CHAPTER 14.docx

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coordinates, monitors, and

CHAPTER 14

evaluates options and services

ORGANIZING PATIENT CARE •

to meet an individual5s health needs through communication

 The fve most well known means means

and availale resource to

o organizing care or patient

promote uality, cost-e/ective

care delivery are total patient care, unctional nursing, team



and modular nursing, primary •

(A"A'!(!"T integrated

nursing and case management.  TOTAL  TOT AL P PA AT!"T #A$!, utilizing

utilization management and discharge planning unctions

the case method o assignment,

and may e unit ased,

is the oldest orm o patient care

assigned y patient, disease

organization and still widely •

ased or primary nurse case

used today today..  TOTAL  TOT AL P PA AT!"T #A$! "%$&"' is sometimes reerred to as

outcomes. A#%T!-#A$! #A&!



managed. 6hile the ocus historically or case management has een the

#A&! (!T)O* O+ A&&'"(!"T ecause patients were assigned

individual patient, the case manager employed in a

as cases, much like

*&!A&! (A"A'!(!"T

contemporary private-duty •





P$O'$A(& plans the care or

nursing is carried out. +%"#TO"AL "%$&"'

populations or groups o

organization reuires the

patients with the same chronic

completion o specifc tasks y

illness. n POP%LATO" 1A&!* )!ALT)

di/erent nursing personnel.  T!A( O$ (O*%LA$ "%$&"'



#A$!, the ocus is on 7covered

organization uses a leader who

lives7 or population o patients,

coordinates team memers in

rather than on the individual

the care o a group o patients. P$(A$0 P$(A$ 0 #A$! "%$&"' also

patient. *++!$!"TAT!* *++!$!"TA T!* "%$&"'



known as $!LATO"&)P-1A&!*

P$A#T#! delineates di/erent

"%$&"' is organized so that

roles or nurses ased on their

the patient is at the center o

skill, knowledge, educational

the structure2 one nurse has 34hour responsiility or the •

nursing care plan. #A&! (A"A'!(!"T is a collaorative process that assesses, plans, implements,



level and motivation.  The two asic di/erentiated di/erentiated practice models are !*%#ATO"AL (O*!L- role di/erentiation ased on type o di/erentiation educational preparation

 



8A"*,1&", and (&"9 and

skills necessary, employee

#O(P!T"!#0 (O*!L- role

evaluation, and communication

di/erentiation di/erentiatio n ased on

patterns are oten a/ected y

individual nurse skill level,

work redesign.

e:pertise, e:perience, etc.  The care (AP 8(%LT*&#PL"A$0 A#TO" PLA"9 is a comination o a critical path and a nursing care plan, e:cept that it shows times when nursing interventions should occur as well as



variances. A new role sometimes termed #L"#AL "%$&!-L!A*!$, an e:perienced e:perience d nurse possessing a accalaureate or higher degree will acilitate care or patients in



the uture. *elivery system may have elements o the various designs present in the system in any



organization. !ach unit5s care delivery structure should acilitate meeting the goals o the organization, e cost-e/ective, satisy the patient, provide role satisaction to nurses, allow implementation o the nursing process, and provide or adeuate communication



among health care providers. 6hen work is redesigned, it reuently has personal conseuences or employees that must e considered. &ocial interactions, the degree o autonomy, the ailities and

 

CHAPTER 15



$!#$%T(!"T is the process o actively seeking out or

EMPLOYEE, RECRUITMENT,

attracting applicants or e:isting

SELECTION, PLACEMENT, PLACEMENT, AND

positions, and it should e an

INDOCTRINATION

ongoing process. &uccessully $!#$%T"' and

• •

&TA++"' &T A++"' is the third phase o the management process. n

adeuate workorce depends on many variales, including

sta;ng, the leader leader-manager -manager

fnancial resources, and

recruits, selects, places, and

adeuate nursing pool,

indoctrinates personnel to

competitive salaries, the

accomplish the goals o the

organization5s reputation, the

organization. t is and especially

location5s desiraility, and the

important phase o the

status o the national and local

management process in health

economy. !/ective recruiting methods

care organizations ecause such



include advertisements, career





organizations are usually laor intensive.  The frst step in sta;ng process process

days, literature and the inormal use o memers o the

is to determine the type and

organization as e:amples o

numer o personnel needed. A numer o actors have

satisfes employees. An "T!$@!6 may e defned



contriuted to a severe nursing

as veral interaction etween

shortage, particularly in acute

individuals or a particular

care hospitals, in the early 3<st century. These actors include a



interview is su?ectivity.

nationwide downsizing o hospitals in the <==>s, the aging



o the nursing workorce,

these are <.9 prepare or the

proessional nursing services,

interview, 3.9 use a team

and inadeuate enrollm enrollment ent in

approach and lastly, B.9 develop

nursing programs o study.  The current current shortage is caused

a structures interview ormat or

y oth inadeuate short-term and long-term supply o human resources resour ces as well as a pro?ected long-term rise in demand or nursing services.

nterview research helped managers to develop strategies or overcoming its limitations

accelerating demand or



purpose.  The ma?or deect o the



each ?o classifcation. *espite their limitations, interviews are widely widely used as a method o selecting employees or hire.

 







 The interview should meet meet the



goals o oth the applicant and

employees on units,

the manager. (anagers must e skilled in

departments, and shits where

planning, conducting and •

succeeding. "*O#T$"ATO" "*O#T$"A TO" consists o



induction, orientation, and socialization o employees. "*%#TO", the frst phase o

controlling interviews. *ue to numerous ederal acts

they have the est chance o

that protect the rights o ?o seekers, managers must e



cognizant o the legal

indoctrination, takes place ater a ter

constraints on interviews. &!L!#TO" should e ased on

the employee has een selected

the reuirements reuirements necessary or

role. O$!"TATO" provides the

the ?o2 these criteria should e



(anagers should place new

ut eore perorming the ?o •

developed eore eginning the

employees with more specifc

selection process. (anagers should seek to

inormation or the position. A well-prepared and e:ecuted



proactively recruit and hire sta/

orientation program educates

that represents age, gender,

the new employee aout the

cultural, ethnic, and language

desired ehaviors and e:pected

diversity in response to the

goals o the organization and

rapidly increasing diversity o

actively involves the new

the communities that they

employee5s immediate

serve.

supervisor.

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