Innovative Nursing Care Delivery Model Essay
Innovative Nursing Care Delivery Model Essay
A nursing care delivery system identifies how the nursing staff works, its organization, and the distribution of the duties for providing appropriate nursing care. Care delivery systems are in charge of the successful nursing care and clinical results. They provide the organization, rules, and structure that determine responsibility and control. This paper studies the newest models of nursing care delivery and discusses the role of the innovations in this sphere.
Unfortunately, health care is still expensive and inaccessible to many people all over the world, especially in undeveloped countries. Innovative Nursing Care Delivery Model Essay. Current health care system lacks the innovative business models. However, nowadays, the business models in health care gradually develop (Skolnik, 2012).
Before speaking about the innovative methods of nursing care delivery, it is important to mention the standard models and why the innovations are better and improved. The typical system for organizing nursing care is Total Patient Care. It plans, arranges, and implements all aspects of nursing care. It is autonomous, united patient care with a clear distribution of responsibilities. It combines all the aspects of nursing care delivery. However, this method is not profitable. It is costly as it needs the employment of many nurses. Innovative Nursing Care Delivery Model Essay. The second model is Functional Nursing. There must be a specialist for each assigned task. Team Nursing is the third standard model. There are several teams of nurses with the leader; each team has to provide care for the appointed group of patients. Primary Nursing is another type of care delivery that involves not only nursing, but also documentation, and so on. Primary Nursing means total and complete care. The essence of this method lies in the fact that one nurse provides full care for a small group of patients who stay in the hospital.
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One of the newest nursing models of care delivery is the so-called Partners in Caring. This model is a new way of nursing care delivery; it lies in the nurse-nurse assistant partnership. The reason for its increasing popularity is that this approach increases the retention rates of the new nurses as it is based on joint efforts. It is the goal of this program. The professional development and opportunities for new nurse graduates are also important aspects (Seifer, 2001). Innovative Nursing Care Delivery Model Essay.
The nursing partners focus on the patient. They organize different parts of complex patient care. There are three goals in the work of this method: improving the health of the patients, developing and supporting an improved system, and providing low-priced but high-quality health care. This model is a great benefit to time management. Changing the work roles and transforming communication patterns are the characteristics of this new model. The patients feel the positive results of this method as well.
It is also important to mention another innovation in the sphere of nursing care delivery – the so-called Program of All-inclusive Care for the Elderly (PACE). The principal goal of this program is the prevention of the unnecessary use of hospital and nursing home care. Every month, Medicare and Medicaid programs pay or give grants to PACE. This program helps the patients in the day centers and clinics, their homes, hospitals, and nursing homes. Patients who are unqualified for Medicaid pay on their own. The consequences of the Program of All-inclusive Care for the Elderly are quite positive. Innovative Nursing Care Delivery Model Essay. The customers are very satisfied as this innovation helps to decrease the use of institutional care; it controls the use of medical services. The great advantage is that it tries to save the costs of not only private customers but also such public organizations as Medicare and Medicaid Minnesota Department of Human Services, 2011).
In conclusion, the number of older people in the United States gradually increases, and it arouses the healthcare providers to provide high-quality care. Nowadays, it is essential for people to get sufficient but not expensive medical support. The PACE model and Partners in Caring method are comprehensive. They work without the involvement of a big staff of nurses. This system of care delivery is good not only in the aspect of the appropriate patient care, but it is also financially effective.
Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations. Innovative Nursing Care Delivery Model Essay.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.
You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Health Care Delivery Models and Nursing Practice
Student’s Name
Institution
Healthcare Delivery Models and Nursing Practice
Current healthcare law
The enactment of the Affordable Care Act (ACA) saw a significant shift in many aspects of US healthcare. Through the legislation, the country took huge steps towards improving the quality of care and controlling rising healthcare costs. According to Salmond and Echevarria (2017), the legislation sought to increase coordination of care to improve care quality and reduce costs attributed to multiple prescriptions, repeated diagnostic testing, and unnecessary hospitalizations. The authors point out that nurses are positioned to lead and be part of these changes that occur in the healthcare sector. As the sector shifts from fee-for-service, provider-based system to patient-centered care, nursing practice as well as nurse roles and responsibilities are changing to conform to the new paradigm.
Value-Based Purchasing (VBP), Pay for Performance (P4P), and Shared Savings Arrangements are some of the approaches supported by ACA (Salmond & Echevarria, 2017). The implementation of these approaches aimed to transform the country’s healthcare to one that is affordable, high-quality, and patient-centered. As informed by Salmond and Echevarria (2017), the new models focus on systems that reward providers depending on measurable quality outcomes and the experiences of patients. Therefore, nursing practice as well as roles have to change to deliver the outcomes. As pointed out by Salmond and Echevarria (2017), the changes in the healthcare sector need a new or enhanced skill set on population care and wellness. Furthermore, nursing practice must renew its focus on care coordination, quality improvement, data analytics, and patient-centered care (Salmond & Echevarria, 2017). Nurses are also expected to partner with patients and their families to understand their social environment and consequently attain patient-defined health outcomes. Innovative Nursing Care Delivery Model Essay. It is evident, therefore, that as a result of the legislation, nurses have to assume roles and responsibilities to improve care and advance the health of members of the population.
Quality Measures and Pay for Performance (P4P)
Some of the key aspects associated with the transformation in the healthcare sector are quality measures and P4P. According to Mendelson, et al. (2017), through the P4P programs, healthcare providers are provided with financial rewards or penalties depending on their performance on quality measures. The authors note that proper design and implementation of the programs would drive healthcare systems to reduce unnecessary hospitalizations as well as to improve the quality of care. However, it has not been conclusively proven that quality measures and P4P programs improve patient outcomes.
While P4P programs have been shown to improve process-of-care outcomes modestly, they have little impact on patient outcomes (Mendelson, et al., 2017). Therefore, the study, alongside many others found that P4P programs are not consistent in improving patient outcomes. In another study by Shih, Nicholas, Thumma, Birkmeyer, and Dimick (2014), it was found that financial rewards to hospitals that showed improvements did not decrease adverse outcomes. Chatterjee and Joynt (2014) found that quality measures for improving patient outcomes are not clear. Therefore, there is no conclusive evidence to show tha
Norlander, L. (Ed.). (2011). Transformational models of nursing across different care settings. Report: The future of nursing: Leading change, advancing health (Appendix G). Washington, DC: National Academy of Sciences, Institute of Medicine.
(CLICK on PDF file: TRANSFORMATIONAL NURSING MODELS)
NOTE: For this assignment, ignore curriculi/nurse education models
Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53, 94-101.
(CLICK on PDF file: NURSING PRACTICE INNOVATIONS)
Baccalaureate-prepared nurses are expected to function as managers, educators, collaborators, advocates, and leaders within a variety of settings. These articles describe a variety of innovative or “transformational” models in nurse-managed care across various care settings. Another source of ideas are the vignettes and case studies found in your textbook chapters.
For this paper, you will develop an innovative nursing care delivery model for a vulnerable population, care specialty, and setting in the United States OR a low income global country that reflects nurse managed care, collaboration, care across settings, and technology. Innovative Nursing Care Delivery Model Essay.
For your paper, it is easiest to focus on one (1) population, one (1) health issue/disease, and one (1) type of setting within a country. Be specific. If you use a low income country, name your low income country (see list in module 1) and adjust your model to the disease(s) and conditions found within that country. Consider that low income countries will not have access to the same level of facilities, technology related to diagnostics and communication, medications, and the health care professionals found in the U.S.
A vulnerable population can include low income children and/or adults; elderly; homeless; migrants; immigrants; racial & ethnic minorities, people with chronic health or terminal conditions/diseases (or any group at risk for obtaining appropriate health care).
A care specialty can include preventative care; primary care; acute care; chronic care; palliative or end-of-life care (including the targeting of any disease or condition that results in a health risk).

A setting can include rural or urban community housing and/or clinic; school; specialty unit in a hospital; emergency room; health provider office; armed services facility; rehabilitation facility; hospice facility; ambulatory health care center; client home; nursing home; prison or detention center; short term stay housing (or any setting where a vulnerable client/patient population is available for care).
a) Content of paper:
Title of Paper (top of page 2, centered) Innovative Nursing Care Delivery: [Name of Your Model]
PAPER HEADING: Introduction [Level 1] What is your model’s population, setting, care specialty, and your model’s goal(s) and/or purpose(s)? For example, are you targeting a particular group or disease/condition? Choose a name for your model and include it in your paper title.
PAPER HEADING: Description of the [Name of Your Model] [Level 2] You are welcome to use your creativity in the model–develop your own or base it on an existing model. For ideas, start with the articles found with the assignment, textbook (Global Health 101) scenarios, or do literature searches on the internet. However, be sure that the model is nurse-led or nurse-managed. Registered nurses have authority to make decisions regarding nursing diagnoses, interventions, and referrals. Registered nurse practitioners have additional authority related to medical diagnoses and interventions (prescriptions). Innovative Nursing Care Delivery Model Essay.
Be sure to include the themes crucial to meeting the challenges of the future: nurse- managed care, collaboration, continuity of care and technology in describing your model. Be aware of cost-effectiveness; you could develop the “Cadillac” of models, but no one would consider implementing it because the cost would be too high.
Nurse led and nurse managed health care. [Level 3] Were nurses instrumental in the development and implementation of your model? How is your model nurse managed? Are nurses consulted and/or make decisions re: budget, personnel, and the communication, referral, and evaluation processes?
Partnerships and collaboration. [Level 3] What partnerships and collaborations exist for your model? Are they at the professional level (i.e., social workers, nutritionists, community leaders) and/or the organizational level (home health care agencies, public health departments, hospitals)?
Continuity of care across settings. [Level 3] What happens when a patient/client moves to a different setting, i.e., home, hospital, hospice, clinic, emergency room, etc. How is communication handled so the patient/family needs are consistently met when moved across settings?

Technology. [Level 3] What technology is used? Is it low-technology (basic assessment tools, screening tests) or high-technology (i.e, patient diagnostic, monitoring, and/or data processing systems) or a combination of both?
PAPER HEADING: Development/Implementation Team for the [Name of Your Model] [Level 2] Your team is important to carry out model’s goal(s). Depending on your model and setting, your team may include other registered nurses, nurse practitioners, community workers, nurse assistants, licensed practical nurses, nutritionists, physical therapists, occupational therapists, dentists, social workers, community leaders, psychologists, clergy, administrators, informatics technicians, physicians (if physicians are part of the team, they should function as consultants, not “captain of the ship”).Innovative Nursing Care Delivery Model Essay. Include your team members and briefly discuss their functions in carrying out the model goal(s)/purposes(s). How would communication and referrals be handled? Again–think about the cost effectiveness–could ancillary staff (nurse assistants, trained community workers) be used just as effectively?
PAPER HEADING: Evaluation of [Name of Your Model]: Outcome Measurement [Level 2] After implementation of the model, what outcomes would you measure Would you look at cost comparisons and/or savings? Patient satisfaction? Staff satisfaction? Fewer ER visits and/or re-hospitalizations? Decreased incidence of a particular disease/condition? Increased number of therapies? Increased knowledge of a disease or intervention?
For outcomes, be specific on what, who, when and how. For example, if you do a survey:
What type of survey is it (i.e., satisfaction, data gathering)?
Who would you survey (i.e., staff, patients, administrators)?
When would you do the survey (i.e., time period; pre/post tests)?
How would you conduct the survey (handout, mailing, computer analysis)?
Below is an idea for a nurse-managed model. Your paper would be organized per the assignment instructions and more detailed regarding the health care delivery (nurse-led, collaboration/partnerships, continuity of care, and technology), and the functions of each of the team members, etc., but this is the start of an idea:
Let’s say you are a nurse working in community health and you are aware of three large migrant communities located in the rural areas around Homestead, Florida. The migrant workers who reside in these communities include their families–from infants to elderly. The communities are isolated and lack transportation and the ability to pay for and access local health care facilities.

You develop a model named Bus Stop for Health. You obtain funding (donor and/or grant) to refurbish a bus or utilize a refurbished bus already owned by a local health care organization. The bus will include an examination room (with assessment devices, such as BP cuffs, otoscopes, exam tables), supplies for health screenings (i.e., diabetes, cholesterol, pap smears, etc.), and two rooms for consultation.
The purpose of the bus is to provide primary health care (preventative care, such as immunizations and well child exams), monitor chronic diseases (such as hypertension and diabetes), diagnose and treat minor illnesses, and provide health-related education for this population. Innovative Nursing Care Delivery Model Essay. A referral system will be established for specialty care, such as obstetrics. An informatics technician (IT) will establish a computerized (e-tablet) system to input, store, and access data in the field. Smart phones will be used for real time communication.
After consultation with and permission from the local community leaders in the migrant communities, the bus is scheduled to drive to and spend 1-2 days/week at each migrant community. Some folding chairs and a tarp will be carried in the bus so small covered outdoor or indoor health education sessions can be provided.
Regular team members on the bus will consist of a nurse practitioner, registered nurse, and receptionist/translator. Other team members will rotate in and out of the scheduled bus times on a regular basis. For example, you could include a social worker and dentist, (describe their specific functions/purposes for this migrant population) as rotating team members. A nurse midwife could also be included in the bus rotation for managing low risk pregnancies. A consultant and referral relationship with a physician or physicians could be established for more complicated health care problems. Commonly prescribed medications can often be obtained through pharmacies at reduced costs or free from donors.
Evaluation? Some outcomes looked at could be increased immunization rates, increased knowledge related to common chronic diseases, child safety, etc. (by using pre & post tests), reduced visits to the local ERs for minor illnesses), earlier prenatal care, or other outcomes of interest. You could also use surveys to determine patient and community leader satisfaction with the model.
c) In-text citations and a reference list MUST be found in your paper. See the Nursing Student Writing Guidelines Checklist for APA formatting.
d) UPLOAD completed paper (file) into the Assignment TURNITIN folder by the due date.
e) WRITING EVALUATION: See rubric on Course Content page
Paper: Innovative Nursing Care Delivery (750 words min)
Innovative Nursing Care Model; Development/Implementation Team for Innovative Nursing Care Model; Evaluation of Model: Outcome Measurement
Critical Thinking Skills (15 pts); Content Development (15 pts); Organization. Innovative Nursing Care Delivery Model Essay.
