Leadership and Management in Nursing Environment

Your facility is a brand new small critical access hospital that has 25 med/surg/OB swing beds and a small rehabilitation unit with 6 beds. As a group, you will need to work together to research and discuss specific issues in creating your nursing unit. Leadership and Management in Nursing Environment

Would you prefer that your unit be part of a centralized or decentralized organization? Explain why you chose one over the other.
Will your unit have a shared governance model? What are the advantages and disadvantages of a shared governance model? What committees/councils will you create to help lead your unit? What will the committees focus on?
Research and describe at least three models of care delivery. One model needs to be an innovative/future model from your assigned readings. Then choose one of these models to be used on your nursing unit. Justify your decision.
Research and describe one professional practice model that will be used to describe the operational mechanisms by which care is actually provided to patients and families on your nursing unit. Why did you choose this professional practice model?
Consider the composition and skill mix of your future staff, both with direct and indirect patient care functions. What skills are needed to accomplish direct client care activities? What indirect patient roles/staff will you want on your unit? What will be the responsibilities of direct and indirect staff?

Question 3

        How care delivery will be organized in the nursing unit will be determined by several factors which include: leadership beliefs, issues in the economy, communication, recruitment and retention of staff. Similarly, practical evidence on the impact of care delivery models on the safety of patients and quality of care will be a guiding factor in decision making on the best model to embrace for the nursing unit (Greene, Tuzzio & Cherkin, 2012).  Inpatient care will be influenced by the primary nursing care model and minimally by the functional model. For the future, the team nursing model will be essential. Despite the fact that these care delivery models differ in terms of management, clinical decision making, allocation of work, and socio-economic factors, they will provide assistance to attain uniformity in the assessment, planning and implementation of care by providing frameworks.

For this nursing unit, the primary nursing care delivery model will be used. This model lays emphasis on care across the continuum and acceptance of responsibility to a single registered nurse who teams up with a nursing assistant or a licensed practical nurse in providing care to patients in their entire hospital stay. Through the supervision of the registered nurse, there will be a significant decrease in general healthcare cost including labor and resources (Greene, Tuzzio & Cherkin, 2012). Besides, patient care will be well coordinated which will enhance the safety and satisfaction of patients. Although the primary nursing model will affect the nursing staff numbers, it will maximize on the flexibility of staff and promote patient-centered care that will ultimately result to good health outcomes (Greene, Tuzzio & Cherkin, 2012). Leadership and Management in Nursing Environment

Another care delivery model is the functional delivery model that is activity and task oriented. It uses auxiliary healthcare providers who are trained with a wide range of skills to provide high-quality, safe and co-ordinated care. Each healthcare worker is assigned particular functions that are required to be done for all patients in specific units as they report to the head nurse. As noted by Curtis, et al., (2016), this model requires nurses to perform only one job for several patients. Therefore, it limits the application of the training and education that most nurses acquired in school. This ultimately limits the growth of registered nurses. To add on, this model is task-oriented, therefore, it results to poor nurse-patient relationships (Curtis, et al., 2016).Therefore, its application in this nursing unit will be limited.

For the future, the total care delivery model will be essential to enhance the establishment of resident facilities for long term care. The staff and the facility will collectively be responsible for providing holistic care to patients and meeting their needs (Hastings, et al., 2016). Most of the patients in these facilities will need assistance in performing activities of daily life although there are those patients who will require little or no assistance referred to as self-care. The facility will also reserve special units for residents who will be highly reliant on total care (Hastings, et al., 2016). Therefore, when the nursing unit may not be able to handle a resident who needs total care, he/she will be referred to the special unit of the resident facility.

Question 4

The nursing professional practice model will be used to illustrate that nurses are major partners in the provision of high-quality patient care through best practices, professional growth, leadership and collaboration (Ng’ang’a, & Byrne, 2012). Apart from unifying nurses within the system in the nursing unit, this practice model elevates skills to knowledge and constantly reminds nurses that the family and the patient are at the core of care. The decision to use this model is attributed to the fact that, it will empower every nurse within the unit to be a leader and actively participate in decision making processes (Ng’ang’a, & Byrne, 2012). By providing expert care, they will be able to express their innovation through evidence-based research, collaboration and problem solving. They will be required to be lifelong learners by taking part in continuous learning, certification and education. Thus, nurses will be able to provide high-quality patient centered care and remain committed to continuous growth and healthcare excellence. Leadership and Management in Nursing Environment


Curtis, K., Foster, K., Mitchell, R., & Van, C. (2016). Models of care delivery for families of critically ill children: an integrative review of international literature. Journal of pediatric nursing, 31(3), 330-341.

Greene, S. M., Tuzzio, L., & Cherkin, D. (2012). A Framework for Making Patient-Centered Care Front and Center. The Permanente Journal, 16(3), 49–53.

Hastings, S. E., Suter, E., Bloom, J., & Sharma, K. (2016). Introduction of a team-based care model in a general medical unit. BMC Health Services Research, 16, 245. http://doi.org/10.1186/s12913-016-1507-2

Ng’ang’a, N., & Byrne, M. W. (2012). Prioritizing professional practice models for nurses in low-income countries. Bulletin of the World Health Organization, 90(1), 3–3A. http://doi.org/10.2471/BLT.11.097659

Leadership and Management in Nursing Environment

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