Purpose Of The Nursing Practice Model

What is a nursing practice model you might ask. It is a model that reflects nursing values that exemplify the culture of an organization. The dominant attributes shared among models and featured in these organizations includes nursing autonomy, empowerment and cost effective quality care. The goal of the practice model is to support the relationship between the nurse and the patient. The nursing care model witnessed by this writer in the long term care facility was based on a team approach. A team based model consist of a registered nurse, licensed practical nurse and unlicensed assistive personnel, who provides total care to a group of patients for an eight hour shift. (Finkelman, 2016) The team leader or the RN coordinates the care of the
patient with the other members of the team, let's take a look at such a team.
The nursing care model witnessed by this writer included a registered nurse, licensed practical nurse, three unlicensed assistive personnel and the physician.
In this approach the registered nurse (charge nurse) took care of twenty patients in an eight hour time frame with the help of a LPN who administered medication and UAPs to care for the patient. The registered nurse would communicate with the doctor and perform the needed care for the patients, such as, treatments and monitoring interventions. However, unlike discussed in the reading this team included social workers, speech therapy, occupational therapy and physical therapy. These other specialists performed task related to there training but it was ultimately the duty of the RN to assess the patient and refer them appropriately. The RN was responsible for total care of the patient from admission all the way to discharge. On admission the plan of care is discussed with all members of the team from the social worker to the physical therapist and physician. From that point the RN assumes all care related to the patient including medication changes and treatments that are needed to be performed. As the patient becomes more stable and able to go back into the community the nurse would first obtain recommendations from the other specialties then communicate this with the physician then proceed with the
discharge.
With any care model or nursing approach there are both positives and negatives involved.
In the team approach care model every member of the team brings something important to patient care. The beginning of the shift is started off with a huddle or conference involving the team leader, assigned nurse and unlicensed assistive personnel, where the plan of care is discussed. The benefits of this is that it provides the best care possible by utilizing the strengths of all healthcare professionals involved. This also helps to further the communication skills due to the fact that it brings together a small group. In this forum each member of the group has the opportunity to contribute to the decision making process which in the long run provides the most comprehensive care. Staff morale was also a big advantage when it came to team nursing care, teamwork while feeling inclusive leads to a higher job satisfaction, increased patient safety, improved quality of care and greater patient satisfaction. However the biggest benefit of team nursing care when compared to another model like primary nursing care according to Zimbudzi (2013), revealed a 50% reduction in clinical errors. The data provided from the study done by Zimbudzi was based on a team nursing care model and its application in an acute hemodialysis setting without compromising patient care. In this study the primary care model was compared with the team care model and according to the evidence team nursing care model has
enough proof to fit in today's healthcare practice.
Team nursing also has its challenges, since communication and delegation are necessary with this model teamwork is essential. There have been an abundance of research that emphasis how effective nursing teamwork is to higher jab satisfaction, safer patient care, better patient satisfaction and decrease nurse turnover. Two essential elements of teamwork include but are not limited to trust and respect, especially in the workplace. Being close personal friends with everyone at work is not something achievable however coworkers should treat each person with respect and professionalism. The inclusion of other staff members in discussion and decision making helps to build trust before change can be made to policies or tasks that affects workflow. (When Nursing Teamwork Suffers, 2016) Other cons related to team nursing care includes, the fact that the nurse remains responsible for the duties being performed without having performed them personally. Which entails that even though the charge nurse is delegating tasks according, they have to make sure that these tasks are done. Lastly, the team may incorporate members who do not know each other as well as members who do not contribute as much as others, and can cause conflict. This conflict can cause a rift in the team, which can cause patient care to suffer and increase nursing turnover.
Now let us take a look at the primary nursing model and how it is implemented through the healthcare system. Under the primary nursing model, patient care is the responsibility of a nurse for the time of the patients hospital stay. The implementation and planning of care is primarily between the patient and the named nurse. However, the nurse does not work alone but works closely with colleagues and other professional groups.