Nursing Care Models for nursing practice settings

Nursing Care Models for different nursing practice settings

Nursing Care Moels for different nursing practice settings. Different nursing care models are appropriate in different nursing practice settings. A nursing model is a set of guidelines for the organization of nursing personnel in the provision of care suitable for the environment and organization systems. There are several nursing care models currently in practice, including; team nursing, primary nursing, total nursing care, and functional nursing care models. The changes in the healthcare industry require a change in nursing care delivery model applied.

Nursing Care Models
Nursing Care Models

Additionally, organizational policies and structures determine the type of nursing care delivery model applied to a specific healthcare provision setting. Availability of resources and training of nursing personnel are critical determinants of the best-suited model of nursing care delivery (Chapman, 2018). The following essay discusses a nursing model in practice and alternative models in practice.

Nursing Care Models for different nursing practice settings. Nursing Care Model Observed

 The nursing care model which was applied in the clinical area during is total patient care. In the total patient care nursing model, a nurse provides care to a patient or a group of patients during the period when the nurse is on a working shift (Butcher, Bulechek, Dochterman, & Wagner, 2018). In the clinical area, nurses were assigned to a patient or a group of patients as during the working shift. During the entire working shift, each was responsible for the care of the patient for which he or she were assigned. The nurse provided all the care to patients including; comprehensive assessment through the head to toe physical examination, history taking, and laboratory investigative procedures at the time of admission.

Additionally, each nurse was responsible for the administration of prescribed medication at specific times of the day when the drug administration was due. The nurse assigned to each patient was responsible for care compensation for the lost ability to perform self -care through activities of daily living, for instance, nurses assisted patients in nutritional care. During the working shift, the nurse was responsible for conducting patient education on drug adherence, keeping the clinical appointment and healthy living. The nurse was part of the healthcare inter-professional team for the patient they were assigned. The nurse assigned to the patient attended the ward rounds with the physician and other healthcare team members as part of collaborative teamwork. At the end of every nursing shift, each nurse provided comprehensive handing over the report of the patient, the care received, evaluation of interventions and further plan of care for implementation.

Nursing Care Models for different nursing practice settings. Total Nursing Care

Model Articles

Dubois, Ardy Amour, Tchouaket, Rivard, Clarke, Sean ( 2013), documented the various determinants of appropriateness and effectiveness of the total nursing care model about staff satisfaction and the quality of patient care. Specifically, the article focused on the environment, the scope of practice and staffing and their impact on the effectiveness of the total nursing care model in practice. The authors report that total nursing care is labor-intensive. Therefore, ensuring the sufficient number of nursing personnel is a requirement for implementing the total nursing care model. In other healthcare settings, however, a single nurse is assigned more than one patients. The number of nurses to which a nurse is assigned based on the ability of the patient to provide self-care and the number of activities of daily living that the patient is capable of performing. The assigning one nurse to one patient or a small of group patients improves the quality of care. Therefore, in order to achieve improved patient care, healthcare facilities need to assess the number of nursing personnel needed according to the number of patients and clinical care needed for each patient. The scope of practice within the clinical setting is another factor that affects the practice of total nursing care as reported by Dubois e al., (2013). Total nursing care offers comprehensive care to a patient or group of patient. Therefore, the nurse should possess the necessary skills and expertise to implement nursing care. According to the findings reported by the article, assigning nurses with necessary professional and educational skills to a patient increases the patient and nurse satisfaction, as evidenced by the improvement of care and reduction of work-related burnout. Finally, the environment within which total nursing care is practiced determines the effectiveness of the model in nursing practice. The physical and institutional structures and guidelines are vital factors that contribute to the quality of total patient care. Nurses are responsible for interpersonal care during the entire period of the nursing work shift. Therefore, supplies and supportive infrastructure should be provided to nurses to support the total patient care model. The physical environment consists of the availability of needed equipment. The clinical guidelines include nursing practice protocols for specific patient needs and several nursing care interventions (Papastavrou, Andreou, & Efstathiou, 2014).

King, Long, Lisy, Karolina (2015), reported on the effectiveness of the total nursing care model as indicated by the nursing staff satisfaction and the patient outcome. The article reports about staff satisfaction based on the reports of burn out and work-related psychological stress. Lack of necessary tools, equipment, and support, have been reported to increase the rate of burn out among nurses implementing the total nursing care model of practice. Improved quality of care to a patient is measured regarding the period of hospital stay, improvement in the ability to perform self-care and the general health status of the patients. Patient satisfaction in total nursing care is attributed to familiarization of the staff to the needs of the patient. Since nurses are responsible for patients care during the working shift hours, based on the baseline assessment data, can predict the patient nursing care needs during the working shift period and thus carry out further assessment and identify patient healthcare needs (King, Long, & Lisy, 2015).

Nursing Care Models for different nursing practice settings. Different Nursing Care Model Articles-Team Nursing

Fairbrother, Greg, Braithwaite, & Jeffrey, ( 2015), documented the appropriateness of team nursing in contemporary nursing practice, about healthcare changes and nursing practice. According to the article, team nursing is one of the nursing care delivery models that respond to the changing professional standards in nursing. Contemporary nursing practice requires collaborative teamwork. Implementation of team nursing requires that a group of nurses provide care to a patient or group of the patient for a given period. Team nursing is a form of professional l teamwork. Team nursing increases the number of expertise and skills available for application in providing care to the given patient. Team nursing minimizes the probability among clinical errors and thus improves the level of patient safety. Nursing education and training are advancing, resulting in the emergence of different levels of nursing expertise in practice. Increase in the level of education and training increases the quality of services that a nurse is capable of offering. Team nursing creates an environment where nurses exchange ideas, skills, and expertise required to implement nursing care interventions. Team nursing foundation is in alignment with the social theory of labor. According to the social model of labor, employees in the work environment develop social groups, interact in a specific manner and develop a unique code of communication. The social group that exists within the work environment contributes towards employees’ performance at work. Team nursing facilitates interaction between the employees, and therefore social interaction creating cohesiveness among the nursing staff, and limiting conflicts among nursing personnel (Fairbrother, Chiarella, & Braithwaite, 2015).

Another article identified the elements of the elements that determine the effectiveness of team nursing. The article reports on the results of a study that investigated the factors that determine the success of the team nursing care model. Responsibility and engagement are aspects to consider when choosing team nursing as a model of practice. In team nursing, responsibility for the care of the patient is shared among some nurses. Supervision of nurses while practicing team nursing is costly. Also, nurses’ ability to interact with nursing colleagues from different and several cultural backgrounds is another determinant of the success of the team nursing care model. In the current healthcare setting, practicing nurses are drawn from across several cultures. Therefore, the ability of each of members of team nursing to interact with each other reflects the level of collaboration of members of the team (Cho, Sloane, Kim, Kim, Choi, Yoo, & Aiken, 2015).

Nursing Care Models for different nursing practice settings. Implementation of Total Nursing Care

Total patient care  is widely practiced in the United States of America (USA). The plan for the application of team nursing begins at the time of recruitment of nursing personnel. Healthcare facilities are established through a plan of the expected number of patient to provide care to. Not only does the anticipated amount of nursing services determine the nursing personnel, but also the model of nursing care delivery to be applied. The implementation of team nursing requires the determination of nursing skills and thus the educational and professional qualifications of the nurses employed. The total patient, nursing care model, is applied in the general patient population and specialized patient care facilities, such as trauma facilities, renal facilities, and intensive care units. To effectively implement the total patient care nursing model, nursing leadership plays a key role. The nurse leader of the facility or unit is responsible for the allocation of nurses to care for specific patients. The nurse leader is responsible for determining the suitable nursing personnel for each of the patients, depending on the educational and professional level about the nursing care needs of the given patient. The nurse leader in the specific clinical unit draws up a duty schedule for nurses. During every nurse’s shift, the nurse leader allocates each of the nurses to the specific patient or a group of patients. Nurses provide all nursing interventions at specific points in time during the working shifts to the patient they have been allocated to. Generally, patients who require more compensation for self-care, are allocated one nurse for the given period. However, with the current emphasis on collaborative teamwork in nursing practice, nurses offer assistance to one another during care for the patient (Nilsen, 2015).

Nursing Care Models for different nursing practice settings. Recommending Different Care Model

Functional nursing care delivery model is an alternative and appropriate model. In the functional nursing delivery of care, a nurse is assigned a given role based on educational and professional qualifications. Nursing specialties in the USA are growing according to patient needs. In order to effectively utilize the existing nursing workforce within the USA, practical nursing puts every nursing specialty into its appropriate practice. Subsequently, the quality of care provided improves. The nurse providing care within their field of specialization minimizes errors while providing care. Therefore, the nurse prevents harm to the patient within the healthcare setting, thus, improving patient safety within the clinical area. Functional nursing reduces the incidence of psychological stress and related work-related burnout syndrome among nurses. Implementation of the functional nursing care delivery model requires less intellectual effort since the nurse in specialized in the nursing care provision (Mäkinen, Elovainio, Virtanen, & Bond, 2013).

In conclusion, there are several models of nursing care delivery currently in practice in the USA and else were. Every nursing care model has its merits and demerits. Further, certain features determine the effectiveness of every nursing care model. Therefore, in order to effectively apply a nursing care delivery model, certain conditions need to be fulfilled, for instance, recruitment of a sufficient number of nursing personnel. Functional nursing and team nursing care some of the nursing care delivery models that are responsive to the continuously changing nursing professional workforce, healthcare advancement and the emergence of new health issues.

Nursing Care Models for different nursing practice settings. References

 Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2018). Nursing Interventions Classification (NIC)-E-Book. Elsevier Health Sciences.

Chapman, H. M. (2018). Nursing Theories 3: Nursing Models. Nursing Times.

Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y., … & Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International journal of nursing studies, 52(2), 535-542.

Fairbrother, G., Chiarella, M., & Braithwaite, J. (2015). Models of care choices in today’s nursing workplace: where does team nursing sit?. Australian Health Review, 39(5), 489-493.

King, A., Long, L., & Lisy, K. (2015). Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care wards: a systematic review. JBI database of systematic reviews and implementation reports, 13(11), 128-168.

Mäkinen, A., Kivimäki, M., Elovainio, M., Virtanen, M., & Bond, S. (2013). Organization of nursing care as a determinant of job satisfaction among hospital nurses. Journal of nursing management, 11(5), 299-306.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53.

Papastavrou, E., Andreou, P., & Efstathiou, G. (2014). Rationing of nursing care and nurse–patient outcomes: a systematic review of quantitative studies. The International journal of health planning and management, 29(1), 3-25.


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