Nurses are responsible for providing care and treatment to many patients within a variety of healthcare settings, and it is in the best interest of all parties to develop models of care that improve delivery in a cost effective manner. Nurses working with patients must adhere to the chosen model of care that will support optimal outcomes. Different models are effective in different organizations; therefore, it is the responsibility of nurse leaders to be proactive in identifying models that are practical, cost effective, and meaningful for patients and also for other nurses. The purpose of this discussion is to identify a nursing care delivery model that is appropriate in meeting the needs of the target population, while also expanding the knowledge that is required to improve nurse-led performance.
New Nursing Care Delivery Model and Patient Goals
The proposed nursing care delivery model is known as the shared governance model, whereby nurses have established core competencies and principles that will influence employee satisfaction and expanded knowledge for the practice setting (Chamberlain et.al, 2013). This model supports the contribution of all nurses and seeks input from employees in order to ensure that creative ideas and solutions are identified to support nurse satisfaction and patient wellbeing (Chamberlain et.al, 2013). In this capacity, nurses must serve as key contributors to the practice environment because they possess knowledge and skills that are viewed favorably by the leadership team (Chamberlain et.al, 2013). In this capacity, nurses must be prepared to address the challenges of the work environment, including work hours, roles and responsibilities, policies, support systems, and leadership capabilities, among other variables. When nurses have a voice that is heard, they are more likely to engage in activities that will have a significant impact on their performance and the practice setting as a whole.
In order for a shared governance model to be successful, a team-based approach must be established that will have a significant impact on its individual members, along with the ability to engage in a variety of activities that will motivate nurses to support the nursing culture and the objectives that have been identified (Wilson, Speroni, Jones, & Daniel, 2014). This requires an understanding of the key factors associated with shared governance that have a direct impact on the nursing profession and the patients who receive care. Nurse leaders are responsible for facilitating a shared governance model so that the delivery of care is optimal and timely for all patients (Wilson et.al, 2014). This model must coincide with the work that nurses perform and for those with authority and leadership to make decisions that are in the best interests of the team and all patients (Wilson et.al, 2014).
The shared governance model requires nurses to be proactive in their efforts to manage goals and objectives which support patient safety. For instance, the prevention of hospital acquired infections requires all nurses to adopt the guidelines set forth by the Centers for Disease Control and Prevention to optimize hand washing and aim to minimize infection risk after surgical procedures, and limit the number of urinary tract infections that are acquired by the use of catheters in patients (The Joint Commission, 2016). It is imperative that patients receive nurse-led care that is of the highest possible quality and which reflects a pattern of positive behaviors that will minimize patient risks relative to infections as frequently as possible (The Joint Commission, 2016). Similarly, the use of proper techniques and knowledge is required in order to prevent the risk of medical errors across a number of different areas, such as errors before, during, and after surgeries, administer medications in a safe and consistent manner, record information in the electronic health record without risk of errors that could be transmitted to other nurses and their delivery of care, and recognize the general responsibility to patients to be proactive in their efforts to administer care that is error free as best as possible (The Joint Commission, 2016).
A shared governance model requires an understanding of the key factors which influence nurse-patient relationships and have a significant impact on patient outcomes (Chamberlain et.al, 2013). In this capacity, nurses must be flexible and knowledgeable of the factors which influence shared governance and identify areas where patient care delivery might be optimized by the development of nurse-led goals and objectives (Chamberlain et.al, 2013). This model emphasizes areas such as evidence-based practice, teams which are self-managed, leadership attributes, nurse satisfaction with the model and the job as a whole, and collaborative efforts with nurse colleagues and across other disciplines (Chamberlain et.al, 2013). These characteristics are essential to the discovery of new strategies to improve nursing practice and to acknowledge that all nurses have a role and are able to contribute to the success of the practice model in different ways which identify their individual strengths to improve the process (Chamberlain et.al, 2013).
Nurses in organizations where a shared governance model is likely to be adopted include those with Magnet status, where there is a high level of focus on excellence and quality of care that is delivered in a consistent manner. This requires all nurses, from leaders and managers to other staff members, to acknowledge the key principles of this model and to determine the best possible approaches to nursing that will ultimately impact the practice setting in positive ways. As a result, there must be a greater emphasis on understanding the role of nurses in shaping a dynamic that is collaborative, supportive, and encouraging in order to improve nurse satisfaction and administer patient care as best as possible.
- Chamberlain, B., Bersick, E., Cole, D., Craig, J., Cummins, K., Duffy, M., Hascup, V.,
Kaufmann, M., McClure, D., & Skeahan, L. (2013). Practice models: a concept analysis.
Nursing Management, 16-18.
- The Joint Commission (2016). 2016 Hospital National Patient Safety Goals.
- Wilson, J., Speroni, K. G., Jones, R. A., & Daniel, M. G. (2014). Exploring how nurses and
managers perceive shared governance. Nursing2015, 44(7), 19-22.