Posted: March 28th, 2021

Health Professions Education Patterns of Nursing Care

Health Professions Education
Patterns of Nursing Care
Order Description
Patterns of Nursing Care
Your lesson this week discussed patterns of nursing care delivery. In your opinion, what is the most
eective nursing care delivery model and why? What are the advantages and disadvantages of your
chosen nursing care delivery model? Give specic clinical examples.
Continuous Quality Improvement for Improved Patient Outcomes
By this point in the course, you have considered a challenge to quality patient care and identied a central
or relevant issue presented by the problem. So far, you have learned about theoretical frameworks or
models that guide nurses to provide nursing care that is supported by evidence-based practice (EBP).
PICO-formatted questions and potential interventions and activities have also been discussed. One must
consider the economic, ethical, and social principles relevant to the current developments in healthcare
and the current status of nursing.

All of the above elements may be a part of the rationale for a chosen solution to an identied problem. By
now, you should have conducted a literature review in order to nd the best and most relevant evidence,
which provides a tentative solution to the identied problem. Within your own work setting, how do those
problems get xed or corrected?
The Implementation Process
When planning the implementation process, permission should be obtained to allow the project to
commence and go forward. Securing permission involves communication with all the stakeholders for the
change to be successful. Organizational culture, group dynamics, and informal and formal power
structure are all elements that are examined during the implementation of a change.
How change is perceived depends on individual perspective. In other words, the whats in it for me”
(WIIFM) mentality plays a role in the success of the innovation. In some situations, a pilot study may be
necessary to determine feasibility for the proposed change. Before a pilot study is initiated, all aspects
must be carefully planned. One must consider how to conduct the pilot study and where it will be
conducted. We will discussion about pilot studies in the lesson next week.
Organization and Patterns of Nursing Care Delivery
Nursing care has been delivered in many ways over the years. Total patient care, functional nursing, team
nursing, primary nursing, and patient-focused care are a few terms that come to mind when discussing
patterns of nursing care. Each pattern of nursing care could be discussed as a single entity; in reality, the
patterns combine. Nurses should be prepared to work with any of the patterns of care. As healthcare
challenges change, so do the patterns of care.
Total patient care started as private duty nursing care in the patients home. In the 1920s and 30s, and
again in the 1980s, the nurse assumed responsibility for the complete care of the patient. This focused
the nurses attention and activities on one individual, thus increasing the quality of care and patient
Functional nursing came about with the start of World War II, when nurses took over the work in the
hospitals. Due to a combination of the war eort and using nurses as employees of the hospital, one of
the rst nursing shortages ensued. Functional nursing allowed nursing care to be broken into a series of
tasks that could be performed by many people. In this model, one nurse would administer medications
for all the patients on a unit while another would sign o on orders and another would do admissions
and discharges. This approach resulted in fragmented and impersonal care. It also caused certain patient
problems to be overlooked, such as psychosocial or spiritual needs. The incidence of errors and
omissions increased with this type of nursing, as did the lack of accountability for the total patient.

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Team nursing evolved in the 1950s as an answer to the problems that were created by functional nursing.
A group of patients was assigned to a team leader who was usually an RN. The care was coordinated for
the patients with other team members. Assignments were made according to the skill level and ability of
the team members. Good communication ensured the success of the team in providing the patient care.
Primary nursing evolved in the 1960s and 70s. This approach to patient care was designed to reduce or
eliminate the fragmentation of care that resulted from the change in caregivers over the shifts. One nurse
was responsible for the planning of care for the patient over a 24-hour period. Caregivers would follow
the plan for interventions and provide feedback on the patients response. In this approach, nursing care
may be provided by dierent levels of sta or all RNs. Because team nursing took the RN away from the
bedside, primary or modied primary nursing was designed to get the nurse back to the bedside.
Patient-focused care evolved over the last 15 years. With this type of care, the nurse supervises the
delivery of care to the patient by unlicensed ancillary personnel (UAP). The UAP are cross-trained to
perform more than one function, which increases their level of productivity. This model of nursing moves
the nurse to a higher level of functioning and autonomy as more tasks are delegated to UAP under the
supervision of an RN. The IOM (2003e) identied the provision of patient-centered care as one of the core
competencies for integrating safety and quality. The idea that health professionals come to the patient
helps prevent fragmented care. Nurses can use knowledge, skills, critical thinking, and judgment to
provide quality, safe patient care by coordinating the care with interdisciplinary teams.
Problem solving relies on decision-making, critical thinking, and/or clinical judgment. How you develop a
solution for a problem is based on your own values, parameters, knowledge, experience, and situational


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