Term
| nursing care delivery model |
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Definition
| method used to provide care to patients |
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Term
| case method/total patient care method |
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Definition
- oldest method
- different from nursing case mgmt
- one nurse provides total care for one pt during the entire work period
- used in ICU
- total pt care during a specific time period
- nurse manager must consider the expense of this system and ID all staff level of ed and comm skills
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Term
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Definition
| technicians, nurse aids, CNAs |
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Term
| functional model of nursing |
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Definition
- popular during WW2
- each licensed & unlicensed staff performs specific tasks for a large group of patients, like an assembly line
- charge nurse coordinates care & assignments, may be only person familiar with all the needs of any individual patient
- emphasizes task-oriented care for a large group of pts
- nurse manager responsible for achieving outcomes; staff only responsible for tasks
- most often used in subacute care facilities
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Term
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Definition
- modification of functional nursing
- "care through others"
- remains in use, esp if staff mix has larger ratio of UAPs to licensed
- team leader is responsible for coordinating a group of licensed & UAPs to provide care for small group of pts
- small team provides care to a small group of pts
- modular method focuses on the geographic location of pt rooms & assignments of staff
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Term
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Definition
- adaptation of case method
- one RN functions autonomously as the pt's primary nurse throughout the hospital stay, 24 hrs a day
- coordinated, comprehensive, continuous care
- primary nurse (RN) is held accountable for meeting outcome criteria
- associate nurse (RN) implements plan when primary nurse not there
- nurse manager is role model, advocate, coach, consultant, budget controller, unit quality manager
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Term
| partnership model/co-primary nursing model |
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Definition
- primary nursing hybrid
- RN paired with a technical assistant
- RN freed to provide "semi-primary care" to assigned pts
- used by rehabilitative settings
- pairs an RN with a technical assistant
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Term
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Definition
- primary nursing hybrid
- developed in late 1980s
- uses principles from business/industry
- goals include 1) improving pt satisfaction & outcomes, 2) improving worker job satisfaction, 3) increasing efficiency & decreasing cost
- decentralized, streamlined, localized care
- multidisciplinary team formulates plan of care after the primary nurse & physician have evaluated the pt
- used by patient-focused care units with multi-skilled team members
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Term
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Definition
- requires a complex set of expectations
- coordinating health by planning, facilitating, & evaluating interventions across levels of care to achieve measurable cost & quality outcomes
- first seen in early 1900s by social works/PH nurses, then again in 1960s & 1980s
- utilization mgmt
- popular & effective method to manage shortened lengths of stay & prevent readmits
- seeks active involvement of the pt
- elements are case manager & the critical pathway
- nurse manager faces increased demand to move pt as quickly as possible
- managed care is a way of organizing pt care delivery with cost savings as the main goal
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Term
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Definition
- may be nurse, social worker, or other
- tries to achieve and evaluate expected outcomes
- may have up to 20 pts
- goal is to provide cost-effective care through integration of clinical services in combo with financial services
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Term
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Definition
- anything that occurs to alter the patient's progress through the normal critical path
- analysis of variance is essential for effective utilization of a path
- can be positive or negative
- circumstances that may cause a variance include operational (broken equipment, interdepartmental delays), provider, pt or clinical elements
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Term
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Definition
- tool used by case managers
- patient focused documents
- clinical standards, interventions, expected outcomes
- not appropriate for all patients
- grids that outline the critical events expected to happen each day of a hospitalization
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Term
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Definition
- became more popular in 1990's
- model of care that coordinates HC interventions & communication for pt whose self-care needs are significant
- those with chronic disease get disease-managed care
- focus is the concept of wellness, living well with a chronic disease
- assist those with chronic illness to manage self-care
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Term
| differentiated nursing practice |
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Definition
- models of clinical nursing practice defined by level ed, expected clinical skills, job descriptions, pay, & participation in decision making
- ADN role, BSN role, APRN (advanced practice)
- emphasizes 2 levels of nursing practice: technical & professional
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Term
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Definition
- developed by AACN in early 2000s
- must pass clinical nurse leader (CNL) certification exam
- is an advanced generalist clinician, masters
- oversees the lateral integration of care for a distinct group of pts
- may provide direct pt care
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Term
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Definition
- by American Association of Critical-Care Nurses
- framework for practice & certification for the critical care nurse & clinical nurse specialist
- IDs pt characteristics as "drivers" of the necessary competencies for nurses
- 8 pt characteristics & 8 nurse competencies
- when there is synergy between char & comp, pt care is optimized
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Term
| Magnet Recognition Program |
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Definition
- based on a 1983 study by the AAN
- hospitals may achieve this through a self-nominating, self-appraisal process; rigorous & lengthy
- takes 2+ years to do application, then site visit
- gets 4 yrs of Magnet status if successful
- ability to attract and retain professional nurses
- excellence in the nurse work environment
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Term
| Transforming Care at Bedside (TCAB) |
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Definition
- initiative to redesign the work environment of nurses in med/surg
- collaboration between Robert Wood Johnson Foundation & Institute of Healthcare Improvement
- design themes
- reliability
- vitality
- patient-centeredness
- increased value
- rapid cycle changes involved plan, do , study, act (PDSA): short studies to evaluate practice changes at participating sites
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Term
| roles of staff nurse & nurse manager |
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Definition
| vary with each care model |
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