Question

Describe an approach to family nursing and delivery of care . Provide Recommendations for improving the health of families in a primary care setting?

Answer 1

The practice of professional nursing includes independent nursing functions, interdependent functions and delegated medical functions which may be performed in collaboration with other health team members or may be delegated by the professional nurse to other nursing personnel.

Primary Nursing is the care delivery system that best supports professional nursing practice. The focus is on the nurse-patient relationship, strengthens accountability for care, and facilitates patient and family involvement in the planning of care. Our care delivery system allows the Primary Nurse to establish a therapeutic relationship with each patient and family. High quality nursing care that is individualized to a particular patient and administered compassionately, competently, and with continuity is achieved through Primary Nursing.

Nursing care models provide the infrastructure for organizing and delivering care to patients and families. Over the decades, the primary nursing model has gained increasing prominence. Nursing care models provide the infrastructure for organizing and delivering care to patients and families. Nursing care is based on the changing needs and situation of each individual patient. The focus of adult patient care has shifted increasingly from the individual patient to also involving their family members. Patient care requires increased planning, interaction and multi professional collaboration. The model of care delivery also affects nursing staff numbers, the flexible use of staff resources and therefore the organization’s costs. Over the decades, the nursing models applied have ranged from Nightingale’s case method to the currently favoured primary nursing and relationship-based care models. Under the primary nursing model, patient care is the responsibility of a named nurse for the duration of the patient’s hospital stay. This means that the planning and implementation of care primarily takes place between the patient and named nurse. The same nurse assumes overall responsibility for patient care and is answerable to her patient, the patient’s family and to her colleagues. However, the named nurse does not work alone but works closely with colleagues and other professional groups. The primary nurse delegates the responsibility of the patient’s care to associate nurses when off duty. Wards organized on the principles of primary nursing have a flat organizational structure because patient care is equally shared between nurses. The primary nursing model is widely implemented since it has been considered to be an ideal way of organizing nursing care delivery. It is grounded in a patient-centred approach and it supports nurses’ professionalism, autonomy, broad job descriptions and independent decision-making. The key is that nurses are driven to address patient needs in their work, rather than perform specific job tasks under given functional structures.

Primary care is the cornerstone of health care that is effective and efficient and meets the needs of patients, families, and communities. Our primary care system currently has significant—and perhaps unprecedented—opportunities to emphasize quality improvement (QI) and practice redesign in ways that could fundamentally improve health care in the United States. To ensure these efforts are successful, there is a need to build and sustain the ability of primary care practices to engage in QI activities in a continuous and effective way.

The Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families (the Guide) is a resource to help primary care practices partner with patients and their families to improve patient safety. The Guide includes materials and resources to help primary care practices implement patient and family engagement to improve patient safety. In primary care, the relationship between the clinician and the patient is a key to high quality, safe, and effective healthcare. Patient and family engagement in primary care helps to forge trusting relationships that promote safety. Evidence-based strategies to improve patient safety by engaging patients and families are integral to enhancing your organization’s mission. The four strategies within this Guide support patient safety by engaging patients and families in closed-loop and collaborative communication within the primary care visit. Engaging patients and families in safe medicine practices is also a key feature of this Guide. Safe medicine practices begin with a complete and accurate medicine list.