Transcript REIMBURSEMENT ISSUES - Trumbull Career & Tech Center

Chapter 1
The Evolution of Nursing
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Illness was considered to be directly related to
disfavor with God.
• Primitive people believed people became sick when an
evil spirit entered the body.
• Good spirit kept disease away.

Medicine men performed witchcraft to induce bad
spirits to leave the body.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Babylonians
• Intellectually, socially, and scientifically well developed
• Lay persons provided medical service, usually men

Ancient Hebrews
• Attributed their misfortunes and illnesses to God’s
wrath; depended on God to restore health
• Combined health and dietary practices from their
religious beliefs with hygienic practices
• Prevented the spread of communicable disease
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 3
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Ancient Egypt
• Established hospitals
• Physicians were skillful at treating fractures
• Became well acquainted with organs of the body during
embalming
• Developed a number of drugs and procedures such as
surgery
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 4
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Ancient Greece
• Hellenic


Established temples (hospitals)
o Spas, mineral springs
o Bath gymnasiums
o Treatment and consultation rooms
Religious influence continued
o Prayer, offerings of thanks, and rituals
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 5
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Ancient Indians
• Established hospitals
• Attendants were males from India



Clever and skillful
Kind with good behavior
Bathed patients, made beds, and attended to patients’
needs
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 6
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Ancient Greece (continued)
• Hippocrates






Brilliant, progressive physician
“Father of Medicine”
Rejected the supernatural origin of disease
Adopted a system of physical assessment, observation,
and record keeping
Hippocratic Oath (oath taken by physicians)
Work is basis for the holistic approach to patient care
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 7
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Ancient Greece (continued)
• Promoted public health and safety; emphasis on the
poor, sick, widowed, and children
• Deacons and deaconesses visited the sick in their
homes, prisons, and hospitals
• Hippocrates: “Father of Medicine” and basis for holistic
approach to patient care.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 8
History of Nursing and Nursing
Education
• Care of the Sick During Early Civilization

Early Christians
• Emphasis on care of the poor, sick, widowed, and
children
• Deacons and deaconesses designated by bishops to
provide care in homes of the sick
• Deaconess Phoebe considered a visiting nurse
• Fabiola provided the first free hospital in Rome in 390
AD
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 9
• Dark Ages






Learning in all disciplines disintegrated
People lost ability to read
Nursing care friends & relatives
No scientific basis for care given
Medical theory disintegrated
Jewish scholars maintained written work of others
• Served as translator
• Kept records in convents & monasteries
• Monks & nuns continue to care for sick
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 10
• Hospitals of Dark Age





No way to meet basic need of ill
Windows too high to open No fresh air
Plumbing, heating, & lighting were non-existent
Linens washed at river
Time of plagues and infectious diseases
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 11
• Renaissance Period

Nursing not moving forward
 Scientific methods of Greeks was restarted
 Disciplines of anatomy, physiology, & scientific
healing
 Tradition of unselfish service to humanity almost
vanished
 St. Vincent de Paul, organized the Sisters of Charity
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 12
•
•
•
•
•
•
•
•
•
Seventeenth & Eighteenth Centuries
US. Family members took care of sick
Almshouses for the poor
Pest houses for contagious people
Protect the healthy not care for sick
Medicine less developed in US
Physicians not well trained
1st hospital built in Philadelphia d/t Ben Franklin
Medical advances slow

Treatment brandy, whiskey, emetics, purgatives, &
bleeding
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 13
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Hospitals
• Overcrowded
• No trained or qualified people


Women of “proper upbringing” did not work
Nurses ended up being “inferior” and “undesirable” lowerclass women
• Place to contract disease rather than be cured



Poor hygienic practices
Unchecked infection
Dirty physical conditions
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 14
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Lutheran Order of Deaconesses
• Established the first real school of nursing
• Located in Kaiserwerther, Germany
• Florence Nightingale attended this school
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 15
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Florence Nightingale
• Changed condition of the hospitals



Cleaned units, washed clothes regularly, provided
sanitary conditions
Through her patience, dedication, and empathetic
treatment, made a psychological change
“Lady with the lamp”
o Carried a lamp to light her way through the rows of
beds of the injured and sick
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 16
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Nursing from occupation to profession
• Florence Nightingale began the reformation of nursing
from occupation to profession by establishing the Saint
Thomas Hospital School of Nursing in London



1 year training
Formal instruction and practical experience
“Register”
o Beginning of control over nursing graduates and
standard of practice
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 17
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Development of nursing education in the United
States
• During the time that Florence Nightingale was active in
Europe, the same kinds of patient care problems were
occurring in America
• In 1849, Pastor Theodore Fliedner of Germany traveled
to America with four highly trained nurse-deaconesses
• Established the first Protestant hospital in the United
States

Pittsburgh Infirmary in Pittsburgh, PA
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 18
• Civil War Era







South - Prejudice about women working in hospitals
Male opposition
Died because of poorly trained medical corps
Southern women offered services
Most of nursing done by infantrymen assigned to the
task
North – Women offered their services as nurses
Dorothea Lynde Dix appointed superintendent of
nurses
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 19
• Requested women under 30
• Plain-looking
• Wearing simple brown or black dresses without
bows, curl, jewelry, or hoop skirts
• Clara Barton collected supplies for soldiers

started the American Red Cross
• Civil War was push needed to establish nursetraining school
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 20
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Development of nursing education in the United
States
• Most early nursing programs were supported by large
hospitals.

First three schools of nursing in the United States
o Bellevue Hospital School of Nursing, New York
o Connecticut Training School, New Haven
o Boston Training School at Massachusetts General
Hospital, Boston
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 21
History of Nursing and Nursing
Education
• Nursing Education in the 19th Century

Development of nursing education in the United
States
• American Society of Superintendents of Training
Schools of Nursing



Established by Isabelle Hampton Robb and Lavinia Dock
Goal was to set education standards for nurses
Code of ethics was adopted by the society
o Nightingale Pledge
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 22
History of Nursing and Nursing
Education
• Changes in Nursing During the 20th Century

Nursing licensure
• First laws were established in 1903
• Protect the public
• North Carolina, New Jersey, and New York were first
states
• Isabelle Hampton Robb and Mary Adelaide Nutting

Developed a program at Columbia University to train and
develop teachers of nursing
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 23
History of Nursing and Nursing
Education
• Changes in Nursing During the 20th Century

World War I
• Increased demand for nurses
• Army School of Nursing was established
• Training focused on “service to the patient” rather than
on comprehensive care
• Most nurses returned to previous jobs after the war
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 24
History of Nursing and Nursing
Education
• Changes in Nursing During the 20th Century

World War II
• Increased demand for nurses
• Cadet Nurse Corps was established
• Nurses stayed in the military after the war


Civilian nursing: low pay, long shifts, atrocious conditions
Military nursing: prestige, good pay, and opportunity for
advancement
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 25
History of Nursing and Nursing
Education
• Changes in Nursing During the 20th Century

Contemporary nursing
• Characteristics of health care changed rapidly as health
care became an industry
• Growth and diversity became the major emphasis
• Beginning of contemporary nursing with specialized
nursing care adapted to areas

Private duty, school nursing, industrial nursing, nurse
anesthesia, and nurse-midwifery
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 26
History of Nursing and Nursing
Education
• Changes in Nursing During the 20th Century

Contemporary nursing
• 1965: American Nurses Association
o
o
o
Education should take place in institutions of learning
Many hospital-based nursing programs were
disbanded
Trend was changed from “training” nurses to
“educating” nurses
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 27
History of Nursing and Nursing
Education
• Changes in Nursing During the 20th Century

Certification
• The nurse is granted recognition for competency in a
specific area of nursing.
• Eligibility



Current RN license
Minimum 2 years’ experience in the designated area
Currently practicing in the designated area
• Some areas include gerontologic, medical-surgical,
psychiatric and mental health, and adult nurse
practitioner
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 28
History of Nursing and Nursing
Education
• Nursing in the 21st Century






Demographic changes
Women’s health care issues
Men in nursing
Human rights
Medically underserved
Threat of bioterrorism
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 29
Development of Practical/Vocational
Nursing in the United States
• Attendant Nurses

The Ballard School
•
•
•
•
First school for training practical nurses
Started in 1892 in Brooklyn, NY
3 months’ duration
Trained students to care for the chronically ill, invalids,
children, and the elderly
• Main emphasis was on home care

Cooking, nutrition, basic science, basic nursing
procedures
• Graduated as attendant nurses
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 30
Development of Practical/Vocational
Nursing in the United States
• Attendant Nurses

Two other programs patterned after Ballard School
• Thompson Practical Nursing School; Brattleboro,
Vermont; 1907
• Household Nursing Association School of Attendant
Nursing; Boston; 1918


Focus continued to be on home nursing care and light
housekeeping duties
No hospital experience
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 31
Development of Practical/Vocational
Nursing in the United States
• Practical Nursing Programs



Before 1940, practical nursing schools had few
controls, little educational planning, and minimal
supervision
Between 1948 and 1954, 260 practical nursing
programs were opened
Students in these programs provided nursing service
while they were obtaining their education and training
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 32
Development of Practical/Vocational
Nursing in the United States
• Organizational Influence

Association of Practical Nurse Schools
• Founded in 1941
• Dedicated to practical nursing
• Planned the first standard curriculum for practical
nursing


1942: changed name to the National Association of
Practical Nurse Education (NAPNE)
1959: changed name to National Association for Practical
Nurse Education and Service (NAPNES)
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 33
Development of Practical/Vocational
Nursing in the United States
• Organizational Influence

National Federation of Licensed Practical Nurses
(NFLPN)
• Founded by Lillian Kuster in 1949
• Membership is limited to LVNs and LPNs

National League for Nursing
• 1961; established a Department of Practical Nursing
Programs
• Developed an accreditation service for PN programs;
Council of Practical Nursing Programs
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 34
Development of Practical/Vocational
Nursing in the United States
• Additional Credentialing

Approved program
• One that meets minimum standards set by the
respective state agency
• Ensures that a given program





Meets the needs of the student
Has adequate course content and qualified faculty
Is of sufficient length
Has adequate facilities
Provides clinical experience
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 35
Development of Practical/Vocational
Nursing in the United States
• Additional Credentialing

Accreditation
• Program voluntarily seeks a review by a given
organization to determine whether the program meets
the preestablished criteria of that organization
• Standards are usually far higher than required by the
state
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 36
Development of Practical/Vocational
Nursing in the United States
• Contemporary Practical/Vocational Nursing
Education




Nursing programs are offered by various
organizations: high schools,trade or technical schools,
hospitals, junior and community colleges, universities,
private education agencies
Length of programs: 12 to 18 months
Skills, theory, and clinical practice
National Council Licensing Examination for Practical
Nursing (NCLEX-PN)
• Examination for licensure as LPN
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 37
Development of Practical/Vocational
Nursing in the United States
• Contemporary Practical/Vocational Nursing
Education

Articulation
• Procedure that allows nursing programs to work
together to plan their curricula to decrease duplication
of learning experiences
• LPN/LVN to RN
• RN to BSN
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 38
Development of Practical/Vocational
Nursing in the United States
• Career Advancement

Career ladder
• Recognizes the clinical expertise of the nurse and
provides a mechanism for providing the nurse with
financial compensation and opportunities for
advancement
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 39
Development of Practical/Vocational
Nursing in the United States
• Events That Changed Practical/Vocational Nursing






The need for trained caregivers
World War I
The self-taught practical nurse
The Great Depression
Duties of licensed practical/vocational nurses
Position Paper of the American Nurses Association
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 40
Development of Practical/Vocational
Nursing in the United States
• Licensure for Practical/Vocational Nursing

Licensing laws
• Protect the public from unqualified persons practicing in
almost any field or profession

Jurisdictions
• Area such as a state that has the legal power to
regulate nursing licensure and practice

State board of nursing
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 41
Development of Practical/Vocational
Nursing in the United States
• Licensure for Practical/Vocational Nursing

Laws that monitor the licensed practical/vocational
nurse
• Licensing for practical nurses in the United States was
begun in 1914 by Mississippi

By 1955, all states had passed licensing laws
• State Board Test Pool

NLN Education Committee established a testing
mechanism for all states and administered the exam
several times a year
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 42
Development of Practical/Vocational
Nursing in the United States
• Licensure for Practical/Vocational Nursing

Laws that monitor the licensed practical/vocational
nurse
• National Council Licensing Examination for Practical
Nurses (NLCEX-PN)


Computerized examination
Receive score of “passed” or “has not passed”
• Interstate endorsement

Reciprocity between states
o Licensing in other jurisdictions can be obtained
without repeating the NCLEX-PN
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 43
Contemporary Practical/Vocational
Nursing Care
• Roles and Responsibilities of the Licensed
Practical/Vocational Nurse
Recognizes the LPN/LVN’s role in the health care
delivery system and articulates that role with those of
other health care team members
 Maintains accountability for one’s own nursing
practice within the ethical and legal framework
 Serves as a patient advocate
 Accepts their role in maintaining and developing
standards of practice in providing health care
 Seeks further growth through education opportunities

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 44
Contemporary Practical/Vocational
Nursing Care
• Objectives and Characteristics of
Practical/Vocational Nursing Education

To acquire the specialized knowledge and skills
needed to meet the health care needs of patients in a
variety of settings
 To be a graduate of a state-approved
practical/vocational nursing program
 To take and pass the NCLEX-PN examination
 To acquire a state license to practice
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 45
Contemporary Practical/Vocational
Nursing Care
• Practical/Vocational Nursing Defined



The activity of providing specific services to patients
under direct supervision of a licensed physician or
dentist and/or RN
Assist individuals, sick or well, in the performance of
those activities contributing to health, to their
recovery, or to a peaceful death
Educated to be a responsible member of a health care
team, performing basic therapeutic, rehabilitative, and
preventive care for anyone who needs it
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 46
Health Care Delivery Systems
• Health Care System Defined

The complete network of agencies, facilities, and all
providers of health care in a specified geographical
area
• Patient, patient’s family, community, current technology,
government agencies, medical professionals, third-party
participants

Goal is to achieve optimal levels of health care
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 47
Health Care Delivery Systems
• Health Care System Defined

Wellness/illness continuum
• The range of a person’s total health; ever changing
• Wellness: A dynamic state of health in which an
individual progresses toward a higher level of
functioning, achieving an optimal balance between
internal and external environment

Highest level of optimal health
• Illness: A diminished or impaired state of health

Opposite end of spectrum from wellness
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 48
Health Care Delivery Systems
• Health Care System Defined

Maslow’s model of health and illness
• Developed by Abraham Maslow

He believed that an individual’s behavior is formed by his
attempts to meet his basic needs
o Physiological, safety and security, love and
belongingness, esteem, self-actualization
• Hierarchy or pyramid
o
Some needs must be meet before advancing to other
needs
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 49
Figure 1-5
Maslow’s hierarchy of needs.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 50
Health Care Delivery Systems
• Health Care System Defined

Health promotion and illness prevention
• U.S. Department of Public Health



Identify what types of diseases are most prevalent, which
age groups are affected by certain illnesses, and which
illnesses are predominant
Direct efforts toward developing treatment of the illness,
establishing methods to decrease its spread, and
isolating its cause
Focus has now shifted from curing the problem to
preventing it
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 51
Health Care Delivery Systems
• Health Care System Defined

Continuity of care
• Ensuring the continuation of care from one setting to
another
• Understanding what procedures are done, why, and by
whom is a discouraging and often impossible task for
patients already bewildered and frightened by medical
conditions that threaten their well-being
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 52
Health Care Delivery Systems
• Delivery of Patient Care

Extremely humanistic activity
• Delivery of services by human beings to human beings







Treatment of disease and injury
Prevention of disease
Restoration of optimal wellness through rehabilitation
Maintenance of a desirable level of wellness
Care of the chronically ill
Provision of assistance to the patient in self-care
Patient education
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 53
Health Care Delivery Systems
• Delivery of Patient Care

Participants in the health care system
•
•
•
•
Professional health care specialists
Registered nurse
Licensed practical/licensed nurse
Additional caregivers

Social worker, physical therapist, dietitian, respiratory
therapist
• Technologists and medical technicians
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 54
Health Care Delivery Systems
• Delivery of Patient Care

Economic factors affecting health and illness
•
•
•
•
•
•
Rising health care costs
Aging population
Advancement of technology
Health care insurance
Malpractice insurance
Miscellaneous factors

People avoid preventive and routine care and are seen
only in crisis situations
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 55
Health Care Delivery Systems
• Delivery of Patient Care

Economic factors affecting health and illness
• Changes in delivery system



Case management
Cross-training
Additional trends
o Multisystem health care chains
o Health maintenance organizations (HMOs)
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 56
Health Care Delivery Systems
• Delivery of Patient Care

Environmental factors affecting health and illness
• Social and physical environmental factors do not
necessarily cause illness, but they do influence the
development or progression of an illness
• Social: Financial hardship, lifestyle, social pressures,
etc.
• Physical: Stress, conflict, smoking, weight, etc.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 57
Health Care Delivery Systems
• Delivery of Patient Care

Expectations of the patient and health care team
• Health promotion

Preventive medicine through education
• Patients’ rights

Patients expect to be treated with dignity and compassion
and have their rights respected
• Health care providers’ rights

Expect that patients will actively participate in their care
as much as possible
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 58
Health Care Delivery Systems
• Delivery of Patient Care

Interdisciplinary approach to health care
• Care plan

Document that outlines the individual needs of the patient
and the approach of the health care team in meeting
these needs
• Communication

Good communication is essential for the exchange of
information among the members of the health care team
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 59
Nursing Care Models
• Four Major Concepts

Nursing
• Encompasses the roles and actions of the nurse

Patient
• The individual receiving the care

Health
• The area in which the patient fits on the wellness/illness
continuum

Environment
• The setting for the nurse-patient interactions
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 60
Figure 1-6
(From Lindeman, C.A., McAthie, M. [1999]. Fundamentals of contemporary nursing practice.
Philadelphia: Saunders.)
A nurse collaborating with other members of the interdisciplinary
health care team.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 61
Health Care Delivery Systems
• Delivery of Patient Care

Interdisciplinary approach to health care
• Documentation




Any form of documentation is the permanent record of the
patient’s progress and treatment
It is the formal and legal record of care received by the
patient and the patient’s response to that care
Provides a progress record of treatment
Provides a history of events
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 62