1. Nursing

2. Nursing Care Delivery Models Nursing teams Registered nurses (RNs) Licensed practical nurses (LPNs) Licensed vocational nurses (LVNs) Nurse assistants

3. Nursing Care Delivery Models Nursing care delivery models Functional nursing Team nursing Primary nursing Patient-focused care

4. Nursing Care Delivery Models Functional nursing One large team to care for all patients in a unit Each member has specific tasks that they always do An RN serves as nursing team supervisor

5. Nursing Care Delivery Models Functional nursing advantages Uses each team member’s strengths Reduces costs Functional nursing disadvantages Right mix of skills Qualified team supervisor Too many people providing care to patient

6. Nursing Care Delivery Models Team nursing Divide into several small teams providing care for group of patients within unit Each member has specific tasks depending on patient’s needs An RN serves as nursing team manager Nursing team manager reports to nursing team supervisor

7. Nursing Care Delivery Models Team nursing advantages Uses each team member’s strengths Closer relationships between member and patient Reduces costs Team nursing disadvantages Members have needed skills Members understand responsibilities Qualified team manager

8. Nursing Care Delivery Models Primary nursing One RN provides all the care to a patient for entire stay Members assisting RN not responsible for specific tasks All RNs in unit report to unit nursing team supervisor

9. Nursing Care Delivery Models Primary nursing advantages More nursing expertise Better continuity of care Close relationship between RN and patient Primary nursing disadvantages Requires RNs Uses LPNs, LVNs and nurse assistants to lesser degree Increases cost

10. Nursing Care Delivery Models Patient-focused care Similar to team nursing Multi-skilled team members Team provides services usually provided by diagnostic or therapeutic departments Nurse assistants trained to provide these services RN as nursing team manager

11. Nursing Care Delivery Models Patient-focused care advantages Use team member strengths Better continuity of care Close relationships Decreases transport time Reduces costs Patient-focused care disadvantages Expensive Members need skills Members understand responsibilities Qualified team managers

12. The Nursing Process The nursing process Step 1 - Assessment Step 2 - Nursing diagnosis Step 3 - Planning Step 4 - Implementation Step 5 - Evaluation

13. The Nursing Process Step 1 - Assessment Collecting information Communicating information

14. The Nursing Process Collecting information Review medical record Take medical history Perform physical exam Observe patient

15. The Nursing Process Observations Objective Subjective

16. The Nursing Process Objective observations or signs can be measured or seen Sight Hearing Touch Smell

17. The Nursing Process Subjective observations or symptoms are comments made by the patient

18. The Nursing Process Communicating information Documenting in patient’s medical record Immediate problems

19. The Nursing Process Step 2 – Nursing diagnosis Statement of the patient’s problem Cause of the problem

20. The Nursing Process Step 3 - Planning Creating a patient care plan Nursing diagnoses Goals for patient Nursing interventions

21. The Nursing Process Nursing diagnoses Goals

22. The Nursing Process Nursing interventions Help the patient reach goals

23. The Nursing Process Changes to interventions and goals Unable to achieve desired level of ability Has achieved a new level of ability

24. The Nursing Process Changes to diagnoses Patient reaches goal New problem develops

25. The Nursing Process Conference Create patient care plan All members of patient’s nursing team Physician Patient and family

26. The Nursing Process Step 4 - Implementation Carrying out nursing interventions Provide care to patient

27. The Nursing Process Step 5 - Evaluation Determining whether patient has reached goals

28. The Nursing Process Nursing process Role of a nurse assistant