Introduction
Nursing care models differ across facilities and depending on the circumstances of the patients. Nursing care models are divided into two categories, task-oriented and patient-oriented. The two most important task-oriented task models include team nursing and practical nursing. On the other hand, the patient-oriented models are primary and total patient care. The following paper explores how the models impact on the safety of the patient and the quality of care delivery.
Nursing Care Model Observed
A case-specific observation involved a 70 years old man in a medical. He was recovering from a fractured femur and soft tissue head injuries. The nurses offering the care were three, the nurse in charge (nurse leader), a registered nurse (RN), and an assistant nurse. During the mid-morning routine care process, the nurse in charge assessed the patient and gave the recordings to the RN after a short discussion about the progress of the patient and the care process the man was undergoing. The RN dressed the soft tissue injuries and then the assistant helped the patient to lay on the bed and turned him. She recorded the time and notified the RN who the procedures she had performed and left the chart by the bedside.
Scholarly Sources Related to the Team Nursing Model
The nursing team model is a traditional care delivery approach that has continued to be practiced to date. In most cases, the tasks are allocated based on experience. A case in point, Fairbrother, Jones, and Rivas (2010) carried out a study at Prince of Wales Hospital in Sydney. This was a trial study in medical and surgical wards in which the main purpose was to investigate the impact of the shift from individual patient care to team nursing model. A pilot study was carried out in two nursing units by replacing the individual patient care with team nursing, composed of two to three-person teams. The nurses were allocated tasks rather than patients. The team members under the instructions of a team leader shared tasks amongst themselves. However, in the two pilot wards, it was found that there was little progress in terms of quality care delivery, and hence the approach shifted to sharing responsibilities amongst the team members in which allocation of the patient took place within the team structure. This recorded a remarkable success as it produced a hybrid model that related to team and functional nursing.
Also, Kalisch, Weaver, and Salas (2009) conducted a study to examine team processes among nurses. This entailed a qualitative study in which nurses recruited in the study were from 5 patient care units. The nurses from the selected care units engaged in focus group discussions in which they described team processes in the areas of operations. One of the key findings was the importance of team leadership. The nurse leader was cited as being critical in ensuring proper functioning and high-level patient care. Also, communication among the team members was pointed out to be an important factor in the effective functioning of the teams.
An alternative model is the primary care model. Nadeau, Pinner, Murphy, & Belderson (2016) evaluated the perceptions of patients/family and nurses of the primary care model. The study design was a descriptive cross-sectional in which the participants were the nurses and patient/family. The study participants comprised of 59 patient/family and 57 nurses. The findings of the study showed that over 85% approved the care model. 63% of the nurses were satisfied with the implementation of the primary nursing care model. Also, 80.7% believed that it would enhance care delivery in terms of patient safety.
Similarly, Cropley (2012) conducted a study to examine the effect of patient-nurse relationship care models on the length of stay, the satisfaction of the patients, and the readmission rates. The study design applied was a retrospective analysis of the patient satisfaction data, the rates of readmission, and the length of stay at a rural hospital in Texas. The review covered the period between 2009 and 2010. The analysis of the data collected showed that there was a positive influence concerning the length of stay and satisfaction of the patients. However, there was a negative correlation in the readmission rate. The model supports patient-centered care that creates a collaborative hospital healing environment.
Current Nursing Care Model
The current team nursing model is being implemented based on ensuring that nurses accomplish their duties. This is the case because the nurses perform the part of work that is assigned and there is no effort to create the patient-nurse relationship. The team nursing care model is implemented based on nurse rank and experience. The team nursing model focuses more on accomplishing one’s task rather than being patient-oriented. Fairbrother et al. (2010) stated, “Collaboration and autonomy are increasingly viewed as interdependent and positively related, rather than mutually exclusive” (p. 218). Even though there are shortcomings in the nursing team model, in acute clinical care, the model can deliver quality care and enhance patient safety if the team leader upholds shared responsibilities among the team members. Nevertheless, it is worth noting that the care models are implemented based on the management and the health facility. Therefore, it is difficult to pinpoint that a model is superior to the other.
Alternative Nursing Care Model
To improve the quality of care, safety, and satisfaction of staff, I recommend the application of the primary nursing model. This is because the model centers on the continuity of care in which one nurse provides complete care for a small number of patients in the health facility. This allows the nurse to provide direct care by building relationships with the patient. According to Nadeau et al. (2016), the design of the model in which the focus is on the nurse-patient relationship leads to the satisfaction of both the patient and the staff. The result is increased safety and satisfaction of patients as it enhances the sense of responsibility. Also, the nurse manages a limited number of patients hence increasing their satisfaction. Despite the enhanced care delivery, it is important to note that there are shortcomings which nurse may face when implementing the model. The study by Nadeau et al. (2016) found out that the satisfaction rate of nurses was 63% which could be a pointer to certain challenges. For example, being assigned, difficult patients, and family members. Therefore, just like the nursing teams, good leadership is important to respond to such challenges.
Conclusion
From the observation in the Texas Hospital and the subsequent review of peer-reviewed articles, I have learned that care delivery varies greatly. Despite, the team nursing model delivering the right medication, it is carried out in the context of obeying the authority rather than the confines of personalized care. As a result, holistic care may not be realized. Therefore, to ensure holistic care delivery and create a hospital healing environment, there is the need to formulate a model that focuses on the patient, the staff, and the disease being treated. In a case, the primary nursing model which is designed in the context of building a relationship is more applicable; however, it should incorporate good leadership to address some of its shortcomings.
References
Cropley, S. (2012). The relationship-based care model: Evaluation of the impact on patient satisfaction, length of stay, and readmission rates. Journal of Nursing Administration, 42(1), 333-339.
Fairbrother, G., Jones, A., & Rivas, K. (2010). Changing model of nursing care from individual patient allocation to team nursing in the acute inpatient environment. Contemporary Nurse, 35(2), 202-220.
Kalisch, B. J., Weaver, S. J., & Salas, E. (2009). What does nursing teamwork look like? A qualitative study. Journal of Nursing Care Quality, 24(4), 298-307.
Nadeau, K., Pinner, K., Murphy, K., & Belderson, K. M. (2016). Perceptions of a primary nursing care model in a pediatric hematology/oncology unit. Journal of Pediatric Oncology Nursing, 1(1), 1-4.