Patient Care Models

Through the years, health care has been showered with various demands and challenges and amid all these the health care team is still expected to render quality health care to the patients. The health team is like a machine with specific parts that must each work efficiently for the whole machine to work perfectly. In this context, each member of team is tasked to perform specific functions, each backed up by their education backgrounds, credentials and experiences. Doctors, for example are the ones responsible for patients with conditions that fall on their specific specialization or in other terms, they work with disease-specific populations. Nurses, on the other hand organized differently from physicians in the hospital setting. Instead of classifying nurses according to their specialty, usually, the patients under their care are grouped according to age and intensity of health care needed, such as those belonging in pediatrics, intensive care, emergency and many more.

In order to achieve quality nursing care, methods have been formulated. However, these methods may vary among hospitals and from one circumstance to another. These are team nursing, primary nursing, progressive patient care. Let us go over the important aspects of each of these models and identify what the deal each for each of them.

Primary or Total Nursing Care

This is a model that generally uses an all Registered nurses within the staff to provide all direct care and allows the RN to care for the same patient throughout the patient’s stay. It emphasizes continuity of care as one nurse is assigned to render complete care for a patient or a small group of inpatients admitted in a nursing unit of a hospital. Here, unlicensed assistive personnel (UAP) are not used and do not provide patient care. The nurse, who holds 24-hour responsibility for a patient’s nursing care in this model, assesses and identifies the patient’s unique health needs and priorities, establishes an individualized plan of care, provides direct care as appropriate, and communicates the plan to other members of the team. The downside of this model, which is the main reason why most hospitals do not utilize this model, is that it is too costly.

Team or Functional Nursing

This model of nursing care delivery involves the use of a team leader and team members to provide various aspects of nursing care to a group of patients. An example of this model is medications might be given by one nurse (team leader) while baths, feedings and physical care are given by a nursing assistant as supervised by a nurse team leader. Another example of this is between two nurses, one may be assigned to administer medications while one is the treatment nurse. However, in this model, there may be fragmentation of care.

Patient progressive care

In this type of model, patients are assigned according to the intensity of nursing care needed and their degree of illness. It is said that by utilizing this method of planning, the individual requirements of the patient are met. They are classified as: Intensive care units for critically ill patients; Self-care units for restorative patients or those requiring investigation; Intermediate care units for those patients are not required to be admitted in either of the previous units; and those beds attached to out-patient departments for “one day” patients. Here, better patient care can be provided by organizing hospital facilities, services and staff depending on the changing medical and nursing needs of the patient.

Just like any other, these different models of health care delivery are approaches of the nursing profession to address the growing needs of the society. As the community changes, and challenges and demands start to emerge, nurses must be flexible enough and ready for change in order to meet patients’ individual needs and to provide quality and responsive nursing care.

Sources:

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

What Do You Think?