NR447 RN Collaborative Healthcare

Introduction

Delivery of nursing care is crucial for promoting safety and wellbeing of patients. To deliver effective nursing care services, implementation of a proper nursing care model is important. The AONE (The American Organization of Nurse Executives) has provided some assumptions for the patient care delivery, according to which “he role of nurse leaders in future patient care delivery systems will continue to require a systems approach with all disciplines involved in the process and outcome models” (Huber, 2013). According to their assumption, patient safety, quality outcomes will improve through the implementation of a proper nursing care delivery system, which would respond to the public and health care demands. There are several nursing care models, some of which has historical perspective, whereas some of which are newly embedded in the health care framework. In the current case study context, the ‘Synergy Model for patient care’ has been implemented’. This assignment would focus on reviewing scholarly resources related to the above mentioned nursing care model along with another care delivery model. In addition, the implementation of the current and another recommended model would be discussed.

Review of resources related to Synergy Model for patient care

The Synergy model for patient care has been developed by the American Association of Critical care Nursing (AACN), but the model is not only applicable in the critical care unit, rather it can be implemented all the nursing units. This model focuses upon recognizing the need for matching the nurse’s competence with the patient’s needs, clinical signs as well as the clinical needs. The model also integrates the patient’s characteristics. The key purpose of this model is to give a theoretical framework for the certified practice. This model is used in various contexts like building nursing productivity measures, staff development and care of patients with acute coronary syndromes. The models include 8 characteristics of patients, i.e. resiliency, stability, vulnerability, complexity, resource availability, participation in decision making and predictability and participation in care. The model also include 8 characteristics of nurses, which include clinical judgment, caring practices, advocacy and moral agency, systems thinking, collaboration, facilitation of learning, response to diversity and clinical inquiry. Finally, the model includes three levels of outcomes, the first set of outcome is from patient, the second one is derived from nurse and the third set of outcomes is derived from the system. In the article by Swickard et al., (2014) this model has been used for assisting nurses to make proper decision and care during patient transfer between hospitals. The model successfully provided the theoretical backing for guiding the decision related to the care required for completing interfacility transfers in effective and safe way.      

In another literature provided by Hardin and Hussey (2003) the AACN Synergy Model for patient care has been implemented in a critical care framework, here the situation is management of patients with chronic heart failure (CHF). The Synergy model is providing the framework to the nurses for managing complex clients, who are experiencing acute exasperation of their illness. The model also helped the nurses to reduce the trajectory of the illness. In this article, authors discussed the characteristics of a patient visiting a local clinic and the way this model helped in aligning the patient’s characteristics with the advanced practice nurse or clinical nurse specialist. In this article the case study of a 82 years old woman Sophie has been focused, her characteristics has been aligned with the 8 nursing characteristics needed for delivering effective critical care services; based on these characteristics of Sophie and nurses, the competencies needed by Sophie’s nurse has been identified here. Finally, the outcomes were measured on the basis of three levels of Synergy model’s outcome levels. The author concluded that the model is suitable to be implemented to a variety of settings. Additionally, the in an ambulatory setting, use of Synergy model links to flexibility of the model.

Review of resources related to Interprofessional practice model

Patient navigation is a care delivery model focusing on quality improvement through the identification of importance of meeting the interprofessional competencies by health professionals, while emphasizing the need for working inter-professional teams “to cooperate, collaborate, communicate, and integrate care in teams to ensure that care is continuous and reliable”. This model helps to address health care needs in improved way with increased complex patient care needs, thereby using a mix of expertise and knowledge required for meeting expected patient outcomes. This approach has been addressed in the article by Légaré et al., (2011). The article reviewed the interprofessional shared decision making model (IP-SDM). This model includes three levels, the individual level (micro) and two health care systems (meso and macro). At the individual level, informed value based decision making is go through the collection of data from the patient, whereas the at the meso level team members’ professional role and decisions are acknowledged; on the other hand, at the macro level, influence of the organizational systems, i.e. policies, social aspects and organizational factors are considered. As a result, the model can integrate care in teams for ensuring continuous and reliable care provision.

In the article provided by Légaré et al., (2011) the authors addressed the development of an interprofessional approach of shared decision making (IP-SDM) in primary care. The validity of the model with stakeholders has also been assessed. 15 individual and 7 group interviews of 79 stakeholders revealed that merging micro, meso and macro levels in one figure, placing patient at the centre, identifying the effect of environment and emotion, clarifying outcomes with the patient’s status, highlighting the concept of time and family are possible changes for improving the model’s efficiency. On the other hand, time constraints, imbalance of power within health professionals, insufficient resources are the key barriers of implementation. On the other hand, Facilitators were training and education, motivation, mutual knowledge and understanding of individual role in the team.  

Observation of current nursing model implementation

In current context, Synergistic model for patient care has been implemented. However, several students and faculties are unable to understand the model, its importance in health care context and some of them are not willing to enhance their burden, as they have limited time and orientation. The shared governance is not involving the nurse managers directly. A lack of collaboration has been observed, for instance, if patient outcome is not met, only the nurse is being responsible (Finkelman, 2015). The decentralized process of decision making is one of the key issues. Staffs are unable to follow the principles of shared governance. As a result, they are unable to meet the goals of the program.

Recommendation

To improve the current situation and manage intra and inter team conflicts, interprofessional practice model can be implemented. This model will help to address decisions of each level, i.e. macro, meso and micro separately and merge the key ideas regarding the patient care, which is being put at the centre of the model. As a result, the shared governance would be easier. The entire process would be devised in a collaborative pattern with a transparent two-way communication, as a result the staffs would be able to understand the purpose of the model implementation, no single staff would be responsible for a fault in the care delivery system, thereby making all the staffs alert about their mistakes (Fawcett & Desanto-Madeya, 2012). It will in turn reduce the number of mistakes and improve the patient outcomes quality. However, communication would play a vital role in this context.

Conclusion

In conclusion, it can be interpreted that this assignment helped in understanding the role and purpose using nursing care model as well as where these models needed to be used. In addition, the importance of assessing the suitability of the model according to the health care context has also been understood.

Reference List

Fawcett, J., & Desanto-Madeya, S. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. FA Davis.

Finkelman, A. (2015). Leadership and management for nurses: Core competencies for quality care. Pearson.

Hardin, S., & Hussey, L. (2003). AACN synergy model for patient care case study of a CHF patient. Critical care nurse, 23(1), 73-76.

Huber, D. (2013). Leadership and nursing care management. Elsevier Health Sciences.

Légaré, F., Stacey, D., Gagnon, S., Dunn, S., Pluye, P., Frosch, D., … & Graham, I. D. (2011). Validating a conceptual model for an inter?professional approach to shared decision making: a mixed methods study. Journal of evaluation in clinical practice, 17(4), 554-564.

Légaré, F., Stacey, D., Pouliot, S., Gauvin, F. P., Desroches, S., Kryworuchko, J., … & Harrison, M. B. (2011). Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model. Journal of interprofessional care, 25(1), 18-25.

Swickard, S., Swickard, W., Reimer, A., Lindell, D., & Winkelman, C. (2014). Adaptation of the AACN Synergy Model for Patient Care to critical care transport. Critical care nurse, 34(1), 16-28.