Comparing Total Patient Care and Team Nursing Models in Practice

This essay provides a comparative analysis of the total patient care model and the team nursing model, particularly within the context of a cardiovascular unit. The author's observations of inconsistencies and lack of coordination in the total patient care approach led to an exploration of the team nursing model as a potentially more effective alternative. The essay reviews research supporting the team nursing model's benefits, including improved communication, balanced workloads, and positive patient outcomes. Recommendations for implementing the team nursing model include effective training, clear task allocation, and workshops on communication and decision-making. The conclusion emphasizes the potential of the team nursing model to enhance patient care and increase job satisfaction among nursing professionals. Desklib offers a variety of resources, including solved assignments and past papers, to aid students in their studies.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the University
Author note

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Introduction
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.
Research about total patient care model
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.

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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).
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

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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).
Team Nursing Model
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),

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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.
Implementation and Recommendation
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

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 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.

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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.

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