Primary Nursing in a Short-Stay Unit

2015 ◽  
Vol 21 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Jane Baynton

Primary Nursing is a model of care delivery that has been shown to improve the quality of care provided to patients and enhance the nurse–patient relationship. Although there is considerable attention in the literature on Primary Nursing concerning inpatient hospital units, there has been no discussion of Primary Nursing in short-stay units. Our hospital aimed to introduce Primary Nursing into all the units including short-stay. Staff were educated about the role of the primary nurse using Koloroutis’s (2004) Relationship-Based Care model, comprising three crucial relationships: care provider’s relationship with patients and families, with self, and with colleagues. The primary nurse develops the plan of care for individual patients based on their therapeutic relationship, which is sustained for the patient’s length of stay in the unit.

2018 ◽  
Vol 6 (10) ◽  
pp. 1895-1901 ◽  
Author(s):  
Ahmad Kalateh Sadati ◽  
Seyed Ziauddin Tabei ◽  
Kamran Bagheri Lankarani

BACKGROUND: Doctor-patient relationship [DPR] refers to verbal and non-verbal communication between doctor and patient, which is of great importance in consultation sessions. AIM: Therefore, the present study attempts to explore the importance and value of DPR in Iran. MATERIAL AND METHODS: The method used in the study was conventional content analysis. The data were collected from 21 faculty members (FMs) of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran, who participated in three focus group discussions (FGDs). Transcribed data were analysed using Conventional Content Analysis (CCA) which identified condensed meaning units, subthemes, and themes. RESULTS: Four themes were extracted from 198 meaning units, 87 condensed meaning units, and 17 subthemes. These included gateway [the role of DPR]; nonlinearity [the nature of DPR]; distortion (quality of DPR in the context); and dysfunctional system (weakness in health system). Generally, results showed DPR to be the gateway to consultations based on non-verbal communication and doctor empathy. The study showed distorted DPR which was due to the dysfunctionality of the health care system. CONCLUSION: As indicated DPR plays an important role in medical contexts, but if distorted it leads to an unsuccessful outcome. Therefore, to promote DPR, it is necessary to reinforce its structure. Thus, the infrastructure has to be modified and developed at all levels.


2020 ◽  
pp. 194187442097230
Author(s):  
Karin Mitiyo Corrêa ◽  
Flávio Moura de Rezende Filho ◽  
Fabiano Ferreira Abrantes ◽  
João Brainer Clares de Andrade ◽  
Orlando G. P. Barsottini ◽  
...  

Background and Objectives: Medical consultation by a specialist physician consists of an evaluation to review diagnosis and management of patients with some neurological conditions referred from other specialty wards. This mode of care delivery has gained relevance in the field of neurology and adequate training on it is valuable, allowing neurologists to provide state-of-the-art management to patients with neurological manifestations. The present study aimed to characterize neurology consults and to discuss the roles of the neurologist within a hospital setting. Methods: A prospective analysis of neurological consultations provided to inpatients of a university hospital in São Paulo, Brazil, was performed from September 2016 to September 2017. These patients were followed by the principal investigator, who was not involved in their care. Results: We evaluated data from 117 female and 106 male inpatients with a mean age of 53.8 ± 2.4. The medical specialties that most frequently requested neurological consultations were Internal Medicine (17%), Cardiology (11.2%) and Pulmonology (9.4%). The main reasons for a neurology consultation request were seizures (15.6%); decreased level of consciousness (8.9%) and confusion (7.1%). The most frequent diagnosis in patients receiving a neurology consult were stroke (10.2%); hypoxic-ischemic encephalopathy (5.3%) and sepsis (2.2%). Conclusion: Our findings show the growing importance of the role of neurologists within hospital settings as many medical conditions present with neurological manifestations and the significance of the neurohospitalist model of care.


2014 ◽  
Vol 2 (5) ◽  
pp. 157-165
Author(s):  
Ratna S Sudarsono

Model Praktek Keperawatan Profesional (PKP) diartikan sebagai suatu system (struktur, proses dan nilai-nilai professional) yang memungkinkan perawat professional mengatur pemberian asuhan keperawatan termasuk lingkungan yang diperlukan. Melalui pengembangan model ini terdapat otonomi dan akontabilitas perawat, pengembangan professional dan penekanan pada mutu asuhan keperawatan. Berdasarkan hal tersebut pada model PKP yang dikembangkan di RSCM diperlukan penataan 3 (tiga) komponen utama dalam pemberian asuhan keperawatan yaitu ketenagaan; metoda pemberian asuhan dan dokumentasi keperawatan. Pada model ini metoda pemberian asuhan keperawatan yang digunakan adalah tim primer (kombinasi metoda keperawatan primer dan metoda tim). Model ini dikembangkan di ruang rawat penyakit dalam dengan kapasitas 30 tempat tidur. Setelah model dimplementasikan +/- 8 bulan, hasil yang dicapai menunjukkan, secara kualitatif perawat primer merasakan kebanggaan professional, perawat asosiet mengatakan pekerjaan lebih terencana dan dokter menilai, bahwa mereka merasakan kerjasama dengan perawat lebih baik dibandingkan dengan ruang rawat lainnya. AbstractProfessional nursing practice model (PNPM) is a system (structure, process and values) that supports nurse control over the delivery of nursing care and the environment in which care is delivered. This model ensure nurse autonomy, nurse accountability, and professional development. It also emphasizes on high quality of care. In order to develop the model at Cipto mangunkusumo hospital, it is needed to focus on three main components. The components are nursing manpower, method of nursing care delivery and nursing documentation. The method of nursing care delivery used in this model is a primary team which is the combination of primary nursing and team method. The model was developed at medical word with 30 beds. After eight month implementation, a qualitative evaluation showed that primary nurses felt a professional pride, associate nurses stated that tasks are more organized and doctors assured that collaboration with nurses in the model unit is better than in order places.Keywords: Professional nursing practice model, primary team, primary nurse.


2021 ◽  
Vol 6 (2) ◽  
pp. 149
Author(s):  
Hendry Kiswanto Mendrofa ◽  
Muhammad Taufik Daniel Hasibuan

The development of science and technology that continues to progress, especially in the health sector requires changes in terms of service so that in providing more professional services in hospitals, nursing care must be of high quality. Nursing Law Number 38 of 2014 Article 3B states that nursing arrangements aim to improve the quality of nursing services, therefore the provision of quality nursing services is important in today's health services. The model of professional nursing care is divided into several models, namely primary, team and case nursing. Based on the results of a survey of research journals, the researchers concluded that there was no research that compared the professional nursing care team model with primary nursing in improving the quality of nursing care. The purpose of this study was to identify the use of the professional nursing care team model with the primary nursing model in improving the quality of nursing care. This type of research is a quantitative research type with a comparative design. The population in this study were all patients at the Inpatient Hospital where the study was conducted. The sampling technique used was purposive sampling technique. Data collection on the quality of nursing care used a quality scale patient assessment instrument – the acute care version (PAQS-ACV). This instrument was developed to assess the quality of nursing care. Data analysis in this study used an independent t-test. normality test using the Kolmorogov-Smirnov test with a significance value (p > 0.05). The results showed that there was a significant difference between the quality of nursing care in the team group and the quality of nursing care in the primary nursing group where the value of sig (2-tailed) was 0.008 where > 0.05, the results also showed that based on the results of the frequency distribution test the quality of nursing care was using the team model and the primary nursing model has a high majority value of nursing care quality, but there is a difference in the average value (mean) where the quality of nursing care in the nursing care model group in the team method group is 144.86 and the quality of nursing care in the primary nursing model group is 155.83. These results indicate that the quality of nursing care with the primary nursing model has a higher quality of care value than the group nursing care model with the team method. Based on the results of this study, it is recommended that hospitals can apply a professional nursing practice model, especially the primary nursing model to further improve the quality of nursing care provided.


2018 ◽  
Vol 35 (11) ◽  
pp. 1433-1438
Author(s):  
Grace Meijuan Yang ◽  
Sungwon Yoon ◽  
Yung Ying Tan ◽  
Karen Liaw

Background: Palliative care is associated with better outcomes in advanced cancer, but there is limited research comparing different models of palliative care delivery alongside oncology care. For inpatients with cancer, palliative care is mostly delivered through a consult service, primarily relying on oncologist-initiated referrals to a separate specialist palliative care team. In our hospital setting, we piloted a palliative care and oncology corounding model of care. Aim: To explore the views and experience of oncology and palliative care professionals on the corounding model compared to an inpatient consult service. Design: A qualitative study nested within a pre–post study of the corounding model of care, with semistructured interviews using thematic analysis. Setting/Participants: Eleven doctors and nurses involved in the pilot corounding model were interviewed. Results: Two main themes emerged: (1) the efficiency of care delivery and (2) quality of patient care. The theme on the efficiency of care delivery was related to access to palliative care input, team communications, and parallel workflow. The quality of patient care was described in terms of holistic approach to cancer care and rapport building with patients and their families. Most participants acknowledged positive aspects of the corounding model, yet some minor concerns were reported, such as disagreements between oncology and palliative care professionals. Conclusions: This study provides insights into the benefits and drawbacks of a corounding model of care for inpatients. The views of health-care professionals can be incorporated into the development of integrated oncology and palliative care models to improve care for patients with advanced cancer.


2010 ◽  
Vol 34 (1) ◽  
pp. 41 ◽  
Author(s):  
Diane Deshong ◽  
Amanda Henderson

With increasing pressures on the skilled nursing workforce, strategies need to be developed to maximise the value of the existing workforce without impacting on the quality of care delivery. This paper reports on the introduction of a Commonwealth and State subsidised program for assistants-in-nursing (AINs) to assist in addressing the global nursing shortage. The program – which has included education sessions with registered nurses about the role of the AIN, delegation and supervision, and has also sustained support to the participants throughout the duration of their employment – has delivered benefits locally to the Princess Alexandra Hospital (PAH) and, broadly, to the nursing profession. Most of the participants completing the program have chosen to continue their employment at PAH or pursue further studies in nursing. What is known about the topic?The shortage of skilled nurses means there is a need for innovative solutions to support the existing workforce. What does this paper add?The development of an assistant-in-nursing role was seen as a successful development for a Queensland hospital. What are the implications for practitioners?The trained assistants have largely remained employed in the area and 68% have gone on to further nursing education.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6029-6029
Author(s):  
J. Watters ◽  
E. Grunfeld ◽  
J. Jaffey ◽  
K. O’Rourke ◽  
D. Maziak ◽  
...  

6029 Background: Diagnostic assessment of patients with suspected cancer can involve multiple points of delay. Methods: We conducted a cohort study of prospective eligible patients referred to a regional hospital in Ottawa, Ontario, Canada over a 12 month period (2004 to 2005) for diagnostic assessment of suspected colorectal (C), lung (L) or prostate (P) cancer. The study addressed three different disease sites, each with a different pre-existing model of care delivery, so that variability could be described. Measurement of diagnostic delay intervals included days to diagnosis (from referral to diagnosis communicated to the patient) and, for patients with cancer, to surgery and to oncology consultation. Differences between disease sites for diagnostic delay intervals, quality of life, and patient satisfaction were analyzed. Results: The proportion of patients who were diagnosed with cancer was: 6.8% (9/132) for C; 80.2% (81/101) for L; and 35% (41/116) for P. The mean [SD] days to diagnosis was significantly less for L (45 [32]) than for either C (81 [68]) for P (82 [43]), (p=.0001). It was also significantly less for patents diagnosed with cancer (57.8)[41.4]) than for those without cancer (79.3)[58.9]) (difference -21.5; 95% CI -33 to -9; p=.0003); a finding which held when C was analyzed separately (33.8 [48.9] vs 84.8 [67.7]; p=.04). L patients had worse physical and mental functioning as measured by the SF36 Physical and Mental Component Scores. Patient satisfaction did not differ across disease site or for patients with and without cancer. Conclusions: Most studies of diagnostic delay intervals use administrative data. This study is unique in prospectively measuring intervals that cannot be captured from administrative data and thus provides important benchmark measures. L patients were most likely to have cancer. Although C patients were unlikely to have cancer, the diagnostic interval was substantially shorter in those with cancer than in those without, suggesting that clinicians have an effective process for triaging patients referred for diagnostic assessment. No significant financial relationships to disclose.


2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 122-122
Author(s):  
Jennifer Anne Cox ◽  
Caroline Hamm

122 Background: One common model of care within the oncology outpatient clinic setting is composed of the physician and primary nurse. We propose that the quality of care provided to oncology patients can be improved in this setting by incorporating the primary clerk into the care team, working in the same office space with the physician and nurse. Methods: Three care teams operating under the new model of care were observed during oncology outpatient clinics periodically from February 2016 to May 2016. The primary clerk’s interactions with the other team members were recorded, along with other tasks completed by the clerk that did not require team interactions but impacted quality of care. Data was later complied and organized into four domains that impacted the quality of care provided to patients. Results: The contributions to the care team by the primary clerk include improved clinic flow (e.g., ensuring treatment orders are inputted by the physician), patient convenience (e.g., identifying regularly scheduled blood work that is no longer necessary), patient safety (e.g., identifying patients scheduled for treatment with rituximab that have not had the required Hepatitis B & HIV screening), and hospital flow (e.g., preventing additional workload in the hospital laboratory by identifying when lab work can be combined in already scheduled appointments, and rescheduling clinic visits when results are not yet ready, which translates into time and cost savings to the hospital). Conclusions: As a result of the enhanced quality of care delivered, it is recommended that this model of care be adopted in the place of the traditional model, which lacks the essential element of interaction between the primary clerk and the rest of the care team.


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