At the end of this presentation, the audience

will be able to:

 Define Nursing Care Delivery System.
 Understand the types of nursing care delivery
system.
 Differentiate between each one.
 Understand advantages and disadvantages of
each one.

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 Nursing leadership is a combination of
personality traits, administrative skills and talents
which enable a nurse to excel in the profession.

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 A nurse leader can be anyone who uses interpersonal
skills to influence others to accomplish specific goals.
 The leader has the capacity to earn and hold trust and can
inspire others to commit to the goals of the health care
organization.
 The leader facilitates group cohesion and performance.
 The authority of the leader is informal, meaning that the
leader has no specific managerial role; however, the
leader's ideas and actions influence the "efficiency of
work flow”.

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 A nursing care delivery system defines how work
is organized, how nursing staff are deployed, and
who will provide nursing care.
 Delivery systems identify who has the
accountability for nursing care and clinical
outcomes.
 Delivery systems provide the organization, rules
and structure that define responsibility and
accountability.

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 Total patient care (Case method)
 Functional Nursing
 Team Nursing
 Primary Nursing

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 The oldest system for organizing patient care.
 Commonly used in intensive care unit (ICU) and post
anesthetic care unit (PACU).
 In Total Primary Care a registered nurse is responsible
for planning, organizing, and performing all aspects of
nursing care.
 Total Primary Care provides a high degree of
autonomy, clear lines of responsibility and
accountability, holistic patient care, un fragmented
care.

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Advantages: 1. Registered nurses were self-employed
2. Patient needs were quickly met
3. Close relationship between the
Registered Nurse and the patient
Disadvantages: Needs high number of Registered Nurses.

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 Specific tasks are assigned to nurses.
 The nurse assigned to a specific task has to carry it out
at all patients.
 Registered nurses (RNs) carry out complex nursing
tasks.
 The idea behind functional nursing is that there is a
specialist for each task.
 The head of the ward assigns the different tasks to
specific nurses based on the nursing care plans for the
different patients.

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Advantages: A very efficient way to delivery care. Could accomplish
a lot of tasks in a small amount of time
Staff did what only they were capable to do: no
extraneous work was added that could be done by
nursing aid.

Disadvantages: Care of persons became fragmented

1. Patients did not have one identifiable nurse and the
nurse had no accountability.
2. Very narrow scope of practice for Registered nurses.
3. Lead to patient and nurse dissatisfaction

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 Care is given by a team composed of registered nurses
(RNs), Licensed Practical Nurses (LPNs) and certified
nursing assistants (CNAs).
 In this model, most direct bedside care is given by the
CNAs while the RNs spend more of their time at the
nursing station.

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 When a ward is organized according to the team
nursing system, the nurses are divided in a
number of teams.
 Each team has to provide care for a fixed group
of patients.

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Advantages: 1. Each member’s capabilities are maximized so job
satisfaction should be high.
2. Patients have one nurse (the Team Leader) with
access to other providers
Disadvantages: 1. Registered Nurse may be the Team Leader one day
and a team member the next, thus continuity of
patient care may suffer.
2. Care is still fragmented with only 8 or 12 hour
accountability.

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 Primary nursing is a method of nursing practice
which emphasizes continuity of care by having one
nurse provide complete care for a small group of
inpatients within a nursing unit of a hospital.

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 Advantages: 1. Increased satisfaction for patients and nurses.
2. More professional system: Registered Nurse plans and
communicates with all disciplines. Registered Nurses are
seen as more knowledgeable and responsible.
3. Registered Nurses more satisfied because they continue to
learn as a function of the in-depth care they are required to
deliver.
Disadvantages: 1. Intimidating for new graduates who are less skilled and
knowledgeable.
2. Where do we get all these Registered Nurses during times
of shortage?

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 If you are a head nurse manager, Which methods
you will use?

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Basically nurses need to understand the positive
and negative consequences of each model in
order to plan and propose to decision-makers the
most efficient and effective way to deliver care.

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 In my hospital we use Total patient care, primary care and
functional Nursing according to the situation.
 In ICU one Registered Nurses assigns to one patient to
give total patient care.
 The head nurse gives assignment of 4-6 patients to each
nurse to give primary Nursing Care.
 Beside total assignment, one nurse will be responsible for
distributing medications to all patients, the other one will
be responsible to check Crash Cart etc.

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 Nursing care delivery system is to organize the
work.
 There are 4 methods of Nursing care delivery
system.
 Each one has advantages and disadvantages.
 It better to mix more than one method in
delivering care to patients.

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 Fawzia Gharbi
 Nadia aseri
 Lyla

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 Young, y. & IlSun, K. Healthcare and Nursing
Care Delivery System in South Korea. Journal of
Nursing Administration: 2010; 40(11):460-462
 Devakirubai , R. et al. Pattern of Nursing Care
Delivery System. 2010
http/www. Pattern of Nursing Care Delivery
System.Presentation.mht

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