The use of nursing care models and theories in practice serves a unique role in transforming the day-to-day profession from systemic medical methodology to the application of nursing principles in practice. Care models provide a foundation and background to practical approaches and help to manage a wide variety of situations. The use of nursing care models is becoming more relevant in the complexities of contemporary healthcare in order to provide structure and guidance to the role of nursing. This report will introduce three distinct models which are utilized in nursing practice and contribute to achieving improved quality outcomes.
Care Model in Practice
The nursing care model that was demonstrated in practice was the interdisciplinary care model. It was observed in an urgent care center during the author’s time of employment there. Interdisciplinary care was evident as staff worked together to ensure patient needs and common objectives were met. This began with efficient communication that confirmed all staff members were aware of ongoing issues and potential concerns for the treatment of certain patients.
Interdisciplinary care was noticed as staff members were delegated to patients in accordance with their skill and expertise. Furthermore, teams engaged in active discussion and problem-solving inpatient treatments. There was a well-integrated and coordinated care plan that included nurses and physicians who would provide treatment for the patient without a delay in the provision of care. Also, evidence of interdisciplinary care, there was clear leadership from nurse managers that promoted an atmosphere of trust and communication.
The article by Ritchie et al. (2016) discusses the implementation of interdisciplinary team care in a program aimed to provide outpatient support for high-risk adult patients. In-home assessments were conducted by a nurse practitioner and social worker who then met with a larger team to create a plan of treatment for the patient, encompassing recommendations from the primary care team and standardized care protocols.
The program demonstrated significant success as acute care utilization declined and improvements were present in self-rated health. This became viable as the interdisciplinary team could make adaptations based on local needs. The interdisciplinary team was able to incorporate a wider range of real-world insights pertaining to expertise and individual patient needs. Interdisciplinary team care is becoming more prevalent as a model, having the support of policies and leaders. The model is able to challenge traditional boundaries and practices in nursing care in order to provide more effective treatments and improved outcomes.
The article by Adogwa et al. (2018) explores the use of interdisciplinary teams for the management of elderly patients receiving spine surgery. The surgery is complex, requiring long rehabilitation and oversight from neurosurgical professionals, commonly in an ICU. The interdisciplinary team approach that introduced co-management between geriatrics and neurosurgery led to the reduced use of ICU resources as well as improved long and short-term health outcomes. In this case, the interdisciplinary team demonstrated that health professionals with different expertise but working together with a patient where their backgrounds and skills complement each other can have successful outcomes. Such collaboration thrives on shared decision-making and value-added from each staff member that participates in the treatment.
Self-Care Deficit Model
The self-care deficit model was developed by Dorothea Orem. It states that an individual performs self-care to maintain life and healthy function only after acquiring an agency for self-care. Self-care agency is influenced by basic conditioning factors such as age, gender, environment, socio-cultural aspects, health state, patterns of living, and availability of resources. These factors influence or limit an individual’s ability to participate in self-care activities or behaviors. The article by Wong, Ip, Choi, and Lam (2015) attempts to determine how basic conditioning factors influence dysmenorrhea in adolescent girls.
The study determined that specific factors such as age, familial education levels, and menstrual education all had an influence on self-care behaviors in cases of dysmenorrhea. In clinical practice, this is relevant since knowledge of factors that influence self-care behaviors for a certain disease, especially for vulnerable populations, can help develop effective interventions to mitigate this. If self-care agency is strengthened through intervention, then an individual would be able to self-manage their condition appropriately.
The study by Sharifi, Majlessi, Montazeri, Shojaeizadeh, and Sadeghi (2017) examined the use of the Orem model in the context of preventive self-care for female osteoporosis, which is a prevalent health condition globally. The intervention consisted of providing educational sessions about preventive self-care. The results found that self-care agency, self-care demand, and self-care operation structures were higher in the intervention group. The study demonstrates that an intervention that inherently addresses the self-care agency and demand of the patient will have beneficial outcomes in developing health behaviors to prevent serious disease.
Improving Quality of Care
A model that is significantly beneficial for the improvement of the quality of care in the healthcare sector is the lean management model. Lean management consists of operating philosophies and mechanisms that attempt to derive the maximum value out of the system for patients through the reduction of waste. The model highlights the importance of customer demands, employee participation, and a process of continuous improvement.
Lean management radically and fundamentally modifies an organization’s values and operations by transforming behavior and culture over a period of time. The model has had its origins in the industrial sector but has been actively adopted in healthcare due to increased demands and rising costs. The lean model is used in combination with strategic management and policy deployment. The primary premise and purpose of the lean model are to focus on the efficiency of resource use and distribution to create value for a customer in every step of the treatment process (Lawal et al., 2014). Therefore, the model is pragmatic and comprehensive, addressing concepts such as business strategy, sustainability, and systemic changes.
Nursing care models have far-reaching effects on nursing practice and principles that guide it. The interdisciplinary model outlines how staff members from seemingly different nursing specializations can complement each other and work together to achieve improved patient outcomes by providing input based on expertise. Furthermore, this activity demonstrates that models are influential in the development of interventions, primarily those that help promote self-care behaviors.
Orem’s model of self-care deficit outlines that self-care agency and behavior are dependent on basic conditioning factors that should be targeted during interventions. Finally, in order to improve the quality of healthcare delivery, the lean management model can be implemented to reduce waste and ensure that optimal value of care is provided to a patient. In conclusion, nursing care models are necessary for organizations to adapt to change and serve the varying needs of diverse patient populations. From a practical and organizational perspective, theories are critical for the effective delivery of care.
Adogwa, O., Elsamadicy, A. A., Sergesketter, A. R., Ongele, M., Vuong, V., Khalid, S.,… Bagley, C. A. (2018). Interdisciplinary care model independently decreases use of critical care services after corrective surgery for adult degenerative scoliosis. World Neurosurgery, 111, e845-e849. Web.
Lawal, A. K., Rotter, T., Kinsman, L., Sari, N., Harrison, L., Jeffery, C.,… Flynn, R. (2014). Lean management in health care: Definition, concepts, methodology and effects reported (systematic review protocol). Systematic Reviews, 3(1). Web.
Ritchie, C., Andersen, R., Eng, J., Garrigues, S. K., Intinarelli, G., Kao, H.,… Barnes, D. E. (2016). Implementation of an interdisciplinary, team-based complex care support health care model at an academic medical center: Impact on health care utilization and quality of life. Plos One, 11(2). Web.
Sharifi, N., Majlessi, F., Montazeri, A., Shojaeizadeh, D., & Sadeghi, R. (2017). Prevention of osteoporosis in female students based on the Orem self-care model. Electronic Physiciane, 9(10), 5465-5471. Web.
Wong, C. L., Ip, W. Y., Choi, K. C., & Lam, L. W. (2015). Examining self-care behaviors and their associated factors among adolescent girls with dysmenorrhea: An application of Orem’s self-care deficit nursing theory. Journal of Nursing Scholarship, 47(3), 219-227. Web.