Nursing Care Assignments/

Modalities of Nursing Care or

System/Pattern of Nursing
Care
 Primary
 Extension of principle of decentralization
 Nursing process driven
 Primary nurses and associate nurses
 24-hour coverage
 Greater patient and staff satisfaction
 Advantages 1) patient & family are able to develop
trusting relationship with RN; 2) there is defined
accountability & responsibility; 3) there is
holistic/continuity of care.

 Disadvantages 1) high cost because there is a higher

RN skill; 2) proximity of patient assignment;
3) overlapping of staff functions; 4) nurse patient
ratio must be realistic.
 Case Method
 1:1 nurse/patient ration
 Examples include private duty, ICU, Community Health
Nurse
 Similar to Primary, however, no Associate RN
 The nurse is responsible for the total care of the patient
for the shift she’s working
 Advantages 1) consistency of one individual caring for
the patient for the whole shift; 2) more opportunity to
observe & monitor the patient.

 Disadvantages 1) the nurse may not have the same

patient the next day; 2) it does not serve the purpose of
decentralization.
 Functional Nursing
 divides the work to be done & every member is
responsible for his actions

 best system that can be used if there are many patient &
professional nurses are few
 Advantages of functional nursing are that 1) work is
done fast; 2) workers learn to work fast; 3) they gain
skill faster in that particular task.
 Disadvantages include 1) fragmentation of nursing
care therefore holistic care is not achieved; 2) patient
cannot identify who their “real nurse” is; 3) nurse-
patient relationship is not fully developed; 4)
evaluation of nursing care is poor & outcomes are
rarely documented, and 6) it is hard to find a specific
person to answer the relative’s questions.
 Joint Practice (Team Nursing / Modular Nursing )
 More than modality
 Involves nurses and physicians collaborating as
colleagues
 Agreed upon protocols to manage care in primary
settings
 Modular nursing is a kind of team nursing that
divides the area into modules of patient, with each
module cared by a team of nurses.
 Advantage 1) work is shared with others

 Disadvantages 1) patient receives fragmented,

depersonalized care; 2) communication is complex;
3) accountability & responsibility is shared which can
cause confusion; 4) these factors affects RN’s
dissatisfaction.
 Case Management
 Clinical system with accountability for individual or
group through continuum of care
 Negotiating
 Procuring
 Coordination of services and resources