Health Care Delivery and Nursing Practice

Health care delivery and
nursing practice
ILOS
On completion of this section, the

learner will be able to:
1. Define health and wellness.
2. Describe factors causing significant
changes in the health care delivery
system and their impact on the health
care field and the nursing profession.
Cont…
3. Describe the practitioner,

leadership, and research roles of the
nurse.
4. Describe nursing care delivery
models.
5. Discuss expanded nursing roles.
Cont…
HEALTH
Definition:
It is state of complete physical,
mental, and social well-being
and not merely the absence of
disease and infirmity.
Cont…
 Byviewing health and illness on

a continuum, it is possible to
consider a person as having
neither complete health nor
complete illness. Instead, a
person’s state of health is ever-
changing and has the potential
Cont…
to range from high-level

wellness to extremely poor
health and imminent death.
 Themodel of the health–illness
continuum makes it possible to
view a person as
simultaneously possessing
Cont…
degrees of both health and

illness.
WELLNESS
 Wellness has been defined as being

equivalent to health.
 Wellness includes a conscious and
deliberate approach to an
advanced state of physical,
psychological, and spiritual health
and is a dynamic, fluctuating state
of being.
Cont…
 Scientistscontended that
wellness is indicated by the
capacity of the person to
perform to the best of his or
her ability, the ability to adjust
and adapt to varying situations,
Cont…
a reported feeling of well-being,

and a feeling that “everything is
together” and harmonious. With
this in mind, it becomes evident
that the goal of health care
providers is to promote positive
changes that are directed toward
health and well-being.
Cont…
 The fact that the sense of

wellness has a subjective
aspect emphasizes the
importance of recognizing and
responding to patient
individuality and diversity in
health care and nursing.
Influences on Health Care
Delivery
 Thehealth care delivery
system is rapidly changing as
the population and its health
care needs and expectations
change. The shifting
demographics of the
population, the increase in
chronic illnesses and disability,
Cont…
the greater emphasis on

economics, and technological
advances have resulted in
changing emphases in health
care delivery and in nursing.
Cont…
Population demographics:
 Population expansion is
attributed in part to improved
public health services and
improved nutrition. Not only is
the population increasing, but
the composition of the
population is also changing.
Cont…
Aging Population:
 Many elderly people suffer
from multiple chronic
conditions that are
exacerbated by acute episodes.
Elderly women, whose
conditions are frequently
Cont…
 underdiagnosed and
undertreated, are of particular
concern. There are
approximately three women for
every two men in the older
population , and elderly women
are expected to continue
Cont…
to outnumber elderly men.

 Thehealth care needs of older
adults are complex and
demand significant
investments, both professional
and financial, by the health
care industry.
Cont…
Cultural Diversity:
 Anappreciation for the diverse
characteristics and needs of
individuals from varied ethnic
and cultural backgrounds is
important in health care and
nursing.
Cont…
 Asthe cultural composition of

the population changes, it
becomes increasingly important
to address cultural
considerations in the delivery
of health care.
Cont…
 Patientsfrom diverse
sociocultural groups bring to
the health care setting
different health care beliefs,
values, and practices, as well
as different risk factors for
some disease conditions and
unique reactions to treatment.
Cont…
 These factors significantly

affect the way an individual
responds to health care
problems or illness, to those
who provide the care, and to
the care itself. Unless these
factors are understood and
respected by health care
Cont…
providers, the care delivered

may be ineffective and health
care outcomes may be negatively
affected.
Cont…
Changing patterns of disease:

 Anincreasing number of
infectious agents are becoming
resistant to antibiotic therapy
as a result of widespread
inappropriate use
Cont…
 ofantibiotics. Therefore,
conditions that were once
easily treated have become
complex and more life-
threatening than ever before.
Cont…
 Aschronic conditions increase,

health care broadens from a
focus on cure and eradication
of disease to include the
prevention or rapid treatment
of exacerbations of chronic
conditions.
Cont…
 Nursing,which always
encouraged patients to take
control of their conditions,
plays a prominent role in the
current focus on management
of chronic illness and disability.
Cont…
Advances in technology and

genetics:
 Advances in technology and
genetics have occurred with
greater frequency during the
past several decades than in all
other periods of civilization.
Cont…
 Sophisticatedtechniques and
devices have revolutionized
surgery and diagnostic testing,
making it possible to perform
many procedures and tests on
an outpatient basis.
Cont…
Economic changes:
 The philosophy that
comprehensive, quality health
care should be provided for all
citizens prompted
governmental concern about
spiraling health care costs
Cont…
and wide variations in charges

among providers. These concerns
led to the Medicare prospective
payment system (PPS) and the
use of diagnosis-related groups
(DRGs).
Cont…
 Theimportance of an effective
discharge planning program,
along with utilization review
and a quality improvement
program, is unquestionable.
Nurses in acute care settings
must assume responsibility with
other health care team
Cont…
members for maintaining quality

care while facing pressures to
discharge patients and decrease
staffing costs. These nurses must
also work with nurses in
community settings to ensure
continuity of care.
Cont…
Demand for quality care:

 The general public has become
increasingly interested in and
knowledgeable about health
care and health promotion.
This awareness has been
stimulated by television,
Cont…
newspapers, magazines, and

other communications media and
by political debate.
 Thepublic has become more
health conscious and has in
general begun to subscribe
strongly to the belief that
Cont…
health and quality health care

constitute a basic right, rather than
a privilege for a chosen few.
Cont…
Quality Improvement and

Evidence-Based Practice:
 As
health care agencies
continue to implement
Continuous quality
improvement (CQI), nurses
have many opportunities to be
Cont…
involved in quality
improvement. One such
opportunity is through
facilitation of evidence-based
practice. Evidence-based
practice—identifying and
evaluating current literature and
research
Cont…
and incorporating the findings

into care guidelines—has been
designated as a means of
ensuring quality care.
Cont…
 Evidence-based practice
includes the use of outcome
assessment and standardized
plans of care such as clinical
guidelines, clinical pathways,
or algorithms. Many of these
measures are being
implemented
Cont…
by nurses, particularly by nurse

managers and advanced practice
nurses.
 Nurses directly involved in the
delivery of care are engaged in
analyzing current data and
refining the processes used in
CQI.
Cont…
 Theirknowledge of the processes

and conditions that affect patient
care is critical in designing
changes to improve the quality of
the care provided.
Cont…
Clinical Pathways and Care

Mapping:
 Many hospitals, managed care
facilities, and home health
services nationwide use clinical
pathways or care mapping to
coordinate care for a caseload
of patients.
Cont…
 Clinicalpathways have been

developed for certain DRGs
(eg, open heart surgery,
pneumonia with comorbidity,
fractured hip), for high-risk
patients (eg, those receiving
chemotherapy),
Cont…
and for patients with certain

common health problems (eg,
diabetes, chronic pain). Using
current literature and expertise,
pathways identify best care.
Cont…
 The pathway indicates key

events, such as diagnostic
tests, treatments, activities,
medications, consultation, and
education, that must occur
within specified times for the
patient to achieve the desired
and timely outcomes.
Roles of the Nurse
 Nursingfocuses on a broad
array of phenomena. There are
three major roles assumed by
the nurse when caring for
patients. These roles are often
used in concert with one
another to provide
comprehensive care.
Cont…
 The professional nurse in

institutional, community-based
or public health, and home
care settings has three major
roles: the practitioner role, the
leadership role and the
research role.
Cont…
 Although each role carries

specific responsibilities, these
roles relate to one another and
are found in all nursing
positions.
Cont…
 These roles are designed to

meet the immediate and future
health care and nursing needs
of consumers who are the
recipients of nursing care.
Cont…
Practitioner role:
 It involves those actions that
the nurse takes when assuming
responsibility for meeting the
health care and nursing needs
of individual patients, their
families, and significant others.
Cont…
Leadership role:
It involves those actions the
nurse executes when assuming
responsibility for the actions of
others that are directed toward
determining and achieving
patient care goals.
Cont…
 Nursingleadership is a process
involving four components:
decision making, relating,
influencing, and facilitating.
Each of these components
promotes change and the
ultimate outcome of goal
achievement.
Cont…
Research role:
 The research role of the nurse
was traditionally viewed as one
carried out only by
academicians, nurse scientists,
and graduate nursing students.
Today, participation
Cont…
in the research process is also

considered to be a responsibility
of nurses in clinical practice.
Models of Nursing Care
Delivery
 Nursingcare can be carried out
through a variety of
organizational methods. The
model of nursing care used
varies greatly from one facility
to another and from one set of
patient circumstances to
another.
Cont…
 Team nursing
 Primary nursing
 Community-based nursing and
community health– public
health nursing.
Expanded Nursing Roles
 Professionalnursing is adapting
to meet changing health needs
and expectations. One such
adaptation is through the
expanded role of the nurse,
which has developed in
response to the need
Cont…
to improve the distribution of

health care services and to
decrease the cost of health care.

Health Care Delivery and Nursing Practice

Uploaded by

Copyright:

Available Formats

Health Care Delivery and Nursing Practice

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Health Care Delivery and Nursing Practice

Uploaded by

Copyright:

Available Formats

Health care delivery and

On completion of this section, the

3. Describe the practitioner,

 Byviewing health and illness on

to range from high-level

degrees of both health and

 Wellness has been defined as being

a reported feeling of well-being,

 The fact that the sense of

the greater emphasis on

to outnumber elderly men.

 Asthe cultural composition of

 These factors significantly

providers, the care delivered

Changing patterns of disease:

 Aschronic conditions increase,

Advances in technology and

and wide variations in charges

members for maintaining quality

Demand for quality care:

newspapers, magazines, and

health and quality health care

Quality Improvement and

and incorporating the findings

by nurses, particularly by nurse

 Theirknowledge of the processes

Clinical Pathways and Care

 Clinicalpathways have been

and for patients with certain

 The pathway indicates key

 The professional nurse in

 Although each role carries

 These roles are designed to

in the research process is also

to improve the distribution of

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.