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4 Health Care Delivery Systems
- Case Management
Case (Total Patient Care)
- Oldest method
- Common for students and private duty nurses
- Patient recvds holsitc nofragmented care by one RN er shift
- RN: respondsible for all planning, organizing, performing all care, including personal hygiene, mediactions, treatment, educational and emotional support
- Staff members are assigned to complete certain tasks for a grp of patients rather than care for specific patients.
- ex: RN= assessment LPN= oral medications CNA= performs hygiene tasks and vital signs
- Care fragmented, skill oriented and less expensive
- RN functions as a team leader and coordinates a small grp of ancillary personnel to provide care to small grp of patients.
- Heart of the system communication Involves all memebrs in the nursing process
- Fragmented care and costly
- 24 respondsibility for planning and directing and evaluate patients care from admission to discharge.
- May delegate some patient care to LPN's
- Fundamental resp. model to maintain clear communication among all HCT including patient, family, nurses.
- Home health, hospice, long term care.
- RN coordinates care throughout course of an illness
- Bothe Team and Primary Nursing
- Manages treatment plans and length of stay of hospital for patients.
- Focus attention on the quality, outcomes and coordinates care.
- 5 components: assessment, planning, implemenation, Evaluation and Interaction.
- Home health agencies, Rehab, Long term
Process of influencing others in the provisions of care for one or more patients
Function of a leader is to guide people and grps to accomplish a common goal.
Leaders behavior is crucial
(Necessary to achieve a goal)
The legitimate right to give commands as determined by postion the oraganization chart
- (Necessary to achieve a goal)
- Ability to influence another thru control of needed resources
Control of rewards to others
Power based on an offical position in the organization
Use of punishment for noncompliance
Based on knowledge skills and information
- Connection to other powerful people in an organization
- Who you know!
Legitimate, Reward and coercieve Power
- Based on position
- where are you in the hiearchy
- Functions with a high sense of task accomplishment and low concern for people.
- Makes all work decisions
- Exercises corecieve powers
- Sets standards and methods of performance
- The go to person in emergency situation
- Dont have to make decisions
- Fear the leader
- Approach this leader with caution
- Leader defines limits but lets the grp make suggestions and decisions
- Focuses on team building
- Engages grp and everyone will buy into system
- Increase productivity
- Is the most desirable work setting
- Do not approach in emergency sitaution
Must be willing to work towards grp goals wven if the goal were not their personal choices.
- Do what you want to do if you feel good about it!Provides minimal or no direction
- Avoids respondsibility
- Don't work well- Not productive
- Has to do everything themselves
- Feels they provide care at a higher level than everyone else
- Takes care of everyone and makes all decisions and knows whats best
Non Productive Followers
- Appliance: only working to buy something not really committed to the team
- Doomsayers: Everything is wrong
- Subversives: Consciously or unconsciously undermind the leader
- Accomodators: Always try to please don't give real feedback.
- Advance degrees
- Those learing exp intended to build upon the educational and experimental bases of the professional nurses for the enhancement of :
- Or theory development
Uniform system of measuring & doucmenting participation in an organzied program.
As the possession of knowledge skills and attiudes necessary to meet a standard of practice.
- an interdisciplanary approach of standarlized medical irders combined with a tracking tool.
- Used as road maps for effective care
- Also used to monitor progress
Rapid Response Team
Activated when nurse recognize a change in pt condition that can be life threatening.
- Recovery Health status even life threathening
- Involves the use of :
- Reflection knowledge Instinct based on exp.
Dominant Thining Strategies:
- Recognize a pattern: id, data that fits together
- Set Prorities: Order concepts in terms of importance
- Search for info: recall missing or concealed information
- Generate a hypothesis: develope tentative explanations
- Make predictions: Declaring in advance
- Form realtionships: Connect info to further understanding
- State a propostion: State a ruel gverned by an if an statement
- Assert a practice rule: a truism about prior practice
- Make Choices: select alternatives
- Draw conclusions: reach decisions from opinion
- Provide an explanation: Offer reasons for actions beliefs or remarks
How to Improve Critical Thinking
- Debriefing critical incidents
- Patients chart reviews
- Grand rounds
- Role modeling
- Total Recall
- New ideas & creativity
- Knowing how to think
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