Nursing Care Delivery within Health Care System
Q&A Guide for Exams and Assignments
Q. Briefly describe the patterns of nursing care delivery within health care system.
Q. Write short notes on:
1. Functional nursing.
2. Team nursing,
3. Total patient care,
4. Primary care nursing,
5. Nursing management.
Answer:
Patterns of nursing care delivery within health care system: There have been many
models of nursing care delivery within health care system. The decision of which
care is used is based on the needs of patients and the availability of competent staff
in the different skill levels. The model of nursing care delivery utilized is often
determined by the nurse leader and applied across the organization. Each model
has its strengths and weakness that should be considered when deciding which to
implement. There are 5 (five) patterns of nursing care delivery within health-care
system. These are:
1. Functional nursing.
2. Team nursing
3. Total patient care.
4. Primary care nursing.
5. Nursing management.
1. Functional nursing: Functional nursing divides the nursing work into nursing
units that are then assigned to one of the team members. In this method, each has
specific duty of tasks, they are responsible for. For example, one is assigned to give
all the medication, another performs all the treatments and another works at the
desk transcribing physician's order and communicating with other nursing
departments about patient care issues.
,This pattern is been used less often becomes its focus tends to be more on
completing the task rather than caring for individual patients.
2. Team nursing: Team nursing is a care delivery model that assigns nurses to
teams that then are responsible for a group of patients. Team nursing is organized
and directed by a nurse called the team leader. The team leader and supervisors, co-
ordinates all the care provided by those on his team. The team is most commonly
made up of various level of nursing staff and personnel. All team members report
the outcomes of their care to the team leader, the outcomes of their care to the team
leader. The team leader is responsible for evaluating whether the goals of patient
care are met.
Conferences are important part of team nursing. They may cover a variety of
subjects but are planned with certain goals in mind, such as determining the best
approaches to each patient's health problems, increasing the team members
knowledge and promoting a cooperative spirit among nursing personnel.
3. Total patient care: Total patient care is a system of comprehensive patient care
that considers the physical, emotional, social, economic and spiritual of an
individual. The nurse is responsible for the total care for the patient assignment for
the shift she/he is working.
The advantage of total patient care - Total patient care is the consistency of one
individual caring for patients for an entire shift. This enables the patient, nurse and
family to develop a relationship based on trust. This model provides a higher
number of nurse hours of care than other models. The nurse has more opportunity
to observe and monitor progress of the patient.
The disadvantage of total patient care - It disadvantage may be that the nurse
may not have the same patients from day to day and therefore looks at the patient
on a shift-by-shift basis rather than on a continuum of care. The model utilizes a
high level of nurse hours to deliver care, and this level of nurse intensity is not
warranted. It is more costly than any others.
4. Primary care nursing: Primary nursing is a care delivery model that clearly
describes the responsibility and accountability of the registered nurse and
,designates her as the primary provider of care to patients. It consists of four
elements. These are -
a. Allocation and acceptance of individual responsibility for the decision
making to one individual.
b. Assignment of daily care by the case method.
c. Direct person to person communication.
d. One person is operationally responsible for the quality of care administered
to patient on a unit for care 24 hours a day, 7days a week. It is a method of
providing comprehensive, individualized and consistent care.
The nurse has accountability and responsibility to develop a plan of care with the
patient and family. There is a holistic approach to care, which facilitates continuity
of care rather a shift-to-shift focus.
Disadvantages include a high cost, a requirement of knowledgeable nurses to
ensure the appropriate matching of nurse to patient etc.
Nursing management: Case management is a strategy to improve patient care
and reduce hospital cost through co-ordination of care. A case manager is
responsible for co-coordinating care and establishing goals from preadmission
through discharge. In this model a nurse is assigned to a specific high-risk patient,
such as cardiac surgery patients.
The case manager has the responsibility to work with all disciplines to work
with all disciplines to facilitate care. The advantage is that it ensures the higher
quality compared to other models.
The disadvantage is that it requires enough nurse time allocated for this activity.
Q. Define Team Nursing.
Answer:
Definition of Team Nursing:
• Team nursing is based on philosophy in which groups of professional and
non-professional personnel work together to identify, plan, implement and
, evaluate comprehensive client-centered care. The key concept is a group that
works together toward a common goal, providing qualitative comprehensive
nursing care (Kron 1978).
• Team nursing was designed to accommodate several categories of personnel
in meeting the comprehensive nursing needs of a group of clients (Donavan
1975).
Q. Write down the objective of team nursing.
Answer:
Objectives of team nursing: The objective of team nursing is to give the best
possible quality of patient care by utilizing the abilities of every member of the
staff to the fullest extent and by providing close supervision both of patient care
and of the individual who give it.
Q. Write down the functions of team nursing.
Answer:
Functions of team nursing: The two important points of functioning are:
1. The head nurse must know at all times the condition of the patients and
the plan for their care and must be assured that assignments and
workmanship contribute to quality nursing
2. The team leader must have freedom to use her initiative and the
opportunity to nurse, supervise, and teach unencumbered by the
responsibility for administrative detail
Q. Mention the advantage and disadvantage of team nursing.
Answer:
Advantages of team nursing:
1. High quality comprehensive care can be provided despite a relatively high
proportion of ancillary staff.
, 2. Each member of the team is able to participate in decision making and problem
solving.
3. Each team member is able to contribute his or her own special expertise or skills
in caring for the patient.
4. Improved patient satisfaction.
5. Organizational decision making occurring at the lower level.
6. Cost-effective system because it works with expected ratio of unlicensed to
licensed personnel.
7. Team nursing is an effective method of patient care delivery and has been used
in most inpatient and outpatient health care settings.
Other advantages:
1. Feeling of participation and belonging are facilitated with team members.
2. Work load can be balanced and shared.
3. Division of labor allows members the opportunity to develop leadership skills.
4. Every team member has the opportunity to learn from and teach colleagues
5. There is a variety in the daily assignment.
6. Interest in client's wellbeing and care is shared by several people; reliability of
decisions is increased.
7. Nursing care hours are usually cost effective.
8. The client is able to identify personnel who are responsible for his care.
9. Continuity of care is facilitated, especially if teams are constant.
10. Barriers between professional and non-professional workers can be minimized,
the group efforts prevail.
11. Everyone has the opportunity to contribute to the care plan.
Q&A Guide for Exams and Assignments
Q. Briefly describe the patterns of nursing care delivery within health care system.
Q. Write short notes on:
1. Functional nursing.
2. Team nursing,
3. Total patient care,
4. Primary care nursing,
5. Nursing management.
Answer:
Patterns of nursing care delivery within health care system: There have been many
models of nursing care delivery within health care system. The decision of which
care is used is based on the needs of patients and the availability of competent staff
in the different skill levels. The model of nursing care delivery utilized is often
determined by the nurse leader and applied across the organization. Each model
has its strengths and weakness that should be considered when deciding which to
implement. There are 5 (five) patterns of nursing care delivery within health-care
system. These are:
1. Functional nursing.
2. Team nursing
3. Total patient care.
4. Primary care nursing.
5. Nursing management.
1. Functional nursing: Functional nursing divides the nursing work into nursing
units that are then assigned to one of the team members. In this method, each has
specific duty of tasks, they are responsible for. For example, one is assigned to give
all the medication, another performs all the treatments and another works at the
desk transcribing physician's order and communicating with other nursing
departments about patient care issues.
,This pattern is been used less often becomes its focus tends to be more on
completing the task rather than caring for individual patients.
2. Team nursing: Team nursing is a care delivery model that assigns nurses to
teams that then are responsible for a group of patients. Team nursing is organized
and directed by a nurse called the team leader. The team leader and supervisors, co-
ordinates all the care provided by those on his team. The team is most commonly
made up of various level of nursing staff and personnel. All team members report
the outcomes of their care to the team leader, the outcomes of their care to the team
leader. The team leader is responsible for evaluating whether the goals of patient
care are met.
Conferences are important part of team nursing. They may cover a variety of
subjects but are planned with certain goals in mind, such as determining the best
approaches to each patient's health problems, increasing the team members
knowledge and promoting a cooperative spirit among nursing personnel.
3. Total patient care: Total patient care is a system of comprehensive patient care
that considers the physical, emotional, social, economic and spiritual of an
individual. The nurse is responsible for the total care for the patient assignment for
the shift she/he is working.
The advantage of total patient care - Total patient care is the consistency of one
individual caring for patients for an entire shift. This enables the patient, nurse and
family to develop a relationship based on trust. This model provides a higher
number of nurse hours of care than other models. The nurse has more opportunity
to observe and monitor progress of the patient.
The disadvantage of total patient care - It disadvantage may be that the nurse
may not have the same patients from day to day and therefore looks at the patient
on a shift-by-shift basis rather than on a continuum of care. The model utilizes a
high level of nurse hours to deliver care, and this level of nurse intensity is not
warranted. It is more costly than any others.
4. Primary care nursing: Primary nursing is a care delivery model that clearly
describes the responsibility and accountability of the registered nurse and
,designates her as the primary provider of care to patients. It consists of four
elements. These are -
a. Allocation and acceptance of individual responsibility for the decision
making to one individual.
b. Assignment of daily care by the case method.
c. Direct person to person communication.
d. One person is operationally responsible for the quality of care administered
to patient on a unit for care 24 hours a day, 7days a week. It is a method of
providing comprehensive, individualized and consistent care.
The nurse has accountability and responsibility to develop a plan of care with the
patient and family. There is a holistic approach to care, which facilitates continuity
of care rather a shift-to-shift focus.
Disadvantages include a high cost, a requirement of knowledgeable nurses to
ensure the appropriate matching of nurse to patient etc.
Nursing management: Case management is a strategy to improve patient care
and reduce hospital cost through co-ordination of care. A case manager is
responsible for co-coordinating care and establishing goals from preadmission
through discharge. In this model a nurse is assigned to a specific high-risk patient,
such as cardiac surgery patients.
The case manager has the responsibility to work with all disciplines to work
with all disciplines to facilitate care. The advantage is that it ensures the higher
quality compared to other models.
The disadvantage is that it requires enough nurse time allocated for this activity.
Q. Define Team Nursing.
Answer:
Definition of Team Nursing:
• Team nursing is based on philosophy in which groups of professional and
non-professional personnel work together to identify, plan, implement and
, evaluate comprehensive client-centered care. The key concept is a group that
works together toward a common goal, providing qualitative comprehensive
nursing care (Kron 1978).
• Team nursing was designed to accommodate several categories of personnel
in meeting the comprehensive nursing needs of a group of clients (Donavan
1975).
Q. Write down the objective of team nursing.
Answer:
Objectives of team nursing: The objective of team nursing is to give the best
possible quality of patient care by utilizing the abilities of every member of the
staff to the fullest extent and by providing close supervision both of patient care
and of the individual who give it.
Q. Write down the functions of team nursing.
Answer:
Functions of team nursing: The two important points of functioning are:
1. The head nurse must know at all times the condition of the patients and
the plan for their care and must be assured that assignments and
workmanship contribute to quality nursing
2. The team leader must have freedom to use her initiative and the
opportunity to nurse, supervise, and teach unencumbered by the
responsibility for administrative detail
Q. Mention the advantage and disadvantage of team nursing.
Answer:
Advantages of team nursing:
1. High quality comprehensive care can be provided despite a relatively high
proportion of ancillary staff.
, 2. Each member of the team is able to participate in decision making and problem
solving.
3. Each team member is able to contribute his or her own special expertise or skills
in caring for the patient.
4. Improved patient satisfaction.
5. Organizational decision making occurring at the lower level.
6. Cost-effective system because it works with expected ratio of unlicensed to
licensed personnel.
7. Team nursing is an effective method of patient care delivery and has been used
in most inpatient and outpatient health care settings.
Other advantages:
1. Feeling of participation and belonging are facilitated with team members.
2. Work load can be balanced and shared.
3. Division of labor allows members the opportunity to develop leadership skills.
4. Every team member has the opportunity to learn from and teach colleagues
5. There is a variety in the daily assignment.
6. Interest in client's wellbeing and care is shared by several people; reliability of
decisions is increased.
7. Nursing care hours are usually cost effective.
8. The client is able to identify personnel who are responsible for his care.
9. Continuity of care is facilitated, especially if teams are constant.
10. Barriers between professional and non-professional workers can be minimized,
the group efforts prevail.
11. Everyone has the opportunity to contribute to the care plan.
