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NURSING CARE MODELS

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 Introduction

 

 “Nursing care models” are frameworks that link facts and phenomena which help nurses in planning nursing care, investigating issues connected to clinical operations and studying the results of nursing interventions. They are immensely used in the current healthcare setting and are task-oriented whereby they use different nursing personnel which includes total patient nursing and primary care. They are patient-centered and mostly depend on registered nurses (RNs) to provide the needed care. The models significantly impact on the management of care as their efficiency enhance nursing care and development. Nursing models are characterized by fundamental concepts, attributes, and principles on modern nursing. This paper is set to look at some of the models that are geared towards ensuring consistent, effective, efficient and friendly nursing care which recommends other considerations in case the patients are not able to accommodate their specific needs.

Nursing Care Delivery Model

The delivery model defines the basic functions and process involved in delivery, the functions of nursing staff at each stage and the core nursing care needed. The design is made up of a team leader who is in charge of the whole process and then the team members who are the nurses who provide different aspects of care to the patients.  Medications are offered by one nurse. The others bath the patients and give them physical care. The delivery model provides a chance for the nurses to interact with the patients and presents a practical framework for sharing duties and ensuring accountability (O'Brien et al. 2011). Nursing care delivery is the underlying factor of any institution that offers nursing care.  In primary nursing, a therapeutic relationship is developed by a skilled registered medical attendant and a patient. The registered nurse initiates the relationship upon giving proper care. A nursing care delivery model provides a framework that empowers medical caregivers to offer undivided nursing attention to patients. This involves reviewing the care that a patient needs, planning on the way the care will be provided, delivering it, and evaluating the response of the patient to the interventions. Nursing systems, nurse surveillance and working environment also affect patient outcomes. Increased nurse training lowers the rate of bloodstream infection in patients (O'Brien et al. 2011).   

Most hospitals use a blend of various nursing care delivery models to remain up to the unusual demands of different patient care departments. Before using any nursing care delivery model, the hospital out to put into consideration its aims, qualities, requirements, and the cost of the entire framework.  A nursing care delivery system is significant as “Care delivery systems” are theoretical models that depict the way in which nursing institutions give care to their patients. It is important to differentiate the nursing concepts that maintain care delivery centered on the patient and their family (O'Brien et al. 2011). It also offers frameworks that allow a registered nurse to deliver services as an expert, an associate and backs the nurse-patient relationship. Basic principles of the nursing care delivery models are:

ü  Patient care delivery: this refers to the continuous incredible consideration of the patient to ensure that quality care is given and seeks to reinforce the relationship between the nurse and the patient. The following components characterize the delivery model; 1) nurse / good rapport and effective leadership. 2) Work allocation, job definition, and calm assessments 3) communication between people from personal services group and management of the healthcare setting.

ü  Primary Nursing Care: this system makes use of all-RN staff to provide immediate nursing care and allows the RN to take attention and observe the patient during the time when he or she is hospitalized; it only uses the licensed staff as they are the best in giving nursing care and patient consideration. (Finkelman, 2016). 

ü  Relationship with nurses and recuperation environment: The environment and relationship with caregivers in showing their concern are the primary determinants of the recovery of the patient. The experiences give the patient comfort and trust thus promoting their recovery.

Literature Review

Jean Ann, an author and nursing lecturer at University of California, evaluations of patient outcomes in connection with the professional duties of nurses in health care institutions mostly comprise of structural measures of providing care such as; numbers of nurses, working hours, nurses to patients proportion, organizational culture, the available workload, and the level of education and experience of the nurses. Studies do not always entail intervention or guidelines of care incorporating studies centered on nursing while others make use of nurses as the intervention. Using structural variables as opposed to process principles in considering the effect of nursing activities shows the increased accessibility of information about the former. Jean argues that some structural measures have been considerably addressed, particularly those of staffing levels amidst a lot of cost reduction and other trends in the healthcare sector in the last 15-20 years. In 1996, the Institute of Medicine made a report that enough data was lacking to make conclusions on the fundamental relationship of nurse staffing with that of inpatient outcomes. Nevertheless, recent studies have allowed us to revisit and evaluate the literature linking patient outcomes to some measures of nurse staffing categories, like full-time equivalents (FTEs), skill mix, or RN hours for each patient daily.

Seago, n.d. Argues that the effect of “evidence-based practice” (EBP) has been felt across the board in nursing practice, education, and science. The evidence-based quality change and social insurance change underrates the need for advancing effective, safe and result-oriented care. National specialists are of the perspective that nurses have resulted to offering services that complement the outstanding commitments made by the medical attendants to provide by EBP. These activities include practice reception; instruction planning; model and theoretical development; intellectual engagement in inventions; and promotion of a better national education system that embraces change.  The EBP puts into consideration its effect on nursing practice, models, and devices in the medical sector. The article concludes by bringing up the next progress in EBP and identifies the challenges encountered as EBP encourages other devices in health care.

Deborah C. Small, in her article, “Patients First,” in 2011 analyzed the standards of patient care compared to family-based care the report identified the subtle elements needed due to the extent of view brought about by the relationships (Deborah & Small, 2011). The examination included offering an extensive course on conveying PFCC necessary for clinical practice and was easy to carry out compared to the practices. Efficient execution needed ultimate cooperation in the ideology of PFCC which the Institute for Healthcare Improvement referred to as “hearts and brains” of nurses (Deborah & Small, 2011).

The level of the hospital and nursing care were two very independent variables. Measures were set up to ensure efficient administration of nursing care, improve quality, and manage the clinical costs. In a study, 88 percent of individuals interviewed agreed that making sure there were enough caregivers to attend to patients and monitor their progress was imperative in any institution.

Implementation and Recommendations

An implementation of the nursing care delivery model in nursing staff incorporates printing the codes of practices against the name identification and documenting patient outcomes and medical history in stored files, defining the responsibilities of each and every staff and performance review and appraisal.  The nurses should also come up with desired code of conduct and interdisciplinary actions, which are professional and include disease prevention measures, and training programs to enhance the knowledge of the nurses.  The care organization is a fundamental element of nursing practice, and once adhered to nurses can provide excellent care. The contemporary nursing care model will be useful in the implementation of a “Primary Nursing and Collaborative Practice” system (Miami Children’s Health System, 2017). This model operationalizes a broad framework to strengthen the focused principles of nursing care conceptualized by way of undivided attention. The PN/CP system undertakes curative based activities with relationship-centered care in a group. The structure coordinates all efforts with people from the social insurance group to facilitate healing of patients.

Some the abstracted review talked about the issue of cost. Nevertheless, many of them focused on the regular period of stay as an outcome element. The quality of care measure using skill mix did not reveal any difference from one of the studies. The caregivers who worked with inexperienced staff had increased workload and stress.  Research by Miami Children’s Health System showed that the number of registered nurses has continued to be less compared to the demand thus increased the workload for the available nurses (Miami Children’s Health System, 2017). As such implementation of the increase in RN staffs may be a challenge. An investigator who gave nurses some data of the intervention of urinary catheter infection said that approximately savings of $403,000.55 could be done (Seago, 2014). Another one dealing with nosocomial pressure gave an estimate of the cost of implementing it, but there were no saving costs (Seago, 2014). This reveals that some interventions in nursing a cost saving.

Conclusion

In conclusion “nursing care models” extracts general ideas from individuals on patients, their environment, and their health.  A nursing care delivery system gives a structure for empowering nurses to provide the best nursing care to a determined group of patients. The care delivery involves offering care needs, coming up with a good nursing plan, carrying it out, and evaluating the response of the patients to the interventions. As at now, the survey is not enough to reach an informed decision on the effects of work organization and environment of nurses in offering nursing care.  Further research is required on the issue of nurse interventions. If efforts have to be made on decreasing severe cases in hospitals and coming up with favorable hospital environments for good health and healing, studies on nursing and nursing interventions have to be done.

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