nursing care model essay

Nursing Care Models Worksheet Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular

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model Review and summarize one scholarly resource (not including your text) related to the nursing care model you observed in the practice setting. Review and summarize one scholarly resource (not including your text) related to a different nursing care model that you observed in the practice setting. Discuss a different nursing care model from step #3 of the directions and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific. Summarize this assignment and what you learned about the two nursing care models discussed. References: NURSING CARE MODELS The Nursing Care Models Chamberlain College of Nursing NUR 447: Collaborative Healthcare Name NURSING CARE MODELS Introduction Nursing care models are used to provide a definition and structure to the different impacts of nursing care. The models show just how diverse nursing practice can be. “Nursing practice models have been used to implement resource-intensive strategies with the goal of decreasing expenses and using staff more effectively. Nursing models help to identify and describe nursing care,” (pg. 111, Finkelman, 2016). Nursing care models also help give direction to nursing care (Finkelman, 2016). In different nursing clinical areas, different nursing care models may be used that best suit the needs of that area. Various Methods The Total Care Method Model, also known as the Case Method Model, is considered the oldest of the models (Finkelman, 2016). This method is considered the “model for all care to a patient during a shift,” (pg. 111, Finkelman, 2016). The Total Care Method Model defines that the primary nurse of a patient is responsible for all care during an eight-hour shift (Finkelman, 2016). While this may have been the first care model, it has criticisms as nursing has evolved (Finkelman, 2016). The type of care that is described by this model is seldom achievable by one registered nurse who has multiple patients under her care, sometimes for 12 hours at time (Finkelman, 2016). This model is mostly used by the home-health sector of nursing, where one nurse visits one patient at a time (Finkelman, 2016). Throughout time, even home-health nurses have adapted this method to better fit their needs by having divided the care amongst nurses, aides, physical therapist, and other members of the healthcare team (Finkelman, 2016). The functional nursing model is task-orientated (Finkelman, 2016). The model focuses on what must be done by each nurse and aide. A charge nurse is responsible for an assignment that gives each nurse a role, such a medication administration, and each aide a role, such as taking vital signs (Finkelman, 2016). A drawback to the functional nursing model is that nurses may feel that they are just NURSING CARE MODELS working to perform a job list instead of patient care (Finkelman, 2016). Patients may also feel they are not receiving individualized care (Finkelman, 2016). This method is primarily used in long term care and behavioral health facilities (Finkelman, 2016). The Team Nursing model uses two or three staff members to provide care for all patients during a shift (Finkelman, 2016). It was created during World War 2 to provide a solution to the nursing shortage (Finkelman, 2016). The team consisted of a registered nurse, a licensed practical nurse, and an assistant (Finkelman, 2016). The registered nurse provided all the decision making for the patients in lieu of a physician due to limited team member collaboration (Finkelman, 2016). This method, like the functional nursing model, is focused on task that need to be completed (Finkelman, 2016). The Primary Nursing method uses a registered nurse as the primary nurse who provides all the direct care to the patient (Finkelman, 2016). An associate nurse focuses on the care plans that are developed by the primary nurse and assist the primary nurse (Finkelman, 2016). A downside of primary nursing is the fact it creates a healthcare team solely of registered nurses which may increase cost (Finkelman, 2016). There are several more methods that nursing may rely on. Each comes with benefits and downfalls. Case Management Nursing I work as a Case Manager in a hospital setting that combines utilization review and discharge planning. I help patients receive the assistance they need to have a safe discharge plan. The job requires constant communication with the entire healthcare team while having little to no direct medical patient care to guide patients through the healthcare system (Finkelman, 2016). Case management in the acute setting typically involves registered nurses, social workers, and physicians (Zander, 2017). “Nurse case managers actively participate with their clients to identify and facilitate options and services for meeting individuals’ health needs, with the goal of decreasing fragmentation and duplication of care, and NURSING CARE MODELS enhancing quality, cost-effective clinical outcomes,” (Hall & White, 2006). Case Management places the focus on the patient as a customer of the hospital that needs a safe discharge plan and prevention of readmissions. “Using the case management approach, nurses can optimize client self-care, decrease fragmentation of care, provide quality care across a continuum, enhance clients’ quality of life, decrease length of hospitalization, increase client and staff satisfaction, and promote cost-effective use of scarce resources,” (Zander, 2017). The Case Management Model With case management nursing, the focus of the patient care is set on coordinating care instead of giving physical care to the patient (Finkelman, 2016). “The case management model is based on the assumption that patients with complex health problems, catastrophic health situations, and high-cost medical conditions need assistance in using the healthcare system effectively, and a case manager can help patients with these needs,” (pg. 113, Finkelman, 2016). Case managers have many different roles at different healthcare organizations to best meet the needs of the patients (Finkelman, 2016). The functional model of the Case Management model includes both utilization review and discharge planning (Zander, 2017). This most accurately reflects the model that is used at my job. A year ago, my employer made the decision to combine the case management department and the unitization review department. This model is typically used to reduce cost and to downsize the department (Zander, 2017). “The role of the new hospital case manager position is often ill defined, the nature of the department’s functions is not clearly articulated, and relationships with other disciplines are often confusing,” (Zander, 2017). With this model, the Case Management nurse performs two separate functions: utilization review and discharge planning (Zander, 2017). Utilization review ensures the appropriate documentation is charted to ensure the quality of patient care (Is utilization review the career for you, 2017). With the combination, the staff have the responsibilities of two separate full-time jobs. This can NURSING CARE MODELS lead to confusion with other employees of the organization, such as physicians as to what a case managers role is (Zander, 2017). “Several healthcare professional organizations and experts have defined case management; however, there clearly is no universally accepted definition for case management,” (Finkelman, 2016). Conclusion Nursing care models should combine responsibility, autonomy, and accountability to serve its purpose (Finkelman, 2016). The nursing models define and give a purpose to the nursing role at each individual job and facility (Finkelman, 2016). As a nurse, it is important to understand the what the nursing care models are to best understand how to fulfill that role (Zander, 2017). “Nursing models of care are developed to support or enhance professional practice,” (pg. 111. Finkelman, 2016). NURSING CARE MODELS References Finkelman, A. (2016). Leadership and Management for Nurses: Core Competencies for Quality Care, 3rd Edition. [Vitalsource]. Is utilization review the career for you? (2017, May 20). Retrieved from https://www.americannursetoday.com/utilization-review-career/ White, P., & Hall, M. E. (2006, April). Mapping the literature of case management nursing. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1463029/ Zander, K. S. (2017). Case management models: Best practices for health systems and ACOs. Brentwood, TN: HCPro. doi:https://hcmarketplace.com/aitdownloadablefiles/download/aitfile/aitfile_id/1942.pdf
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