Evolving Practice of Nursing and Patient Care Delivery Models

This article discusses the evolving practice of nursing and patient care delivery models. It explores the importance of continuity of care and the introduction of accountable care organizations, medical homes, and nurse-managed health clinics. Additionally, it covers patient care delivery models such as team nursing, primary nursing, and progressive patient care. The article also highlights the role of nurses in providing quality care and the future of nursing with the developments in technology and online education.

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Running Head: PRACTICE OF NURSING
Evolving practice of nursing and patient care delivery models
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Contents
Evolving practice of nursing.........................................................................................................................2
How is nursing expected to grow and change.............................................................................................3
Continuity of care....................................................................................................................................3
Accountable care organizations...............................................................................................................3
Medical homes........................................................................................................................................4
Nurse-managed health clinics.................................................................................................................4
Patient care delivery models.......................................................................................................................5
Team nursing...........................................................................................................................................5
Primary nursing.......................................................................................................................................5
Progressive patient care..........................................................................................................................6
Bibliography................................................................................................................................................7

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Evolving practice of nursing
Nursing has come a long way from the time where we had no recognition at all to a
time where our nursing services are highly valued in any hospital set up. As nurses we offer a
unique approach to patient care, because unlike other professions in the health industry we spend
the most time with our clients monitoring their disease process step by step. This enables us to
form a unique bond with our clients such that they are able to confide in us and get information
from them that could not be known if it were not for our unique relationship with our clients
(Cherry, 2016). As nurses we are the first to know when a client condition changes or when the
condition is improving we then document this for other professionals involved in patient care to
read.
Nurses are able to get the deepest of information from clients and we play a major
role in diagnosing conditions that would go undiagnosed if it were not for our relationship with

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our clients. For instance community health nurses can be able to tell when a child is being
abused, or tell victims of abuse because they spend so much time with families listening to them
and analyzing their every word, which enables them to come to a conclusion that lead to
identifying a problem. Our services are not limited to finding out problems but we also come up
with unique problem solving strategies that provide our clients with coping mechanisms. For
example if a client resents with anxiety and panic attacks the nurse will offer a listening ear and
this alone can prevent the client from causing harm to themselves or those surrounding them.
How is nursing expected to grow and change
Nursing practice is expected to grow through the awareness of continuity of care,
introduction of Accountable care organizations, medical homes and nurse-managed health
clinics.
Continuity of care
This is a process that is concerned with the provision of quality care to clients where by
different health care professionals collaborate in the provision of patient care, with a similar goal
of improving the client’s condition, offering quality care and ensuring the client’s safety.
Accountable care organizations
These are organizations whereby theirs is team work involving the coordination
of different health care professionals in the provision of patient care. This organization’s goal is
to provide quality patient-centered care at a reduced cost (McWilliams, 2016). These
organizations are formed with the aim of encouraging everyone to seek and access healthcare
regardless of their financial status. In this organization’s nurses play the central role of being
quality improvement managers, communicators and care collaborators.

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Medical homes
These refer to primary care practices whereby patients receive inter-professional and
interdisciplinary care through the utilization of team work to meet the patient’s short term and
long term health care goals (O’Malley, 2015).
Nurse-managed health clinics
These are practices that offer primary community based care regardless of the client’s
financial status (Pilon, 2015). These practices are primarily run by nurses who are also the main
care providers.
All of these elements of care have one thing in common, the nurse. The nurse is the
central and most valued person for this type of care modalities; therefore the future of nurses is a
bright one.
With the developments in technology and the newly acquired self-
awareness among nurses, the nursing profession is expected to grow tremendously. Nurses have
the political, social and educational support that they need to go beyond the expected boundaries.
Currently it is possible for nurse who has already qualified to pursue further education online.
The internet has made it possible for registered nurses to take a bachelor of science
in nursing through online classes (McDonald, 2018). Previously this was impossible because
according to the nurses curriculum, all nurses were required to attend a school of nursing
physically for their training; however nowadays nurses can take theory lessons over the internet
and then take practical lessons in any institution they wish to. Again technological development
has made it possible for all institutions to offer quality health care; therefore nurses who are

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pursuing further education have a wide range of choices when it comes to the institution they
want to practice in.
Patient care delivery models
There are three main types of care models that are used by nurses to provide care to
the patients. There is team nursing, primary nursing and progressive patient care.
Team nursing
This care model was developed in the 1950s, it involves a team leader and team
members who provide assorted patient care to their clients. The team leader allocates duties to
the team members regardless of their specialties and needs (King, 2014). For example a nurse
can administer medication while an orderly does the bed bath under the nurse’s supervision. In
this care model quality of care is highly questionable and these doubts lead to the evolution of a
new model of care.
Primary nursing
This refers to an all-round individualized care provided to patients by one nurse. This
model emphasizes on provision of care by the same person. The nurse is able to accord care to a
small group of clients. This model ensures quality care is provided to patients through continuity
of care. In this model the nurse provides direct care to the patients for 24 hours. The downside of
this model is that it is too costly but it is the best form of nursing care because it enables a nurse
concentrate on one client through provision of undivided attention (Mattila, 2014).

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Progressive patient care
This refers to a model whereby patients are placed into units according to their
specific needs and care is provided according to the client’s specific needs and not the nurse’s
medical specialty (Urden, 2015). This model ensures that all the patients receive undivided
attention from the nurses according to their medical needs; it also helps the nurse concentrate
better on clients. Progressive patient care is very useful in the intensive care unit and high
dependency unit.
These patient care delivery modalities have been evolving and are still evolving
according to the nature of the client’s condition. Nurses are looking for modalities that offer
quality cost effective and efficient modalities in provision of nursing services.

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Bibliography
Cherry, B. &. (2016). Contemporary nursing: Issues, trends, & management. . Elsevier Health Sciences.
King, A. L. (2014). Effectiveness of team nursing compared with total patient care on staff wellbeing
when organizing nursing work in acute care ward settings: a systematic review protocol. JBI
Database of Systematic Reviews and implementation reports,, 1(12), 59-73.
Mattila, E. P. (2014). The effects of the primary nursing care model: a systematic review.
McDonald, E. &. (2018). E-learning and nursing assessment skills and knowledge–An integrative review. .
Nurse Education Today.
McWilliams, J. M. (2016). Early performance of accountable care organizations in Medicare. New
England Journal of Medicine, 24(374), 2357-2366.
O’Malley, A. S. (2015). Overcoming challenges to teamwork in patient-centered medical homes: a
qualitative study. Journal of general internal medicine,, 2(30), 183-192.
Pilon, B. A. (2015). Evidence-guided integration of interprofessional collaborative practice into nurse
managed health centers. Journal of Professional Nursing,, 4(31), 340-350.
Urden, L. D. (2015). Priorities in critical care nursing. Elsevier Health Sciences.

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