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Nursing
Nursing Care Delivery Models
• Nursing teams
• Registered nurses (RNs)
• Licensed practical nurses (LPNs)
• Licensed vocational nurses (LVNs)
• Nurse assistants
Nursing Care Delivery Models
• Nursing care delivery models
• Functional nursing
• Team nursing
• Primary nursing
• Patient-focused care
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
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
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
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
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
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
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
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
The Nursing Process
• The nursing process
• Step 1 - Assessment
• Step 2 - Nursing diagnosis
• Step 3 - Planning
• Step 4 - Implementation
• Step 5 - Evaluation
The Nursing Process
• Step 1 - Assessment
• Collecting information
• Communicating information
The Nursing Process
• Collecting information
• Review medical record
• Take medical history
• Perform physical exam
• Observe patient
The Nursing Process
• Observations
• Objective
• Subjective
The Nursing Process
• Objective observations or signs can be measured or seen
• Sight
• Hearing
• Touch
• Smell
The Nursing Process
• Subjective observations or symptoms are comments made by the patient
The Nursing Process
• Communicating information
• Documenting in patient’s medical record
• Immediate problems
The Nursing Process
• Step 2 – Nursing diagnosis
• Statement of the patient’s problem
• Cause of the problem
The Nursing Process
• Step 3 - Planning
• Creating a patient care plan
• Nursing diagnoses
• Goals for patient
• Nursing interventions
The Nursing Process
• Nursing diagnoses
• Goals
The Nursing Process
• Nursing interventions
• Help the patient reach goals
The Nursing Process
• Changes to interventions and goals
• Unable to achieve desired level of ability
• Has achieved a new level of ability
The Nursing Process
• Changes to diagnoses
• Patient reaches goal
• New problem develops
The Nursing Process
• Conference
• Create patient care plan
• All members of patient’s nursing team
• Physician
• Patient and family
The Nursing Process
• Step 4 - Implementation
• Carrying out nursing interventions
• Provide care to patient
The Nursing Process
• Step 5 - Evaluation
• Determining whether patient has reached goals
The Nursing Process
• Nursing process
• Role of a nurse assistant