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and provided. It depends on the philosophy of the organizations, nurse staffing and client population. Purpose of Assignment: To delegate the work to be done to the nursing personnel To gain the cooperation of the nursing personnel by knowing and accepting the acceptance of the work to be done. Primary Nursing Primary Nursing, as a form of assigning responsibilities for patient care, is an extension of the principle of decentralization of authority. The hallmark of this modality is that one nurse cares for one group of patients with a 24-hour accountability for planning their care. Each registered nurse is responsible for the total care of a small group of patients from admission to discharge. In other words a Primary Nurse cares for her patient every time she works and as
long as the patient remains on her unit. The Primary Nurse assesses the patient’s needs for care, sets care goals, writes a nursing care plan, administers care according to that plan, evaluates the outcomes of care, and makes the necessary changes or adjustments as necessary. He / She provide pre-discharge planning and teaching.
Therefore she communicates directly to any member of the health team within the hospital and the community. decision maker and coordinator of patient care to role model. The primary and secondary nurses are freed from administrative and housekeeping responsibilities to maximize their time for patient care. secondary or associate nurses execute the nursing care plan during the afternoon and night shifts and on days when the primary nurse is off duty. Authority.Since the primary nurse assumes a 24-hour responsibility for nursing care. and autonomy rest with the primary nurse. She encourages clinical decision making and ensures needed support in coordinating the functions in patient care managements. accountability. Figure: Lines of Authority in Primary Nursing The Head Nurse’s role in this kind of assignment shifts from taskmaster. . consultant and quality control expert for the Primary Nurse in the unit.
When the lines of communication are open. must follow the plan to ensure continuity of care. Both health care discipline and members of the patient’s family must aware of the patient – nurse relationship so they can look for her when they have questions or concerns about the patient. Encourages of Specialization Skills Primary Nursing produces specialization of nursing skills due to repetition. If he handles the chest tube each time he comes to work. 4. When the PN receives a patient with special needs.The Advantages Of Primary Nursing: 1. Promotes Autonomy The PN carries out order that are written during the day. However. which are individualized to the patient. Creates Knowledgeable Nurses . he may initially not know how to care for him. 3. he eventually becomes an expert. such as someone with a chest tube. Care plans. Secondary nurses who work the evening and night shift. he can educate himself about the chest tube by asking other members of the health care team for help. Creates a Central Figure The PN is the central figure in the assigned patient’s care. the PN appears responsible. and provides basic care like giving baths or changing wound dressings. develops care plans. plus associate nurses who will fill in during PN’s absence. knowledgeable and approachable 2. are communicated to staff members. She learns to become incredibly efficient and organized during her shift.
. Disadvantages Of Primary Nursing: 1. Promotes Strong Nurse – Patient Relationship Primary Nursing strives to create a strong nurse – patient relationship by building trust. The nurse’s familiarity with her patient allows her to communicate effectively with members of the health care team. 5.Because the nurse takes care of the same patient day after day. so other patients cannot benefit if the RN is competitive. It also enables her to detect subtle changes in the patients condition that may require immediate action. health care providers and patients are impacted by the characteristics of each system. Can be intimidating for RN’s who are less skilled and knowledgeable Primary Nursing Vs. Only confines a nurse’s talents to a limited number of patients. Each management style has advantages and disadvantages. She may even know her family members by name. Team Nursing Primary Nursing and Team Nursing are the most commonly used nursing management styles in hospital settings. the patient becomes confident about his abilities. As the bond between the Primary Nursing and his patient strengthens. which leads to decreased recovery time and shorter length of stay. Nurses. she becomes very knowledgeable about her medical history and her treatment plan. The result of a strong. She trusts that she is working to her benefits. 2. positive nurse –patient relationship is greater patient satisfaction.
It differs from team nursing in that the registered nurse provides direct nursing care with the assistance of aides. charge nurses are held accountable for unlicensed personnel.Primary Nursing In Primary Nursing one nurse provides patient care on an individual basis from the time a patient is admitted to the time of discharge. Comparison The work load is shared in team nursing and individualized in primary nursing. as this can be distracting. Home health care and hospice settings often use the primary nursing style to manage nursing practices. Health care professionals work in a team to complete all assignments for each shift. as patients are able to develop trust and become comfortable with the nurse’s performance while providing care. Team Nursing Team Nursing consists of a charge nurse leading nursing assistants and other personnel to provide care to a group of patients. As registered nurse. . Primary Nursing is also costly but necessary in some instances. The patient-nurse relationship is an advantage in primary nursing. Patients are more likely to become uncomfortable with numerous team members providing care. MODULAR NURSING Is a modification of team and primary nursing. A lack of communication can be detrimental in team nursing due to the shared work load.
plans and implements care. . as in primary nursing. and assesses outcomes including guiding and instructing her partners. It is similar to primary nursing in that each pair or trio of nursing personnel is responsible for the care of patients from admission to discharge. and throughout any subsequent admissions in the same institution. another group of nurses will care the patients on alternate shifts and during their day offs. following discharge. It is customary to assign the two-or three worker team full responsibility for a case load of 8 to 12 patients in a particular section of the nursing unit. Again. The greatest responsibility falls on the registered nurse who assesses the patient’s needs. support and instruction to the nonprofessional nursing personnel. It may therefore be observed that the role of the nurse in the modular form of assignment is more difficult than a primary nurse.The professional nurse provides leadership.
Figure: Modular method ADVANTAGES OF MODULAR METHOD 1. Geographic closeness and efficient communication . Useful when there are few RN’s 2. RN more involved in planning and coordinating care 3. Continuity of care is improved 4.
Rigid rules in the choice of health care providers . Advantages 1. Preferred Provider Organizations (PPOs). PPOs. Scope of Managed Care: Inhospital services. various ambulatory. credentials and experiences are carefully analyzed This gives the members peace of mind and feeling of safety knowing that their health is in good hands Disadvantages: 1. longterm and home care services. and diagnostic and therapeutic services. HMOs. Health care providers became readily accessible 3. Most common forms of managed care: Health Maintenance Organizations (HMOs). Managed care operates by health care providers and referring these to their members to avail of services and procedures at discounted rate. Health care professionals have gone through an accreditation process. It is a leading form of health care in the United States. Lower health care costs 2. and point-of-Service Plans (POS).MANAGED CARE: The goal of managed care is to keep the health care costs down without sacrificing quality.
Differentiated Nursing Practice Structuring of nursing roles and functions based on the individual’s education. experience. there are also inconvenient locations for health care providers clinics.- These are the cases when a patient is not satisfied with the care that is rendered by a primary care physician and would want to consult with another who is not included in the network through their managed care provider - Other members reported that their primary care physicians skip on the necessary tests in order to save money - There are those members who complain that their primary care physicians make them go through unnecessary treatments to make move money 2. Strict SOPs: For instance. there is a consistent greater need for differentiated nursing practice. or the available times for appointment do not fit their busy schedule 3. . As health care continues to evolve. and competence is the main feature of differentiated nursing practice. There is some degree of loss of privacy: The managed care company receives summaries with details of their medical conditions and treatments availed. the need to obtain approval from insurance provider before any treatment is commenced results to long waiting period.
competence and licensure of the staff members involved. Differentiated nursing is informally practiced in almost every setting.N.P.N: - Associate Degree Nurse .N? - Increased patient satisfaction Decreased length of hospital stay Decreased patient cost Positive effects on nurses’ satisfaction Maximized use of scarce nursing resources Models of D.P.P. Example. include: Optimal nursing care matching patient’s needs with the nurse’s competencies Effective and efficient use of scarce nursing resources Equitable compensation Increased career satisfaction among nurses Greater loyalty to employer Enhanced prestige of nursing profession What are the advantages of D. when a nurse manager plans the staff assignments according to knowledge. Goals of D.
Responsible for the shift of service Strong emphasis on meeting the physiological and comfort needs of patient Implement nursing care plans developed by nurse clinician and primary nurse Baccalaureate Degree Nurse or Primary Nurse Responsibility starts from admission and ends with discharge Coordinate medical and nursing orders. Advanced Practice Nurse (APN). There are representations from all health care providers. Certified Nurse Midwife (CNM) Assumes the role of case manager and client advocate Collaborative Nursing Practice In this practice modality.P: . Working together for the greater good Conditions in order to meet a successful C. nurses. and ancillary health personnel collaboratively make clinical decisions for the patient. There is joint patient care reviews. physicians. client education and prepares patient’s discharge plan Master’s Degree Nurse Advanced Registered Nurse Practitioner (ARNP). Collaborative Nursing Practice is a multidisciplinary plan of care that promotes shared participation. responsibility and accountability in order to meet complex patient needs.N.
there will be no consistency and continuity in care. . - Lack of understanding and appreciation for the other disciplines’ contribution to the team Some discipline have a feeling of superiority and self centeredness in that they seem to think that their role is the solely important aspect in making the patient well. It also puts the patient in the position of feeling unsafe. - Lack of mutual trust and respect amongst nursing professionals If there is no respect and trust for each discipline in the collaborative team. Working together requires communication. If the members are not communicating with each other. P: - Lack of communication Collaborative care can only be successful if the team works together. the team will not effectively work together.- Must have similar value system and shared objectives and goals Communication must be honest. N. respectful and purposeful Health care team members must be willing to work together Barriers to C. putting the patient at risk.
com/doc/36521093/Team-Nursing .com/nursing-notes-reviewer/fundamentals-of-nursing/modalities-of-nursingcare/) http://books.com.References: (http://nursingcrib.google.ph/books? id=hCBNRm520MQC&pg=PA316&lpg=PA316&dq=example+of+modular+nursing&source http://www.scribd.
MAN. Nagtalon. Venzon.RN.BSN. RN .Nursing Management Towards Quality Care 3rd edition Lydia M.RN Group 1 Members MARK BACHARO. RN ANDREA BESONAYA.FPCHA Jennifer M.V.
RN EDGAR GARGANERA. DADULA.LILIBETH O. GEODESICO. DE LA TORRE. RN MAY KLAIRE PARPARAN. RN MARICEL DESUYO. RN MA.MARIA AURORA BRITON. RN ANNA MARIE J. RN LUCITA B. RN .
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