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Primary Nursing: Common use areas Home
Health
Hospice
Long-term Care
Partnership Model (Co-primary RN is partnered with an LPN/LVN or a nursing
Nursing) assistant; pair work together consistently
Modification of primary nursing designed to ensure
more efficient use of RN
Partnership Model (Co-Primary RN responsible for planning care, assigning duties,
Nursing) : Lines of responsibility and coordinating care, and supervising the partner
accountability
RN is accountable for patient care for all assigned
patients
Partnership Model (Co-Primary More cost-effective than the primary care system
Nursing): Advantages
RN can encourage training and growth of partner
Partnership Model (Co-Primary RN may have difficulty delegating to the partner
Nursing): Disadvantages
Consistent partnerships are difficult to maintain on the
basis of varied staff schedules
Mayo's Model Relationship-Centered Nursing Practice
> Nurse in the role of the Caring Healer
> Accountability to patient - Problem Solver
> Continuity for patients as Navigator
> Empowerment serve as Teacher
> Synergy crated by Pivotal Communicator
> Safety increased through - Vigilant Guardian
> Professional Development as - Transformational Leader
Relationship Centered Care PEARLS
, I'll be here if you need me"
Patient-Centered Care - Definition " Providing care that is respectful of and responsive to
by IOM individual patient
preferences, needs, and values and ensuring that
patient values guide all clinical decisions."
Nurses, physicians, and other health professionals
partner with patients and
families to ensure that health care decisions respect
patient's wants, needs, and preferences
Patient-Centered Care - Methods to > Include them in developing care plans and discharge
engage patients, families, and plans
> Include them in change-of-shift or handoff reports
significant others as partners in
> Provide them with the information and education
care...
needed to make informed decisions
> Establish "family advisory councils" to engage
patients and families in decision- making
Case Management Nurse case manager "manages" a "caseload" of
patients from readmission (onset of illness) to
discharge (resolution of illness)
RN case manager assumes a planning and evaluative
role and usually is not responsible for direct care
duties
Case management is generally reserved for the
chronically ill; the seriously ill or injured; and long-
term, high-cost cases
Newer Models of Case Management Newer models are emerging because of health care
reform and the need to move patients to less costly
home and community care settings
Patient Navigators Help people "navigate" the complex health care system
> Physicians, clinics, hospitals, outpatient centers,
insurance and payment systems, patient-support
organizations, etc
,The History of Nursing Licensure: In early times by pins and registries
Recognition > Nursing Pins
> Registry
Nursing Pins Symbolize the school's philosophy,
beliefs, and aspirations Evidence of
achievement, learning and skills
Primary and Secondary Purpose of Protection of the public and the nurse
Nursing Licensure
Permissive Licensure Voluntary - Permitted but did not require nurses to
become registered
> Have to have two years of practice/experience
> Must pass the exam
Nurse Practice Act Each state develops laws & rules to govern the
practice of nursing within that state
Purpose of the Nurse Practice Act Protecting the health and safety of the citizens
Describes the qualifications and responsibilities of the
nurse
Licensure by Endorsement A nurse who gets their license in one state but wants
to practice in another state has to apply for a license
by endorsement.
> Withoutrepeating examination
> Some states participate in the Nurse Licensure
Compact that allows a nurse to practice in other
states that are a part of that compact.
Nurse Licensure Compact (NLC) is an agreement between states that allows nurses to
have one license but the ability to practice in other
states that are part of the agreement.
allows nurses to have one multistate license, with the
ability to practice in both their home state and other
compact states.
Not all states are compact states
How many states are a part of the 41 States
Nurse Licensure Compact (NLC)
Components of Nurse Practice Act > Description of requirements and procedures necessary
for entry into practice
, Role of regulatory boards are to? Ensure safe practice
Membership of the board of nursing usually appointed
by the governor's office
Duties of board of nursing? Administering the state's nurse practice act
Granting and renewing licenses and taking disciplinary
action when provisions of the act are violated
Special Cases of Licensure As a U.S. government employee, nurses have to be
licensed in only one state to practice across the
country
> Military and government nurses
Foreign Nurse Graduates Nurses who receive education in another country must
take a special examination administered by the
Commission on Graduates of Foreign Nursing Schools
before applying for a license to practice in this
country
International Practice Must contact either the International Council of
Nurses or the nursing regulatory board of the
country in which they wish to practice.
Nurse practice acts are written and Legislators
passed by?
Sunset Legislation Laws found in many states to ensure legislation are
current and reflect the needs of the public
Through sunset activities, nurse practice acts are
updated and revised
Licensure Establishes minimal levels of practice
Granted and governed by legislation and administered
through the state boards of nursing
Certification Recognizes excellence in practice
Awarded by nongovernmental agencies
What group became the first nursing Nurse anesthetists
specialty to certify practitioners in
1946?
What organization was formed as a American Nurses Credentialing Center (ANCC)
central organization for certification
of nurses?