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4 Health Care Delivery Systems
- Functional
- Case
- Primary
- Case Management
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Case (Total Patient Care)
- Oldest method
- Common for students and private duty nurses
- Patient recvds holsitc nofragmented care by one RN er shift
- RN: respondsible for all planning, organizing, performing all care, including personal hygiene, mediactions, treatment, educational and emotional support
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Functional Nursing
- Staff members are assigned to complete certain tasks for a grp of patients rather than care for specific patients.
- ex: RN= assessment LPN= oral medications CNA= performs hygiene tasks and vital signs
- Care fragmented, skill oriented and less expensive
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Team Nursing
- RN functions as a team leader and coordinates a small grp of ancillary personnel to provide care to small grp of patients.
- Heart of the system communication Involves all memebrs in the nursing process
- Fragmented care and costly
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Primary Nursing
- 24 respondsibility for planning and directing and evaluate patients care from admission to discharge.
- May delegate some patient care to LPN's
- Fundamental resp. model to maintain clear communication among all HCT including patient, family, nurses.
- Home health, hospice, long term care.
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Case Management
- RN coordinates care throughout course of an illness
- Bothe Team and Primary Nursing
- Manages treatment plans and length of stay of hospital for patients.
- Focus attention on the quality, outcomes and coordinates care.
- 5 components: assessment, planning, implemenation, Evaluation and Interaction.
- Home health agencies, Rehab, Long term
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Nursing Leaderships
Process of influencing others in the provisions of care for one or more patients
Function of a leader is to guide people and grps to accomplish a common goal.
Leaders behavior is crucial
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Authority
(Necessary to achieve a goal)
The legitimate right to give commands as determined by postion the oraganization chart
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Power
- (Necessary to achieve a goal)
- Ability to influence another thru control of needed resources
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Reward
Control of rewards to others
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Legitimate
Power based on an offical position in the organization
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Coercive
Use of punishment for noncompliance
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Expert
Based on knowledge skills and information
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Referent
- Connection to other powerful people in an organization
- Who you know!
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Legitimate, Reward and coercieve Power
- Based on position
- where are you in the hiearchy
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Authoritarian
- Functions with a high sense of task accomplishment and low concern for people.
- Makes all work decisions
- Exercises corecieve powers
- Sets standards and methods of performance
- The go to person in emergency situation
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Authoritarian- followers
- Dont have to make decisions
- Fear the leader
- Approach this leader with caution
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Democrate
- Leader defines limits but lets the grp make suggestions and decisions
- Focuses on team building
- Engages grp and everyone will buy into system
- Increase productivity
- Is the most desirable work setting
- Do not approach in emergency sitaution
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Democrate- followers
Must be willing to work towards grp goals wven if the goal were not their personal choices.
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Laissez Faire
- Do what you want to do if you feel good about it!Provides minimal or no direction
- Avoids respondsibility
- Don't work well- Not productive
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Non-Productive Styles
Sacrifical Lambs
High Prietess
Mother
- Has to do everything themselves
- Feels they provide care at a higher level than everyone else
- Takes care of everyone and makes all decisions and knows whats best
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Non Productive Followers
- Appliance: only working to buy something not really committed to the team
- Doomsayers: Everything is wrong
- Subversives: Consciously or unconsciously undermind the leader
- Accomodators: Always try to please don't give real feedback.
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Continuing Eduaction
- Advance degrees
- Seminars
- Workshops
- Insititues
- Conferences
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ANA
- Those learing exp intended to build upon the educational and experimental bases of the professional nurses for the enhancement of :
- Practice
- Administration
- Education
- Research
- Or theory development
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CEU
Uniform system of measuring & doucmenting participation in an organzied program.
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Competence
As the possession of knowledge skills and attiudes necessary to meet a standard of practice.
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Clinical Pathways
- an interdisciplanary approach of standarlized medical irders combined with a tracking tool.
- Used as road maps for effective care
- Also used to monitor progress
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Rapid Response Team
Activated when nurse recognize a change in pt condition that can be life threatening.
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Critical thinking
- Impacts:
- Recovery Health status even life threathening
- Involves the use of :
- Reflection knowledge Instinct based on exp.
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Dominant Thining Strategies:
- Recognize a pattern: id, data that fits together
- Set Prorities: Order concepts in terms of importance
- Search for info: recall missing or concealed information
- Generate a hypothesis: develope tentative explanations
- Make predictions: Declaring in advance
- Form realtionships: Connect info to further understanding
- State a propostion: State a ruel gverned by an if an statement
- Assert a practice rule: a truism about prior practice
- Make Choices: select alternatives
- Draw conclusions: reach decisions from opinion
- Provide an explanation: Offer reasons for actions beliefs or remarks
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How to Improve Critical Thinking
- Mentoring
- Debriefing critical incidents
- Patients chart reviews
- Grand rounds
- Role modeling
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THINK
- Total Recall
- Habits
- Inquiry
- New ideas & creativity
- Knowing how to think
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