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How would you differentiate among the various types of nursing care delivery models?
- Team nursing: develop as a care delivery models in response to the severe nursing shortage. The team members provide direct client care to a group of client under the direction of the RN team leader, but may not be assigned same client each day. The team leader, an experience Rn, develops client care plans, coordinate cares delivered by the nursing team and provide care requiring complex nursing skills.
- Total patient care: delivery was the original care delivery model develops during Florence Nightingales time. An Rn is responsible for all aspect of care for one or more clients. Rn can delegate but at the end she is responsible for the care of all assigned clients. Care is provided using a shift based model. With this model client satisfaction is high but total pt care is not cost-effective because it requires a high number of RN to provide care
- Primary nursing: model of care delivery was developed to place Rn's at the bedside and to improve nursing accountability for client's outcomes and the professional relationship among staff members. An RN is case manager over a period of time.
- Case management: is a care management approach that coordinates and links health care services to clients and their families while streamlining costs and maintaining quality. This is a collaborative process of assessment, planning, facilitation and advocacy for options and services.
What are the elements of decentralized decision making?
- Responsibility: duties and activities that an individual is employed to perform Autonomy; is freedom of choice and responsibility for the choices.
- Authority: refers to legitimate the power to give command sand make final decisions specific to a given position
- Accountability: refers to an individual being answerable for their actions.
How can the nurse manager encourage staff involvement in a decentralized decision making model?
- A-Establishment of nursing practice or problem solving committees
- B-Nurse/physician collaborative practice
- C-Interdisciplinary collaboration
- D-Staff communication
- E-Staff education
How are clinical care coordination skills applied to nursing practice?
- Clinical Decision making: assessment of all your client conditions and required therapies
- Priority setting: deciding what clients or procedures need the first priorities
- Organization skills: implementing a plan of care effective and efficient.
- Use of resources: this includes utilizing members of the health care team
- Time management: skill that involves learning how, where and when to use our time.
- More information about time management in Time management box 21-5 pg 281
- Evaluation: is not only at the end but an ongoing process
What are the general principles in delegation of client care activities?
- What are the general principles in delegation of client care activities?
- Delegation is transferring responsibilities for the performance of an activity or task while retaining accountability for the outcome.
- Rights of delegations are (requirements for appropriate delegation); Right task, right circumstances, right person, right direction/communication, and right supervision.
- More info box 21-6 pg 282
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