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Nursing Care Delivery Models

Nursing Care Delivery Models: Patient-Centered Progressive Care Model and Primary Nursing

Nursing care delivery models are essential in nursing practice, because they provide guidance on the way nurses can organize their care to meet the requirements of patients. There are many nursing care delivery models; however, some of them have undergone transformations to enhance medical practices. Finkelman (2015) indicates that for nursing care models, such as primary care and team nursing models, to be effective, nurses should work in collaboration. However, Constand, MacDermid, Bello-Haas, and Law (2014) recognize the need to involve patients in decision making process to improve service delivery in nursing practice. Accordingly, a discussion and explanation of articles about patient-centered progressive and primary care models, as well as a set of recommendations for the latter can help nurses understand the importance of considering patient decisions in nursing care.

Scholarly Articles Relating to the Patient Centered Progressive Care Model

Accessibility as an Important Aspect of Patient-Centered Care

The current healthcare system emphasizes the significance of provision of patient-centered care. However, information regarding some of the important aspects of patient-centered care is limited. For that reason, it is necessary to describe the relevance of patient-centered care in the wards. According to Azimzadeh et al. (2013), patient-centered care considers the needs and values of patients as well as ensures that their preferences are incorporated in all the approaches of nursing care in hospitals. The authors of this article further stress the significance of patient’s contentment with nursing care in enhancing medical services and facilitating earlier recuperation. For instance, Azimzadeh et al. (2013) believe that if an admitted individual requests nursing care and agrees to the interventions, they are likely to experience satisfaction with nursing services, which can shorten the recovery process. The descriptive design that the authors applied to 200 patients ascertained that enhanced accessibility to nurses is one of the most efficient approaches to patient-centered care. In the experiment, the nurses were accessible all the time until the end of the shift, thereby making this article relevant to the patient-centered progressive care model.

Communication as an Important Aspect of Patient-Centered Care

Healthy communication between nurses and patients is another relevant aspect that fallows continuous accessibility. Slatore et al. (2012) view communication in the healthcare environment as one of the key determinants of viable patient-centered care. The authors further explain that usually nurses communicate with patients and their families, and, thus, they should utilize such approach that would ensure active participation of patients in their care. The authors employed an ethnographic observation method and discovered that the communication behaviors in clinical settings influenced the way nurses delivered their care and enhanced interpretation of healthcare interventions. In the patient-centered progressive care model, the nurses communicated with patients helping them understand the necessary stages of medical treatment. Therefore, this article is relevant to the abovementioned model due to the connection between a necessity of proper communication and raising patients’ awareness.

Scholarly Articles Relating to the Primary Nursing Care Model

A different theory that is relevant to nursing practice is the primary nursing care delivery model. In this technique, nurses form therapeutic relationships with patients and accept the responsibility for providing care services for the duration of the patient stay in the hospital (Nadeau, Pinner, Murphy, & Belderson, 2016).Various researchers have analyzed this model presenting different findings.

Primary Nursing Care Model Perceptions

Although the primary nursing care delivery model is appropriate to nursing practice, the information regarding the perception of caregivers and patients it is limited. Therefore, Nadeau et al. (2016) ascertained that it was necessary to evaluate the views of nurses, patients, and families regarding the model to understand its applicability in nursing practice. After employing a descriptive cross-sectional design to study the abovementioned participants of the experiment, the authors noticed that the model was essential in caregiving practices. For instance, many patients and nurses valued the nurse-patient relationships and the idea of continuous nursing supervision. Additionally, the latter fostered positive attitudes while utilizing the model. Therefore, this approach is not only vital to improve the health outcomes of patients but also results related to personal complacency of nursing staff.

Primary Nursing Care Model Effects

In spite of the primary nursing care model being relevant to nursing practice, there is only a handful of evidence regarding its effects on nurses, patients, and families. Mattila et al. (2014) established that although the model facilitates the development of strong relationships between patients and nurses, its relevance to family members is understudied. For that reason, Mattila et al. (2014) assessed its effects in nursing care and concluded that the model needs further analysis since comprehensive information regarding its influence on family members is limited. However, the authors contend that the primary nursing care model enables nurses to have autonomy and a sense of increased job control which augments the chances of receiving job satisfaction.

Implementation of the Patient Centered Progressive Care Model

Implementation of this model includes the patient as a participant of the nursing care. As opposed to the primary care model where the nurse makes most of the decisions, patient-centered progressive care model considers the perspectives of the patient before initiating caregiving. For example, one medical ward in the hospital developed a culture of including patients in the decision-making process from their admission to discharge. Additionally, medical professionals recognized such nursing care approach as one of the most efficient in the entire hospital. Therefore, it was necessary to visit the ward to understand the care delivery model that nurses used.

Two female senior nurses and one junior male nurse notified the unit in the morning and received a report from the night shift nurse. While delivering the report, the nurse who was on night duty not only mentioned the peculiarities of care that she provided to the patients but also explained the way individuals felt about the medical services they received. Afterwards, the nurse left, and other caregivers began performing their usual tasks.

The nurses started from ensuring that the ward was clean and hygienically appropriate for implementing various nursing interventions. For instance, one senior nurse asked the patients whether they had taken a shower. Individuals who had not managed to accomplish this task underwent a bed bath with the help of her colleague. While the male nurse was delivering bed baths, the two senior nurses were cleaning the surfaces, including the trolleys necessary for executing various nursing interventions, such as drug administration.

After ensuring cleanliness of the working space, the nurses started administering medications as per the recommendations of the physician. However, they began with the most critical patients and asked them about the responses of their organism to various clinical practices. Thus, patients could give their opinions, and, sometimes, they could reject therapeutic interventions. The nurses educated patients on the importance of necessary medical processes and the influence of a variety of drugs on their health. Most patients accepted the interventions, and nurses ensured appropriate care starting from the sickest patients to the individuals ready for discharge. On the day of observing this model, nobody opposed to the therapeutic interventions due to the adequate information they received from nurses.

At the end of the shift, it was apparent that nurses had focused on both the therapeutic interventions and the perceptions of patients regarding their care. No nurse administered any medication to a patient who did not understand its mode of action and possible side effects, thus ensuring patient safety and satisfaction. Additionally, all patients, including individuals in critical condition and those ready for discharge, consented to all the nursing practices, which could contribute to the development of a sense of job satisfaction. Additionally, one nurse said that the model was a progressive approach that considered the values and preferences of patients.

Primary Nursing Care Delivery Model

Implementation of this model begins immediately after admission. The nurse should identify a patient and establish a good relationship, which they are obliged to sustain during the entire period of the patient’s stay in the hospital. However, the nurse does not provide comprehensive patient care. According to Mattila et al. (2014), patients actively participate in this model. Therefore, in the process of providing nursing care, the caregiver communicates with the person, identifies their problems, and creates an individualized plan of care. The nurse should notify other members of the healthcare team of the plan as they can play an immense role in caring for the patient during the period of the hospital stay. Therefore, the collaborative aspect of this model can improve the quality of patient care since nurses and other medical practitioners will employ their skills and qualification. Additionally, it can develop the job satisfaction of the nursing staff, because it demonstrated productive performance of the caregivers. Consequently, the model can simplify tasks of the medical staff and ensure impeccable caregiving services, thereby enhancing the safety of both patients and nurses.

Conclusion

Nursing care delivery models are necessary to guarantee that nurses deliver care of high quality that can facilitate earlier and smoother patient recovery. The patient-centered progressive nursing care delivery model is useful since it facilitates friendly relationships at the workplace and enhances patient compliance with the health care therapy requirements. The primary nursing care delivery model is equally significant as it guarantees collaboration among nurses. Additionally, it ensures that nurses work in a safe environment, thus improving the quality of nursing services that patients receive. From this paper, one can learn that nursing models make the work of nurses easier and help them win the trust of patients, thereby encouraging their direct participation in the treatment process. Consequently, utilization of all characteristics of the three models can improve patient outcomes and increase nurses’ job satisfaction.

References

Azimzadeh, R., Valizadeh, L., Zamanzadeh, V., & Rahmani, A. (2013). What are important for patient centered care? A quantitative study based on perception of patients’ with cancer. Journal of Caring Sciences, 2(4). doi:  10.5681/jcs.2013.038.

Constand, M. K., MacDermid, J. C., Bello-Haas, V. D., & Law, M. (2014). Scoping review of patient-centered care approaches in healthcare. BMC Health Services Research, 14(1).Retrieved from http://download.springer.com/static/pdf/28/art%253A10.1186%252F1472-6963-14-271.pdf?originUrl=http%3A%2F%2Fbmchealthservres.biomedcentral.com%2Farticle%2F10.1186%2F1472-6963-14-271&token2=exp=1490248090~acl=%2Fstatic%2Fpdf%2F28%2Fart%25253A10.1186%25252F1472-6963-14-271.pdf*~hmac=bc4dd9a8085e042adf9ea69d5b2cf350fb308b23c075a8999b2f033a20055dc3.

Finkelman, A. (2015). Leadership and management for nurses: Core competencies for quality care. London, UK: Pearson.

Mattila, E., Pitk?nen, A., Alanen, S., Leino, K., Luojus, K., Rantanen, A., & Aalto, P. (2014). The effects of the primary nursing care model: a systematic review. Journal of Nursing Care. doi: 10, 2167-1168.

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. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/1043454216631472?journalCode=jpob.

Slatore, C. G., Hansen, L., Ganzini, L., Press, N., Osborne, M. L., Chesnutt, M. S., & Mularski, R. A. (2012). Communication by nurses in the intensive care unit: Qualitative analysis of domains of patient-centered care. American Journal of Critical Care, 21(6), 410-418. doi: 10.4037/ajcc2012124.