeatedly assigned to them.Less equipment is needed and what is available is usually

better cared for when used only by a few personnel.


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Disadvantages:

-Fragmented care.-No one nurse is familiar with

patient total needs.-It is difficult to fix responsibility

for errors.

-Depersonalized patient care.-Less satisfaction for nurses and

patients .


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3-Team nursing method:

-Team nursing uses a group of healthcare workers with varied skills, andtraining. They are directed by a leaderto provide total services for a definedpatient population.

-Team nursing usually refers to largegroup of patients.


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-The team leader plans, coordinatesand supervises, evaluates andparticipates in the delivery of care topatients.

-The main features of team nursing are

the nursing care plan and teamconference.


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Nurse Manager

RN Team Leader

RN

LPNs/LVNs

Nursing Assistants

RN Team Leader

RN

LPNs/LVNs

NursingAssistants

Assigned Patient Group Assigned Patient Group

Team Nursing Model


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Advantages:

- High quality of care.- Nurses satisfaction is high.

- Patients and physician satisfactionis high.

- Development of leadership skills.


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Disadvantages:-Very high cost.

-More time needed by the team tomeet and share ideas andcoordinate efforts.

-Need more equipment and supplies.


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4-Primary nursing method:-Primary nursing features a registered nurse who

gives total patient care from four to six

patients, while she is on duty; and remainsresponsible for the care of these patientstwenty four hours a day throughout the

patient's hospitalization.


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Primary Nurse24-hour responsibility forplanning, directing &

evaluating patient care

Patient

Associate Nurses

Provide care

when primarynurse is off duty

Physician andother members

of the health care

team

Primary Nursing Model


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Primary Nursingcontd

AdvantagesHigh-quality, holistic patient care

Establish rapport with patient

RN feels challenged and rewardedDisadvantages

Primary nurse must be able to practice

with a high degree of responsibility andautonomy

RN must accept 24-hour responsibility

More RNs needed; not cost-effective


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5-Modular method:

It is a combination of primary method

and team method.-Varied from primary nursing that, it can be

used when nursing staff includes practical

nurses and professional nurses.


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-It is similar to primary assignment in thateach pair of nursing personnel isresponsible for care of patient from

admission to discharge.

-It is similar to team nursing that

professional and non professional workerswork together.


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Geographic

Patient UnitPatient Care

Team:

RNsLPNs/LVNs

Nurse Aides

Meds

Supplies

Linens

Geographic


Team:

RNsLPNs/LVNs

Nurse Aides

Meds

Supplies

Linens

Geographic


Team:

RNsLPNs/LVNs

Nurse Aides

Meds

Supplies

Linens

Nurse Manager

Modular Nursing Model


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Modular Nursingcontd

AdvantagesContinuity of care is improved

RN more involved in planning and

coordinating careGeographic closeness and efficient

communication

DisadvantagesIncreased costs to stock each module

Long corridors not conducive to modularnursing


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Methods of Nursing Assignment

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