So welcome back, everyone.
When you're thinking
about health care organizations,
the nursing care
that is delivered to patients
is sometimes organized
in different ways.
Today, we're going to be talking
about nursing care delivery systems.
Care delivery models
are the operational mechanisms
by which care is provided
to patients and families.
And there are several traditional models
that we're going to discuss today,
these include total patient care,
team or modular nursing,
and case management.
When you think
about total patient care,
this is the type of care
where the registered nurse
for a group of patients for a shift
and provides all care
to the patient.
There are some advantages
to this particular model of care.
This provides continuity for the shift.
Provides clear responsibility,
we know who is taking care of the patient.
And it's generally satisfying for nurses.
But there are some disadvantages,
one, it can be very expensive,
and it may not utilize the RN time wisely
because they're doing activities
that might not require an RN license,
and it may not be possible
with staffing shortages today.
The next one is functional nursing.
Staff members are assigned
to specific tasks
or group of tasks for the patient.
For example, you could have
a medication nurse,
you might have an IV nurse,
or someone who is exclusively
taking vital signs.
The registered nurse, however,
assumes overall direction of care
for all of the patients.
The advantages to this model
is that it actually incorporates
the use of licensed practical nurses
and unlicensed assisted personnel.
This gives them the opportunity
to maximize their skills
and it can be very cost effective.
There are some disadvantages
to functional nursing.
First, it can lead to fragmentation
because one team member
may not know what the other
team member might be doing.
And that can lead to a gap
in patient care
which means it's not holistic.
So, for example, if you have one nurse
who's only doing medications
and you have one nurse or team member
who's only taking vital signs,
you may not connect the dots
to know that a certain vital sign
or certain parameter might prohibit
the need to take a medication
in the event that there's not
between the team members.
The next one is team
or modular nursing.
The registered nurse team leader
coordinates care for a group of patients
working with other team members,
such as other registered nurses
and other unlicensed assisted personnel.
Also, utilizing their skills.
the advantages to this particular model
is that it's very satisfying
for both staff and patients,
and it is very cost-effective.
Some disadvantages include:
it does require
a high-level leadership skill
from the registered nurse.
And, actually, today is harder to do
when you have high patient acuity,
meaning you have a patient load,
it has very complex health situations,
or you have inconsistent team members.
When you have inconsistent
you always have to recalibrate
and get to know each other
a little bit better
every time you're assigned
to different team members.
If you have a consistent team,
then it can definitely be an advantage.
The next model is primary nursing.
This is where the registered nurse
or complete accountability
all of the time
for their primary patients,
and they establish a plan of care
and coordinate care even in their absence.
The advantage to this one
is that it has a high job satisfaction
and it does provide excellent
holistic care for the patient.
The disadvantages, however,
is that it does require a high RN mix.
And it's difficult to do with today's
flexible scheduling needs of most nurses,
and some staff, honestly, don't want
the accountability and responsibility
of a patient load 24 hours,
seven days a week.
The last one is case management.
The RN case manager
supervises the care of the patient
and the use of resources
across the continuum
and lays focus on individual patients.
The advantage to this model
is that it is very cost-effective
and it, again, is satisfying for patients
who are high risk or problem prone.
There's really only one disadvantage
to the case management model
and that it's not
a true inpatient delivery system
but rather it's a management
of patient care.
So, for example, a case manager
or some nurses
who are in this role
may be called care coordinators,
they don't necessarily work
inside a hospital system,
but they work outside
of a hospital system
to help the patient navigate
the continuum of care
from the beginning of an issue
all the way to its resolution
whether it could be services
they need at home
or maybe after hospitalization
in a rehabilitation center.
So, remember, nursing shortages
and health care reform
will continue to have a strong impact
on the creation of current
and evolving types
of patient care delivery models.
So what do we learn today?
We've learned that since
the nursing profession began,
there have been various
care delivery models used.
Each model has its advantages
and its disadvantages.
And the model chosen
should be the most appropriate
for the current situation.
And, finally, we understand that
the healthcare landscape is ever-changing.
Therefore, nursing care delivery models
may be required to change as well
to adapt to current organization
and patient needs.
I hope you've enjoyed this video
on care delivery models.
Thanks so much for watching.