NR 447 Week 5 Assignment – Nursing Care Models Worksheet

NR 447 Week 5 Assignment – Nursing Care Models Worksheet

The profession of nursing has transformed and evolved tremendously over time. That transformation is reflected in the ever-evolving delivery of care methods known as nursing care models (Finkelman, 2016). Nursing care models are the blueprints of how patient care is delivered, who is involved in it, and who is responsible for each specific aspect. They are comprised of knowledge, beliefs, facts, and a desire to heal. Nursing care models are ever-changing due to successes, failures, and adaptations to the humans we, as nurses, mend. There have been numerous nursing care models over the history of nursing. The one that I have observed and will focus on for this paper is the interprofessional nursing practice model. The interprofessional nursing practice model is a delivery of care model that establishes the patient as the central focus, and all appropriate medical entities take ownership of the common goal, optimal patient health (Finkelman, 2016).

Observation of interprofessional nursing practice model

My observation of the interprofessional nursing care model takes place in the unit that I am the manager of, but I was also once a staff nurse of the Preadmission testing unit. A preadmission screening call nurse is an autonomous position. Being an autonomous nurse within an interprofessional practice model means they are self-reliant, proficient, thorough, and have a solid understanding of the impact their detailed evaluation has on the patient’s surgical outcome (Finkelman, 2016). There are eight scheduled preadmission screening call nurses every Monday to Friday. They work independently, as in; they have their own schedule of patients, which are scheduled every forty-five minutes, to interview during their eight- or ten-hour shifts. They also collaborate appropriately inside and outside of their department. In my network, preadmission testing is divided into two types of preadmission: the preadmission visits and the preadmission. Screening calls. In both cases the preadmission nurse works closely with other healthcare entities, but it is the preadmission screening call nurse that works the closest and with the most diverse healthcare entities. This is due to not having a Certified Registered Nurse Practitioner (CRNP) from the Anesthesia department coming in and completing the preadmission encounter; the preadmission screening call nurse must rely heavily on their nursing background and their critical thinking skills when completing the patient interview and chart review.

These interprofessional working relationships materialize as the result of the preadmission screening call nurse completing the surgical database, which includes: allergies, medications, medical and surgical history, pre-op instructions, etc. After the patient interview is concluded, the preadmission screening call nurse directs all red flags discovered during the patient interviews and chart investigations to the correct healthcare entities. Some of the most common healthcare entities that the preadmission nurse interacts with are Anesthesia, Primary care physicians, Cardiology, Pulmonary, and Endocrinology, just to name a few. The autonomy of their position allows them to freely collaborate with specific entities ensuring patients’ health objectives are met via the formulation of a custom plan of care on the patient’s behalf. An example of this collaboration would be: the preadmission screening call nurse learns via the patient interview that the patient has a history of severe obstructive sleep apnea and a BMI greater than 45, and the patient does wear CPAP at HS. He is scheduled to have outpatient surgery at the Ambulatory Surgery Center. She calls and delivers the previous details to the CRNP with the Anesthesia department, and she tells the CRNP where she can find his most recent Pulmonary note and sleep study. The CRNP reviews all the patient’s information. The CRNP then calls the Pulmonologist and asks him for recommendations for the patient’s care for before and after his surgery. One of the recommendations by the Pulmonologist is that the patient has his surgery at an in-patient hospital instead of an ambulatory setting. He also gave the CRNP some recommendations for supportive care after extubation. The CRNP then calls the surgeon’s office to ask them to move the patient’s surgery from the ambulatory setting to the in-patient setting. Everyone is working together to support the patient the best they can.

NR 447 Week 5 Assignment – Nursing Care Models Worksheet

Supporting Literature

The first supporting article I reviewed is titled Interprofessional Collaboration and Education. It is an inclusive article that details the importance of multiple healthcare entities working together to deliver the patient to optimal health. It insists on different healthcare entities working side-by-side, educating each other, gaining respect for each other, and learning how to complement each other’s continuum of care. It puts a lot of emphasis on the profession of nursing and its ability to make extensive changes in the healthcare field in light of a medical profession shortage. Essentially it implies that nursing must be held accountable for using its influence appropriately, and it must help lead the way to interdisciplinary collaborations, therefore holding healthcare shortages at bay (Sullivan, Koivsky, Mason, Hill, and Dukes, 2015).

The second supporting article I reviewed is titled, Interprofessional Collaboration: three best practice models of interprofessional education. The article speaks specifically to the core competencies that need to be adhered to to allow for effective and efficient interprofessional collaboration. This effective and efficient interprofessional collaboration, if practiced by all, will lead to better patient care, overall better health for the greater masses, and a proportional decrease in healthcare costs (Bridges, Davidson, Odegard, Maki, and Tomkowiak, 2011). Additionally, it goes on to reiterate that patients in this day and age are experiencing health issues that are more complex (Bridges et al., 2011). Therefore, they should be more than taken care of; they should have the genuine feeling of being cared for as a whole, and it takes a team to accomplish this task (Bridges et al., 2011).

Implementation of the current practice model and another recommendation

In 2002 the network that I work within applied for and obtained its first Magnet designation. In order to be a Magnet organization, the organization’s care model must be the direct representation of the nursing profession and the patients they support and care for. The interprofessional nursing practice model within my network was built on the framework of patient care will be a team approach, which will assure thorough, continuous care with measurable outcomes. It relies on multi-disciplinary communication and collaboration as well as shared governance to maintain its framework (Finkelman, 2016). Ad hoc committee meetings were scheduled with varying levels of network staff and executed with the sole purpose of the implementation of the interprofessional nursing model. All potential issues were explored and rectified prior to the roll-out date. At the start of the new fiscal year in 2001, it was rolled out to all members of the network with the common goal of patient-centered care.

Recommendation of a Different Practice Model

 Relationship-based care would be my recommendation for a different nursing care model that could be integrated into my network to produce positive, measurable satisfaction in both the physical and emotional aspects of delivery of care. Relationship-based care is built on the concepts of safety and quality strategies, employee satisfaction, patient and family involvement, and fiscally sound decisions (Winsett & Hauck, 2011). I believe the relationship-based care model would deliver measurable satisfaction on many levels to nurses, patients, families, and my healthcare organization that supports us.

NR 447 Week 5 Assignment – Nursing Care Models Worksheet

Supporting Literature

This article speaks of one organization’s desire to reach Magnet designation and what it learned and changed about itself on its journey to the Magnet designation. On its path to becoming Magnet certified, this organization created a new framework directly related to its new nursing model, which was built around the word “caring” (Winsett & Hauck, 2011). “CARING” is a wordplay for all the ways the nursing staff would connect with the patient and the patient’s family. For example, the “C” in CARING stands for making a connection with the patient (Winsett & Hauck, 2011). Based on the previously stated information, it selected a relationship-based nursing care model as its new foundation of care. Within one year of implementation, this organization saw a decrease in staffing turnover, an increase in overall employee satisfaction, an increase in patient satisfaction, and better nurse-patient relationships (Winsett & Hauck, 2011).

The second article that I reviewed on relationship-based care was titled, Relationship-Based Care: A Model for Transforming Practice. It speaks of care being delivered in the form of a relationship and rewinding nursing practice back to the foundation (Shellner, 2007). Additionally, it states relationship-based care model is comprised of six key components that surround the center hub, which is the patient; One of those intergyral keys is professional nursing practice (Shellner, 2007). It is in this professional nursing practice that nurse-patient relationships pave the way to healing (Shellner, 2007).

Conclusion

With my completion of this assignment, I learned that nursing care models have an extensive history. A history that has seen many, many changes, which have also come full circle. I learned that the unit that I observed could implement many different nursing models and still be a successful unit. I found it very interesting that some nursing models were not patient. Centered. The reason I find this so interesting is we are nurses, and nurses need patients so we can be nurses. It’s a relationship that can not exist without each other.

References

Bridges, D. R., Davidson, R. A., Odegard, P. S., Maki, I. V., & Tomkowiak, J. (2011).

Interprofessional collaboration: Three best practice models of interprofessional education. Medical Education Online, 16(1). https://doi.org/10.3402/meo.v16i0.6035

Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). Boston, MA: Pearson.

Sheller, P. (2007). Relationship-Based Care: A model for transforming practice. Critical Care Nurse, 27(66). Retrieved from http://ccn.aacnjournals.org/content/27/1/66.full

Sullivan, M., Koivsky, R. D., Mason, D. J., Hill, C. D., & Dukes, C. (2015). Interprofessional collaboration and education. American Journal of Nursing, 115(3), 47-54. https://doi.org/10.1097/01.NAJ.0000461822.40440.58

Winsett, R. P., & Hauck, S. (2011). Implementing Relationship-Based Care. The Journal of Nursing Administration, 41(6), 285-290. https://doi.org/10.1097/NNA/0b013e31 821c4787

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Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how, and what led you to identify the particular model.