Models For The Delivery Of Nursing Care Study

There are four types of Advanced Practice Nurse roles, the nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse-midwife. The Family Nurse Practitioner is the advanced practice role that will be discussed. According to Hamric, Hanson, Tracy, and O 'Grady (2014) the primary care NP provides care for patients in diverse settings, including community-based settings such as private and public practices, acute, and long-term care settings across the life span (pg. 396). Family Nurse Practitioners have faced many challenges in the medical profession to be recognized as health care providers. Most of these challenges where from fellow nurses. According to Hamric, Hanson, Tracy, and O’Grady (2014) conflict and discord about the Nurse Practitioner role continued to characterize relationships between NPs and other nurses (pg. 18). Despite the resistance to NPs in nursing, physicians increasingly accepted NPs in individual health care practices (Hamric, Hanson, Tracy, and O’Grady, 2014, pg. 18). Physicians readily accepted the role of the Nurse Practitioner, working together to improve patient outcomes and safety.

system after the RN has been evaluated and approved as having met the education and

Advance practice registered nurse who provides care to patient through their life span from premature birth to the elderly , their focus is physical examination diagnose and treatment (ect)

Healthcare reform in the United States (U.S.), continues to be a hot topic in the news. Whether it discusses how the program will be financed, the need to redesign the organization, or how the process of delivering healthcare will be implemented; one thing that is a frontrunner, is the need for registered nurses (RNs) and advanced practice registered nurses (APRNs) to fill the increased demands on the primary care system (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 375). “Several programs and initiatives included in the health reform legislation involve interdisciplinary and cross-setting care coordination and care management services of RNs” (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 377).

With the implementation of two milestone in the healthcare system, the Affordable Care Act (ACA) and Health care education and reconciliation act of 2010. The ACA assist in easy access to high-quality and cost-effective and also assist in the shift of the nation’s health care system in the direction of primary and preventive care. Also the health care education and reconciliation act is an initiative to motivate nurses and provide grants and scholarships to acquire higher education and take active part in the reformed health care system. In order to create the health care system which focus on primary and preventive care, the role of nurses is very vital and important especially the advanced practice registered nurses (APRN) (Implementing Health Care Reform: Issues for Nursing, 2010). American Nurses Association always advocate and nurture nurses including APRNs and Patient Protection and Affordable Care Act (PPACA) also acknowledged and recognized the role of APRNs in the provision of primary and preventive care. This acknowledgement of PPACA open the new horizon for the APRNs in the transformed patient-centered care system (Haney, 2010). In this presentation, the writer will discuss new emerging care delivery model which are mentioned in the PPACA. These delivery model involve interdisciplinary and care management services of RNs (The National Academies Press, 2011).

The Nurse Practitioner, Nurse Educator, Nurse Informaticist, and Nurse Administrator have different educational background and training, thus they play a different role in the field of advance practice nursing but they have a common goal, and that is to ensure a safe and effective delivery of care to every patient, regardless of the type of health care setting. The difference is their roles lies in the fact that the Nurse Practitioner practices in the advanced clinical role while the Nurse Educator, Nurse Informaticist, and Nurse Administrator have the non-clinical roles. Having a clinical role means that the having a direct contact with patient. The NP’s main role is to provide direct care to patient, making diagnosis

The purpose of this paper is to identify the type of facility and the resident being served. In addition, this paper will identify the role of the Nurse Practitioner (NP), and the regulatory issues as it supports this role.

Advanced practice nurses include Certified Nurse Practitioner (CNP), Clinical Nurse Specialist (CNS), Certified Nurse Midwife (CNM) and Certified Registered Nurse Anesthetist (CRNA). Certified nurse practitioners provide primary and acute care in hospitals, community clinics, schools and other settings, and perform services such as diagnosing and treating acute illness and injuries, conducting physical exams, providing immunizations and managing chronic problems (American Association of Colleges of Nursing, 2017). The restrictive scope of practice of CNP is a barrier to accessible care. In many states, NPs does not have authority to prescribe medications. This is a disadvantage in providing care efficiently.

Nurse Brink designed a care modality that follows the functional model. With the functional model, care is provided by all members of a nursing team through different tasks (Yoder & Wise, 2015). Nurse Brink uses this model as each RN, LPN, and UAP are assigned a specific job. The jobs that each member of the nursing team has, correspond to their scope of practice (Yoder & Wise, 2015). By having each member complete their job, they’re supporting how a patient’s care is provided. With this design, it allows for each member of the team to work together in union. Though there may be a small number of staff members, they still have a role and responsibility to meet the needs of all patients.

The Robert Wood Johnson Foundation, in the beginning of 2007, funded Health Workforce Solutions LLC (HWS) in their project to create new innovative care models that can establish proficient and successful ways to deliver health care (Joynt & Kimball, 2008, January). In total, HWS selected 24 models of the original 60 care delivery models to conduct in-depth research. Throughout the years, many institutions have incorporated these different models, either independently or in combination. Although all models met the criteria of HWS, and are beneficial in their own way, the Unit-Based Care Manager model will be the subject of this paper. The Unit-Based Care Manager model, "is a new role created for Clinical Nurse Leaders (CNL 's), where a hospital unit 's care team and delivery is redesigned to leverage the CNL 's knowledge, experience, and functionality" (Joynt & Kimball, 2008, January). In fact, one example of the benefits of implying this model is hand hygiene compliance. Results show from CNL Role Immersions Practicum Experiences, that improvement went from 30% to over 70% with just this implementation ( Reid & Dennison, 2011, September 30).

Delegation in the health care setting is very important for the nurses, unlicensed assistive personnel, and for the patients. The delegation of indirect and direct patient care allows the Registered Nurse (RN) to spend more time toward the patient care, education, and patient advocacy. This delegation of patient care helps to improve patient outcomes and increases satisfaction for the patient and the nurse (Snyder, Medina, Bell, & Wavra 2004). “Nurse delegation is considered a “professional right and responsibility” requiring a “skill that must be taught and practiced for nurses to be proficient in using it.”

For the last two weeks I have had the opportunity to shadow a case involving Mr. S, who is 36-years-old. He was admitted to the hospital due to aggressive behaviour at his group home. Mr. S has a complex health and placement history. He has grown up in foster homes as a child and was diagnosed with fetal alcohol syndrome without any formal documentation of an evaluation. Moreover, Mr. S was in a motor vehicle accident in his early 20s which lead to a brain injury. Mr. S had to go through brain surgery and since then his behavior has changed significantly. After his surgery, he stayed at the Burnaby general hospital for 5 months and was placed in a group home. His behavior was unmanageable and reports indicate that he was at risk of self-harm

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

In team nursing the responsibilities usually divided in between the personnel, so that everyone’s has its own role in patient’s care.

The team model allows the utility of nonprofessional nursing personnel such as LPNs and nursing assistants, through delegation and observation by an RN while holding a team leader accountable.( Tiedeman&Lookinland,2004) The focus is to work collaboratively and cooperatively with shared responsibilities, and to some extent accountabilities, for assessment, planning, delivering, and evaluation of patient care. ( Tiedeman&Lookinland,