Nursing Care Delivery Models

There are various models of care utilized in the entire healthcare system. These models are believed to influence “nurse satisfaction and retention”. This, in turn, produces improved patient care and outcomes. Reviewing such models provide ideas for improvement of care and clinical practice. A study conducted by Hall, McCutcheon, Deuter, and Matricciani published on 16 July 2012 by Elsevier Australia, aimed at evaluating and improving “the models of nursing care delivery for general surgical ward patients using the participatory action research”.

There were two problems identified which affect the nurses’ ability to provide quality care to the patients. One of which is the practices and behaviors of the nurses themselves. The nurses in the ward were able to state that the model they used at the time of the study was working well in some capacity. However, many of them were not able to articulate a clear definition of the Team Nursing model of care adopted by the ward. It goes to show that these nurses lack a shared understanding of the nursing care model being utilized.

The other problem area identified is the infrastructure and physical layout of the ward they are in to. The issues raised were disorganized ward and hospital equipment. The medication room was also crowded due to multiple uses. Overcrowding of the ward was also observed which was caused by the influx of nurses, doctors, and allied health staff doing their usual rounds at the ward.

It was recommended that the ward, as well as other health institutions, organize education sessions aimed at coming up with a shared understanding of the ‘Team Nursing’ approach or any other approach that the institution adopted in order to clearly redefine the specific duties and roles of the nursing staff. Further, it was also recommended that the ward start a general cleaning and auditing of its hospital supplies. The ward should initiate efforts in lessening high-volume and or high-traffic areas especially the medication room, waiting area, and handover area.

There is a concern with regards to the nurses’ notion that their Team Nursing approach is ‘functioning’ despite the fact that they lack a common understanding of the said model. This study has provided an opportunity for nurses “to plan, act, observe, and reflect on their practice.” The shift from task-centered care to patient-centered care approach leads to changes in the utilization of resources thereby improving the cost-effectiveness of care rendered as well as the over-all job satisfaction of the nursing staff.

One of the major strengths of this study was the participation of the nurses and staff with the use of observation data and focused group discussions which led to the creation of new ideas precipitating changes in the system.

The results of this study will guide administrators and managers in the allocation or delegation of nursing duties across similar settings. In a sense, the study provided a new knowledge about the required social and material resourcing which are key factors in the rendering of effective and quality care given by nurses.

I do agree with the authors that a shift from task-centered to patient-centered approach could lead to improved patient care and eventually patient outcomes. I think this is the best argument that the research article presented. It is clearly supported by some other journal articles stemming from a comprehensive literature review.

There were two recommendations. One is aimed at addressing the issue on lack of shared understanding of the nurses regarding the use of the ‘Team Nursing’ approach. Another recommendation is the decongestion of the ward especially in areas where there is high-volume or high-traffic. I think these recommendations are good. But, I also think these problems should’ve already been addressed by the administrators or managers.

Like other journal articles, I see the need for this article to be replicated in the Philippine setting. I can attest that some of our wards experience the same problem as overcrowding especially in areas like storage room and medication preparation area/room.

I would like to discover the perception of the Philippine nurses with regards to the approach they use in their respective units. This will surely help the institutions device or adopt their own models or approaches of care that best suit the conditions of the ward which is affected by both internal and external factors.


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