Nursing Care Assignments or Mod Ali Ties of Nursing Care or System or Pattern of Nursing Care

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Nursing Care Assignments/

Modalities of Nursing Care orSystem/Pattern of NursingCare

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Primary  Extension of principle of decentralization

Nursing process driven

Primary nurses and associate nurses

24-hour coverage

Greater patient and staff satisfaction

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 Advantages 1) patient & family are able to developtrusting relationship with RN; 2) there is definedaccountability & responsibility; 3) there isholistic/continuity of care.

Disadvantages 1) high cost because there is a higher

RN skill; 2) proximity of patient assignment;3) overlapping of staff functions; 4) nurse patientratio must be realistic.

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Case Method

1:1 nurse/patient ration

Examples include private duty, ICU, Community HealthNurse

Similar to Primary, however, no Associate RN

The nurse is responsible for the total care of the patient

for the shift she’s working

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 Advantages 1) consistency of one individual caring forthe patient for the whole shift; 2) more opportunity toobserve & monitor the patient.

Disadvantages 1) the nurse may not have the samepatient the next day; 2) it does not serve the purpose of 

decentralization.

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Functional Nursing

divides the work to be done & every member isresponsible for his actions

best system that can be used if there are many patient &professional nurses are few

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 Advantages of functional nursing are that 1) work isdone fast; 2) workers learn to work fast; 3) they gainskill faster in that particular task.

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Disadvantages include 1) fragmentation of nursingcare therefore holistic care is not achieved; 2) patientcannot identify who their “real nurse” is; 3) nurse-patient relationship is not fully developed; 4)evaluation of nursing care is poor & outcomes arerarely documented, and 6) it is hard to find a specificperson to answer the relative’s questions.

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 Advantage 1) work is shared with others

Disadvantages 1) patient receives fragmented,depersonalized care; 2) communication is complex;3) accountability & responsibility is shared which cancause confusion; 4) these factors affects RN’s

dissatisfaction.

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Case Management Clinical system with accountability for individual or

group through continuum of care

Negotiating Procuring

Coordination of services and resources