Healthcare Delivery Model Redesign : Effects On Licensed Practical Nurse Professional Practice

A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.

According to Canadian Nurses Association(2009), human health resources have stated that by the end of 2011 Canada will experience shortage of 78 000 registered Nurses (RN) and shortage of 113 000 nurses by the end of 2016. Globally there will be shortage of 4.3 million health care workers. It was also shown that approximately 38% of new graduate nurses leave their workforce within the first year of employment (Lavoie-Tremblay, Wright, Desforges, Gelinas, Drevniok & Marchionni, 2008). According to registered Nurses Association of Ontario (2011), full time positions of RN dropped to 57.9 % in 2010 from 58.9% in 2009. With the current trend it is expected that the Canadian Nursing shortage will increase significantly. In

In her charge nurse role, Ms. Cetiner evaluates the daily activities of the unit and delegates care appropriately while promoting autonomy of others. She has the skill to make independent and interdependent decisions regarding patient care, staffing and unit issues. She communicates and collaborates with the interdisciplinary care team for seamless, patient-driven

The Saskatchewan Nursing Advanced Practice (SNAP) model is the framework that developed by the Master of Nursing –Collaborative Nurse Practitioner Program (CNPP) at the University of Regina and Saskatchewan Polytechnic in order to guide the successful implementation of the NP role for advanced nursing practice (SPUR, 2015). This paper compares and contrasts the registered nurses and nurse practitioners' roles to the SNAP model. The purpose of the paper is to analyze the characteristics, responsibilities, and legal legislatives for advanced practice roles.

Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that

In the healthcare facility there are many things that can benefit from change. Bedside rounding with the inclusion of the entire care team would be a beneficial change to any healthcare facility. By doing bedside rounding it promotes patient and family involvement in the exchange of information and planning of their care. This also allows for the interdisciplinary team to be completely involved rather than picking up bits and pieces of information throughout the day from multiple different people. This is also a great opportunity for the patient and their family to ask questions with the entire care team available for answers.

According to Shellebarger & Edwards (2012), Nurse Educators help shape the future of nursing by educating future novice nurses. Nurse Educators have a core curriculum to follow to ensure lifelong learning in their role. They help shape critical thinking skills in our future nurses by giving them the knowledge needed to think critically. “ Evidence has found that hospital based nurse educators influence safe patient outcome through contemporary evidence based teaching and their contribution of policy development supports safe practice” (Sayers,2012, p. 45). Nurse Administrators take on the role of patient advocates, by ensuring that patients are receiving the highest level of care (Hamic, Hanson, Tracy, & O’Grady, 2014). Nurse Administrators are an important part of management of nurses , they help develop policies and procedures and are change agents in their fields. The Nurse Educator and the Nurse Administrator should be

Accessibility and quality are being threatened due to cutbacks coupled with a lack of funding. There is a consensus now between medical professionals, the public, and the government that the health care system is deteriorating. It is failing to provide the quality of care promised in the CHA and prided by so many Canadians.

The role of a physician assistant was created specifically to help adjust for the shortages of physicians. Unfortunately, these shortages are occurring in underserved communities that need readily available healthcare facilities and employees. Physician assistants, are trained to be able to handle a wide variety of health disease, and with a background in public health physician assistants are able to extend the “one provider, one patient” mentality and focus on the community as a whole. PAs not only treat disease, but they also promote health, decreasing healthcare demand through preventive care. For example, the U.S. Department of Health and Human Services, has four foundational health principles that align with the type of care that PAs

Clinical Nurse Specialists (CNSs) and Nurse Practitioners (NPs) are both considered advanced practice nurses (APNs) in Canada (Donald et al., 2010). Although these roles have existed in Canada for decades (Canadian Nurses Association, 2008), confusion still remains about the titles and exact roles that these professionals play (Donald et al., 2010). This paper will use the Saskatchewan Nursing Advanced Practice model as a framework to highlight the similarities and differences between both types of advanced practice nurse. The scope of practice, registration, education, practice settings, and effectiveness of CNSs and NPs will be examined. Although their roles overlap, CNSs and NPs have both been shown to be important members of the health care team (DiCenso & Bryant-Lukosius, 2010). Research has shown that adding CNSs and NPs to our health care system can increase patient satisfaction, decrease wait times, and decrease readmissions (DiCenso & Bryant-Lukosius, 2010). Increased public and health care professional awareness is needed to have these roles fully incorporated into our current health care system (DiCenso & Bryant-Lukosius, 2010).

214) “The ACA and the need for APRNs, nurse faculty, and nurse researchers would have increased dramatically under any scenario.” (L R Cronenwett [RWJF Iniative on the Future of Nursing], 2010, table 1). “Not only must schools of nursing build their capacity to prepare more students. Nursing need to focus on fundamental improvements in the delivery of nursing care to improve patient safety and quality is key.” (IOM, 2010, p. 208)

This paper seeks to expand upon the 2010 Institute of Medicine’s report on the future of nursing, leading change, advancing health and illustrating its impact on nursing education, practice and leadership. There is an ongoing transformation in the healthcare system necessitated by the need to achieve a patient centered care in the community, public, and primary care settings in contrast to previous times. Nurses occupying vital roles in the healthcare system, need improvements in the areas mentioned above to

Nursing practice is also one of the key messages addressed in the IOM report. The report suggests that “nurses should practice to full extent of their education and training”. Furthermore, “nurses should be full partners with physicians and other health professionals, in redesigning health care in the United States. This report has a great impact on nursing practice. The IOM report suggests that greater focus on managing the transition from nursing to practice. It recommends that regulatory reforms must be made to allow nurses to expand their scope of practice (IOM report, 2010).

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

Ongoing development and changes in healthcare delivery enable nurses to maintain standards of nursing and develop their competence and performance. Through this the patients well-being is maintained, respecting them through accessing up to date knowledge and skills that are essential in an ever changing environment.