Nursing Care Delivery System (1)
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Transcript of Nursing Care Delivery System (1)
At the end of this presentation, the audience will be able to:
Define Nursing Care Delivery System. Understand the types of nursing
care delivery system. Differentiate between each one. Understand advantages and
disadvantages of each one.
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Nursing leadership is a combination of personality traits, administrative skills and talents which enable a nurse to excel in the profession.
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A nurse leader can be anyone who uses interpersonal skills to influence others to accomplish specific goals.
The leader has the capacity to earn and hold trust and can inspire others to commit to the goals of the health care organization.
The leader facilitates group cohesion and performance.
The authority of the leader is informal, meaning that the leader has no specific managerial role; however, the leader's ideas and actions influence the "efficiency of work flow”.
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A nursing care delivery system defines how work is organized, how nursing staff are deployed, and who will provide nursing care.
Delivery systems identify who has the accountability for nursing care and clinical outcomes.
Delivery systems provide the organization, rules and structure that define responsibility and accountability.
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Total patient care (Case method) Functional Nursing Team Nursing Primary Nursing
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The oldest system for organizing patient care.
Commonly used in intensive care unit (ICU) and post anesthetic care unit (PACU).
In Total Primary Care a registered nurse is responsible for planning, organizing, and performing all aspects of nursing care.
Total Primary Care provides a high degree of autonomy, clear lines of responsibility and accountability, holistic patient care, un fragmented care.
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Advantages: 1. Registered nurses were self-employed2. Patient needs were quickly met3. Close relationship between the
Registered Nurse and the patient
Disadvantages: Needs high number of Registered Nurses.
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Specific tasks are assigned to nurses. The nurse assigned to a specific task has
to carry it out at all patients. Registered nurses (RNs) carry out complex
nursing tasks. The idea behind functional nursing is that
there is a specialist for each task. The head of the ward assigns the different
tasks to specific nurses based on the nursing care plans for the different patients.
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Advantages: A very efficient way to delivery care. Could accomplish a lot of tasks in a small amount of timeStaff did what only they were capable to do: no extraneous work was added that could be done by nursing aid.
Disadvantages: Care of persons became fragmented1. Patients did not have one identifiable nurse and the
nurse had no accountability.2. Very narrow scope of practice for Registered nurses.3. Lead to patient and nurse dissatisfaction
Care is given by a team composed of registered nurses (RNs), Licensed Practical Nurses (LPNs) and certified nursing assistants (CNAs).
In this model, most direct bedside care is given by the CNAs while the RNs spend more of their time at the nursing station.
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When a ward is organized according to the team nursing system, the nurses are divided in a number of teams.
Each team has to provide care for a fixed group of patients.
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Advantages: 1. Each member’s capabilities are maximized so job satisfaction should be high.
2. Patients have one nurse (the Team Leader) with access to other providers
Disadvantages: 1. Registered Nurse may be the Team Leader one day and a team member the next, thus continuity of patient care may suffer.
2. Care is still fragmented with only 8 or 12 hour accountability.
Primary nursing is a method of nursing practice which emphasizes continuity of care by having one nurse provide complete care for a small group of inpatients within a nursing unit of a hospital.
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Advantages: 1. Increased satisfaction for patients and nurses.2. More professional system: Registered Nurse plans and
communicates with all disciplines. Registered Nurses are seen as more knowledgeable and responsible.
3. Registered Nurses more satisfied because they continue to learn as a function of the in-depth care they are required to deliver.
Disadvantages: 1. Intimidating for new graduates who are less skilled and knowledgeable.
2. Where do we get all these Registered Nurses during times of shortage?
If you are a head nurse manager, Which methods you will use?
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Basically nurses need to understand the positive and negative consequences of each model in order to plan and propose to decision-makers the most efficient and effective way to deliver care.
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In my hospital we use Total patient care, primary care and functional Nursing according to the situation.
In ICU one Registered Nurses assigns to one patient to give total patient care.
The head nurse gives assignment of 4-6 patients to each nurse to give primary Nursing Care.
Beside total assignment, one nurse will be responsible for distributing medications to all patients, the other one will be responsible to check Crash Cart etc.
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Nursing care delivery system is to organize the work.
There are 4 methods of Nursing care delivery system.
Each one has advantages and disadvantages. It better to mix more than one method in
delivering care to patients.
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Fawzia Gharbi Nadia aseri Lyla
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Young, y. & IlSun, K. Healthcare and Nursing Care Delivery System in South Korea. Journal of Nursing Administration: 2010; 40(11):460-462
Devakirubai , R. et al. Pattern of Nursing Care Delivery System. 2010
http/www. Pattern of Nursing Care Delivery System.Presentation.mht
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