Team Nursing Model will be effective in supervising the new rehabilitation unit at Memorial Hospital. Care delivery models in the healthcare sector are chosen to optimize healthcare outcomes among patients. Different care delivery models elicit optimal outcomes in different patient populations. For example, the Primary Nursing Model yields optimal results when applied in a population of patients with mental illnesses. On the other hand, Functional and Team Nursing models yield optimal results when used in patients with multi-faceted chronic conditions (Anat & Einav, 2017). In applied settings, the choice of patient care delivery models is not only informed by the specific patient populations, but is also informed by the qualifications and skills of available nursing personnel.
Team Nursing Model will be applicable in the rehabilitation care unit at Memorial Hospital because of the multi-faceted needs of patients with chronic physical and neurological deficits. The rehabilitation unit will care for patients with spinal cord injuries, cerebrovascular accidents and amputations. The population of patients with neurological deficits has needs ranging from physical to occupational therapies. Therefore, the various needs of the patients will only be met by a mix of nurses with respective knowledge and experiences in specific clinical practices. Therefore, a mix of Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and ward clerks will provide holistic services for the wide range of patients’ rehabilitative needs.
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Also, Team Nursing Model will be suitable for the rehabilitation care unit because of the combined use of RNs and LPNs. The primary purpose of Team Nursing Model is to solicit the respective knowledge and experiences of team members towards providing comprehensive care to patients. Registered Nurses have specialized in core nursing responsibilities including the interpretation of patients’ diagnostic results, the modification of patients’ treatment plans, and the preparation of patients for specialized treatment procedures. On the other hand, Licensed Practical Nurses have specialized in responsibilities including administration of medications, adjustment of intravenous fluid catheters, and informing Registered Nurses of any changes in patients’ vital signs (Chen, Hebert, Hu & Rothberg, 2015). Ward clerks have specialized in maintaining accurate patients’ records. The specialization of functions for RNs, LPNs, and ward clerks means the Team Nursing Model facilitates the provision of wholesome care for patients.
The Team Nursing Model is also applicable in the rehabilitation care unit for purposes of minimizing idleness and duplication of roles. In applied settings, healthcare institutions often struggle with low staffing (Chen et al., 2015). Most health institutions recruit few staff members because of the erratic and fluctuating needs of medical services whereby a 7-bed ward may be completely occupied in one week and empty the next week. Therefore, maintaining a low staff volume is beneficial in preventing high labor costs attributable to idle staff and unworked hours (Anat & Einav, 2017). The rehabilitation care unit at Memorial Hospital is operating at a moderate staff capacity. Consequent to the moderate staff volume, there was a need to use a care delivery model that assigns duties to every staff member; hence, avoiding idleness. Combining Registered Nurses, ward clerks, and Licensed Practical Nurses in a team ensures that there will be no duplication of roles; hence, keeping every nursing personnel occupied throughout the working hours.
Regarding staffing patterns, the rehabilitation care unit at Memorial Hospital will benefit from the Acuity-based staffing system. The rehabilitation care unit lacks the presence of adequate full-time RNs and LPNs. Absence of adequate full time staff members means the supervisor in charge must distribute the scarce human resources in a manner that optimize patient care but at the same time prevents the burn-out of available nursing personnel (Anat & Einav, 2017). The Acuity-based staffing pattern ensures that the most qualified nurses are assigned to patients with the greatest nursing needs while the supplementary staff members are assigned to patients with moderate to mild clinical needs.
The Acuity-based staffing system is applicable in the rehabilitation care unit at Memorial Hospital because the rehabilitation unit serves a small number of patients (approximately seven patients) with chronic neurological conditions. The chronic nature of the patients’ conditions means that every shift must have a highly qualified and clinically competent nurse (RN) and a handful of licensed but moderately-skilled nurses (LNPs and ward clerks). The two tables below show 7-day and 24-hours staffing schedules developed based on the Acuity-based staffing system.
Table 1: 7-day Staffing Schedule
Day | Full Time RNs | Full Time LNPs | Ward Clerk | Part Time RNs | Part Time LPNs | ||||||||
RN 1 | RN 2 | RN 3 | RN 4 | LNP 1 | LNP 2 | LNP 3 | RN 1 | RN 2 | LNP 1 | LNP 2 | |||
Monday | X | X | X | X | |||||||||
Tuesday | X | X | X | X | |||||||||
Wednesday | X | X | X | ||||||||||
Thursday | X | X | X | X | |||||||||
Friday | X | X | X | X | |||||||||
Saturday | X | X | X | X | |||||||||
Sunday | X | X | X | X |
Table 2: 24-hours Staffing Schedule
Full Time RNs | Full Time LNPs | Ward Clerk | Part Time RNs | Part Time LPNs | |||||||||
Shifts | Time | RN 1 | RN 2 | RN 3 | RN 4 | LNP 1 | LNP 2 | LNP 3 | RN 1 | RN 2 | LNP 1 | LNP 2 | |
Shift 1 | 6am – 7am | X | X | X | |||||||||
7am – 8am | X | X | X | X | |||||||||
8am – 9am | X | X | X | x | |||||||||
9am – 10am | X | X | X | ||||||||||
10am-11am | X | X | X | ||||||||||
11am-12pm | X | X | X | ||||||||||
12pm-1pm | X | X | x | ||||||||||
1pm-2pm | x | X | X | ||||||||||
Shift 2 | 2pm-3pm | X | X | x | X | ||||||||
3pm-4pm | X | X | X | ||||||||||
4pm-5pm | X | X | X | ||||||||||
5pm-6pm | X | X | X | ||||||||||
6pm-7pm | X | X | X | ||||||||||
7pm-8pm | X | X | x | ||||||||||
8pm-9pm | X | X | |||||||||||
9pm-10pm | X | X | |||||||||||
Shift 3 | 10pm-11pm | X | X | X | X | ||||||||
11pm-12am | X | X | X | ||||||||||
12am-1am | X | X | x | ||||||||||
1am-2am | X | X | |||||||||||
2am-3am | X | X | X | ||||||||||
3am-4am | x | X | X | ||||||||||
4am-5am | X | X | X | ||||||||||
5am-6am | X | X |
- Anat, D & Einav, S. (2017). Nurses’ personal and ward accountability and missed nursing care: A cross-sectional study. International Journal of Nursing Studies, 75, 163-171
- Chen, Y., Hebert, M., Hu, B & Rothberg, M. (2015). A team-based odel of primary care delivery and physician-patient interaction. The American Journal of Medicine, 128(9), 1025-1028