Running head: SELECTING A CARE DELIVERY MODEL 1

Selecting a Care Delivery Model

Samantha R. Wiederkehr

Grand Canyon University: NSG-436

June 14, 2020

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Selecting a Care Delivery Model

Patient care is something that is continuously being modified and having new practices

implemented so that best practice can be achieved. Care delivery models are implemented in

order to structure this care so that goals and objectives can be met while doing the best work with

the resources given (Huber, 2018). There are several types of delivery models that are

implemented in practice, and there is no one model that is the correct way to provide care.

Traditional nursing care delivery models have influenced nursing and the way in which certain

tasks are carried out, but evolving models and innovative models have begun to be incorporated

as well. Two nursing care delivery models that are implemented in practice include primary

nursing and team nursing.

Primary vs. Team Nursing

Primary nursing is a model that is built on a 24 hours basis. In this model the nurse is

held accountable for their patient from their arrival at the hospital until they are discharged.

However, when the primary nurse is not present other nurse provide care for the patient based off

of that specific nurses plan of care (Huber, 2018). In contrast, team nursing is based on a group

of nurses that is managed by a nurse leader to provide care to their patients. This team of nurses

consists of RNs, LPNs, CNAs, and a supervisor in order to incorporate each members skills and

capabilities to carry out tasks (Huber, 2018). Both of these models provide excellent care to

patients but do so by taking different approaches. When brought about, primary nursing was not

only designed to have nurse assignments delegated to one nurse for a specific patient, but it was

also intended that tasks were not delegated to individuals who had less qualification (Huber,

2018). This is different than team nursing, because in the team model it is recommended to

delegate tasks to less qualified individuals if it falls within their scope of practice. In the primary
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model, the nurse who is in charge of the patients care is also responsible for all outcomes

regardless of if they were on shift or not. This is unlike the team model because everyone takes

responsibility for patient outcomes. Although there are several differences between these two

models, there are similarities as well. Both models are intended to provide high quality care to

patients in order to reach the best possible outcomes. In primary nursing, although the primary

nurse is technically in charge of all aspects of care, associate nurses are also involved when these

nurses are not working. This is similar to the team model, because although the nurse assigned

may be there they may be busy with another task and fellow RNs or LPNs can carry out tasks for

them. Another aspect of these models is the cost that comes with them. It has been seen in

studies that primary nursing is cheaper to implement than team nursing, and that it is also

associated with higher quality of care (Huber, 2018). Although these two models are shown to

have more differences than similarities, they are both implemented to provide high quality,

holistic care.

Implementation

Medical/surgical units within hospitals need plenty of attention in order to provide good

care to reach the best possible patient outcomes. Choosing between the two models above, I

believe that in a 24-bed medical/surgical unit implementation of team nursing would be the best

choice. With the amount of patients and the wide range of care needed, using a team that can

collaborate so that all patient needs are met is the most logical option. In team nursing each team

member is expected to communicate and help each other when necessary so that each patient is

well taken care of. There are several occasions on medical/surgical units where one nurse may be

busier than other RNs on that unit. In a situation like this they can receive help to carry out tasks

in a timely manner and ensure that each need is met so that there are improved patient outcomes.
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Team nursing is also ideal in this case, because with multiple members at different skill levels

there is a wider range of knowledge and skill (Fairbrother, Chiarella, & Braithwaite, 2015). One

downfall of team nursing is that it is more costly due to that fact that there is more staff needing

to be paid. Although this impacts the unit budget, it is worth it in order to give high quality care.

Advocating for patients is a key component of nursing, and if a higher budget is necessary to do

so, then it is worth it.

Conclusion

Each care delivery model provided high quality care to patients in different aspects,

however, the way they are implemented effects these outcomes greatly. Care models may be

more beneficial in different areas of nursing, Each unit has different needs that are necessary to

be met, and one care model may be more beneficial to one unit than another. Finding the right

model to incorporate is important to achieve best practice. Although both primary nursing and

team nursing are great approaches of care, specifically for a medical/surgical unit team nursing

will result in the best outcomes.

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References

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.

doi: 10.1071/ah14091

Huber, D. (2018). Leadership and nursing care management. Philadelphia: Saunders.