Total Patient Care Model: An Evaluation

1. Why is it important for the students and faculty to understand the model?
2. How does the nursing model relate to the organization’s theory or approach?
3. How would you describe this model? Consider methods and examples.
4. Develop a plan that you will submit to the CNE explaining how you will address
this problem. Whom might you include in developing the plan and in implementing it?

Total Patient Care Model

Total Patient care model is one of the oldest care model which is used by the registered nurses, while caring for patients. While working in the cardiovascular unit for a patient, I observed this care method being applied for that particular patient. As the registered nurse was only providing care for a shift and after the shift of that registered nurse was over, care process used to face inconsistency and hence, patient condition was not improving properly (Ibrahim et al., 2016). Four registered nurse were allotted for the care process of the patient however, while caring for the patient there was no coordination between them and they applied the task-oriented care model for the care of the patient that led me made this observation that the total patient care/case model has been used as the care approach of the patient. As per researchers the care model involved in the care process for the patient involved in the care process for the patient admitted in the care ward was total patient care model as in this care process nursing professionals are only concerned about the care process for their shift and no specific handover is provided to other care professionals, leading to inconsistency for the other care professional. Further, this care model was also relevant with the care provided to the patient as the primary care plan was developed by one of the primary registered nurse and others were providing care to the patient as per the care model developed by the primary registered nurse. Hence, it was clearly evident that this was the care model the patient in the cardiovascular unit was receiving.

This section will discuss about two research articles in which scenario related to total patient care/case method has been discusses, which is similar to the care method which was applied to the above-mentioned scenario.

The first research was conducted by Paddison et al. (2012) in which the aim of the researchers was to identify the qualitative and quantitative effect of the Total patient care method applied for the patient care and the uncertainty in created in the care process using a survey method among patients receiving those care interventions. For this purpose, the responses were collected from more than 2163456 patients admitted in more than 8267 registered helathcare facilities and then it was assessed using statistical analysis and it was found that more than 29% of the care receivers used to receive uncertain care process and due to that their health condition became worst after few care interventions due to which, their care professionals were switched (Paddison et al., 2012). Therefore, the research clearly determined from its survey results that due to the application of total patient care model for the care process of the patients, majority of the patients suffered due to the interventions inconsistency and improper handover of the patients. Further, for the care process, only one care model was developed which was applied to a large number of population and hence, it was unable to improve major amount of people (Paddison et al., 2012).

Research Study 1

The second research was conducted by King, Long and Lisy (2015) and in this aspect, the primary aim of the researchers was to observe the work pattern and ability pf the nursing professionals that affect the wellbeing and health of the patients. For this purpose, all the nursing professionals in 3 of the healthcare facilities were included in the survey and their action and working patterns were observed for a specific time period. It was found that majority of the nursing professionals were only concerned about care process within their shift and for this purpose they used interventions that can improve patient condition (King, Long & Lisy, 2015). Hence, the patient care process was observed in the research and due to this the mortality rate in the acute care ward was increasing. As the nursing professionals were implementing interventions for their shift timings, no coordination or consistency was observed in the care process, leading to increase the mortality rate in the patients (King, Long & Lisy, 2015).

The origin of the team nursing model approach is dated back to the time during the world war II when there was an acute crisis of nursing professionals. The central theme of the ‘Team Nursing’ model focuses on a coordinated team work. It comprises of the registered nurse, licensed or vocational nurses and UAP. The professionals work as a team on the basis of task priority. It should further be noted that the clinical decision making rests with the team of the professionals. In addition to this, it should further be stated that the team nursing model has been criticised because of an ineffective communication network. It has been typically observed that the major clinical decision making authority lies with the registered nurse and the decision is not undertaken in partnership with the physician and the patient (Glen, 2017). Hence, the model has reformed to a great extent in recent times.

According to a research study it has been mentioned that the team nursing approach yields positive patient outcome along with increased level of job-satisfaction among professionals. It has also been reported that working within a team helps in effective balancing of the work load along with a reduction in the turnover ratio (Van Bogaert et al., 2013). The research study was based on a cross-sectional design. The researchers conducted a survey in order to deduce a possible relationship between the service quality offered to the patients and a team based working environment. The findings revealed that out of the 32 units that were critically evaluated, the units that were handled by efficient supervisors and followed a team coordination revealed higher level of patient satisfaction. According to Brock et al. (2013), effective team work can lead to positive outcomes in terms of improved flow of communication and reduction in medical errors. The researchers made use of the team strategies tool to enhance the performance quality of the nursing professionals within a hospital setting. Interestingly, the findings revealed that effective training enhanced the ability of the professionals to communicate and perform better within a team environment. Pre and post assessment evaluation further stated that the decision making ability was also reformed to a great extent.

The care model witnessed by me within the cardio vascular unit was the total patient model. According to my perspective I feel that it is an ineffective care model. This is primarily because the main decision making responsibility rests with the primary nurse. Also, the primary nursing professional focuses on devising a care plan in order to meet the short term recovery goal of the patient. This presents an example of inconsistent and incomplete care delivery. On the other hand, the care plan researched by me is broadly based upon a ‘team based approach’. It relies upon the working of nursing professionals in close association with the physicians and other health care professionals. It should be noted here that the cardiovascular unit is a busy unit with a lot of work load. Working in a team can help in the smooth flow of communication and equal distribution of tasks so as to deliver positive patient outcomes. Recommendations for improvement would include the following:

• Effective training and awareness about the team based nursing care model
• Training dispensed to the professionals by supervisors and team leaders
• Proper allocation of tasks to nurses based upon the priority
• Organizing workshops to educate the nurses about effective methods of communication and decision making based upon evidence based practical scenarios

Conclusion

Hence, to conclude, it must be stated that the two models covered in the assignment include the total patient care model and the team nursing model. The pros and cons associated with both the model have been discussed above. It has helped me in understanding the process in which the nursing care model operates and according to my perspective the implementation of the team nursing model can help in attaining positive patient outcomes and greater level of satisfaction among the professionals.

References

Brock, D., Abu-Rish, E., Chiu, C. R., Hammer, D., Wilson, S., Vorvick, L., ... & Zierler, B. (2013). Republished: interprofessional education in team communication: working together to improve patient safety. Postgraduate medical journal, 89(1057), 642-651.

Glen, S. (2017). Problem-based learning in nursing: A new model for a new context. Macmillan International Higher Education,pp.55-69

King, A., Long, L., & Lisy, K. (2015). Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care wards: a systematic review. JBI database of systematic reviews and implementation reports, 13(11), 128-168.

Paddison, C., Elliott, M., Parker, R., Staetsky, L., Lyratzopoulos, G., Campbell, J. L., & Roland, M. (2012). Should measures of patient experience in primary care be adjusted for case mix? Evidence from the English General Practice Patient Survey. BMJ Qual Saf, bmjqs-2011

Van Bogaert, P., Wouters, K., Willems, R., Mondelaers, M., & Clarke, S. (2013). Work engagement supports nurse workforce stability and quality of care: nursing team?level analysis in psychiatric hospitals. Journal of Psychiatric and Mental Health Nursing, 20(8), 679-686.