Bill, Ann, and Connie are in different clinical sections at separate facilities. As they discuss their clinical experiences, they note some variances in nursing care delivery. Bill says that at his facility there is one charge nurse who is responsible for the functions of others—the medication nurse, treatment nurse, several nursing assistants, and secretaries. Ann relates that her hospital uses a patient-focused care model, whereby the nurse supervises all those who come into contact with the patient. She explains that the aides are trained in dietary education and that the lab draws are done by the nurse. Connie describes how she participated in a meeting in which the dietitian, respiratory therapists, nurses, aides, and a physician met to discuss the more complicated patient cases. She explains how the facility uses a care map that shows each day and details outcomes the patient should achieve daily to move forward.

1. What are the three patterns of nursing care delivery described?

2. Which of the patterns described would benefit the intensive care patient? Why

3. Although each of the various models works toward quality patient care, which pattern of care delivery makes the best use of available resources? Why?

References:

Zerwekh, J. A. G., & Garneau, A. Z. (2021). NCLEX-RN Exam and the New Graduate. In Nursing today: transitions and trends. Elsevier.

Solution

1. Patterns of Nursing Care Delivery:a. Functional Nursing: This model, as described by Bill, involves dividing nursing tasks among different staff members based on their specialized skills or functions. Each nurse or assistant is responsible for specific tasks, such as medication administration or treatments, and reports to a charge nurse who oversees their activities.b. Team Nursing: Ann describes a patient-focused care model where a team of healthcare professionals, including nurses, nursing assistants, and other support staff, collaborates to provide comprehensive care to patients. The nurse coordinates and supervises the care provided by the team members, ensuring that all aspects of the patient’s needs are addressed.c. Collaborative/Interdisciplinary Care: Connie’s facility utilizes a collaborative approach involving various healthcare professionals, including nurses, dietitians, respiratory therapists, and physicians, who meet regularly to discuss complex patient cases and develop care plans. Care maps are used to outline specific goals and outcomes for patients, guiding their care progression.
2. Benefit for Intensive Care Patients:
   • The patient-focused care model (Team Nursing) described by Ann would likely benefit intensive care patients the most. Intensive care patients often have complex needs requiring comprehensive, coordinated care from a multidisciplinary team. In this model, nurses supervise and coordinate the activities of all healthcare team members, ensuring that each aspect of the patient’s care, including medication administration, treatments, and lab draws, is effectively managed.
3. Best Use of Available Resources:
   • The patient-focused care model (Team Nursing) makes the best use of available resources by promoting collaboration and teamwork among healthcare professionals. By involving nursing assistants in tasks such as dietary education and allowing nurses to perform procedures like lab draws, it maximizes efficiency and ensures that each team member works at the top of their license or skill level.
   • Additionally, the use of care maps and interdisciplinary meetings (Collaborative/Interdisciplinary Care) helps streamline communication and care coordination, optimizing resource utilization and enhancing patient outcomes through a holistic approach to care.