WRITE a paper (at least 750 words) on a Innovative Nursing Care Delivery Model.
Read the two (2) articles below:

• Norlander, L. (Ed.). (2011). Transformational models of nursing across different care
settings. Report: The future of nursing: Leading change, advancing health (Appendix
G). Washington, DC: National Academy of Sciences, Institute of Medicine.
(CLICK on PDF file: TRANSFORMATIONAL NURSING MODELS)
NOTE: For this assignment, ignore curriculi/nurse education models
• Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing
Review, 53, 94-101.
(CLICK on PDF file: NURSING PRACTICE INNOVATIONS)
Baccalaureate-prepared nurses are expected to function as managers, educators,
collaborators, advocates, and leaders within a variety of settings. These articles describe a
variety of innovative or “transformational” models in nurse-managed care across various
care settings. Another source of ideas are the vignettes and case studies found in your
textbook chapters.
For this paper, you will develop an innovative nursing care delivery model for a vulnerable
population, care specialty, and setting in the United States OR a low income global country
that reflects nurse managed care, collaboration, care across settings, and technology.
For your paper, it is easiest to focus on one (1) population, one (1) health issue/disease,
and one (1) type of setting within a country. Be specific. If you use a low income country,
name your low income country (see list in module 1) and adjust your model to the
disease(s) and conditions found within that country. Consider that low income countries will
not have access to the same level of facilities, technology related to diagnostics and
communication, medications, and the health care professionals found in the U.S.
• A vulnerable population can include low income children and/or adults; elderly;
homeless; migrants; immigrants; racial & ethnic minorities, people with chronic health
or terminal conditions/diseases (or any group at risk for obtaining appropriate health
care).
• A care specialty can include preventative care; primary care; acute care; chronic
care; palliative or end-of-life care (including the targeting of any disease or condition
that results in a health risk).
• A setting can include rural or urban community housing and/or clinic; school;
specialty unit in a hospital; emergency room; health provider office; armed services
facility; rehabilitation facility; hospice facility; ambulatory health care center; client
home; nursing home; prison or detention center; short term stay housing (or any
setting where a vulnerable client/patient population is available for care).
a) Content of paper:
Title of Paper (top of page 2, centered)
Innovative Nursing Care Delivery: [Name of Your Model]
PAPER HEADING: Introduction [Level 1] What is your model’s population, setting,
care specialty, and your model’s goal(s) and/or purpose(s)? For example, are you
targeting a particular group or disease/condition? Choose a name for your model
and include it in your paper title.
PAPER HEADING: Description of the [Name of Your Model] [Level 2] You are
welcome to use your creativity in the model–develop your own or base it on an
existing model. For ideas, start with the articles found with the assignment, textbook
(Global Health 101) scenarios, or do literature searches on the internet. However,
be sure that the model is nurse-led or nurse-managed. Registered nurses have
authority to make decisions regarding nursing diagnoses, interventions, and
referrals. Registered nurse practitioners have additional authority related to medical
diagnoses and interventions (prescriptions).
Be sure to include the themes crucial to meeting the challenges of the future: nursemanaged
care, collaboration, continuity of care and technology in describing your
model. Be aware of cost-effectiveness; you could develop the “Cadillac” of models,
but no one would consider implementing it because the cost would be too high.
Nurse led and nurse managed health care. [Level 3] Were nurses
instrumental in the development and implementation of your model? How is your
model nurse managed? Are nurses consulted and/or make decisions re: budget,
personnel, and the communication, referral, and evaluation processes?
Partnerships and collaboration. [Level 3] What partnerships and
collaborations exist for your model? Are they at the professional level (i.e., social
workers, nutritionists, community leaders) and/or the organizational level (home
health care agencies, public health departments, hospitals)?
Continuity of care across settings. [Level 3] What happens when a
patient/client moves to a different setting, i.e., home, hospital, hospice, clinic,
emergency room, etc. How is communication handled so the patient/family needs
are consistently met when moved across settings?
Technology. [Level 3] What technology is used? Is it low-technology (basic
assessment tools, screening tests) or high-technology (i.e, patient diagnostic,
monitoring, and/or data processing systems) or a combination of both?
PAPER HEADING: Development/Implementation Team for the [Name of Your
Model] [Level 2] Your team is important to carry out model’s goal(s). Depending on
your model and setting, your team may include other registered nurses, nurse
practitioners, community workers, nurse assistants, licensed practical nurses,
nutritionists, physical therapists, occupational therapists, dentists, social workers,
community leaders, psychologists, clergy, administrators, informatics technicians,
physicians (if physicians are part of the team, they should function as consultants,
not “captain of the ship”). Include your team members and briefly discuss their
functions in carrying out the model goal(s)/purposes(s). How would communication
and referrals be handled? Again–think about the cost effectiveness–could ancillary
staff (nurse assistants, trained community workers) be used just as effectively?
PAPER HEADING: Evaluation of [Name of Your Model]: Outcome Measurement
[Level 2] After implementation of the model, what outcomes would you measure
Would you look at cost comparisons and/or savings? Patient satisfaction? Staff
satisfaction? Fewer ER visits and/or re-hospitalizations? Decreased incidence of a
particular disease/condition? Increased number of therapies? Increased knowledge
of a disease or intervention?
For outcomes, be specific on what, who, when and how. For example, if you do a
survey:
What type of survey is it (i.e., satisfaction, data gathering)?
Who would you survey (i.e., staff, patients, administrators)?
When would you do the survey (i.e., time period; pre/post tests)?
How would you conduct the survey (handout, mailing, computer analysis)?
b) An example of a nurse-managed model:
Below is an idea for a nurse-managed model. Your paper would be organized per the
assignment instructions and more detailed regarding the health care delivery (nurse-led,
collaboration/partnerships, continuity of care, and technology), and the functions of each
of the team members, etc., but this is the start of an idea:
Let’s say you are a nurse working in community health and you are aware of three large
migrant communities located in the rural areas around Homestead, Florida. The migrant
workers who reside in these communities include their families–from infants to elderly.
The communities are isolated and lack transportation and the ability to pay for and
access local health care facilities.
You develop a model named Bus Stop for Health. You obtain funding (donor and/or
grant) to refurbish a bus or utilize a refurbished bus already owned by a local health care
organization. The bus will include an examination room (with assessment devices, such
as BP cuffs, otoscopes, exam tables), supplies for health screenings (i.e., diabetes,
cholesterol, pap smears, etc.), and two rooms for consultation.
The purpose of the bus is to provide primary health care (preventative care, such as
immunizations and well child exams), monitor chronic diseases (such as hypertension
and diabetes), diagnose and treat minor illnesses, and provide health-related education
for this population. A referral system will be established for specialty care, such as
obstetrics. An informatics technician (IT) will establish a computerized (e-tablet) system
to input, store, and access data in the field. Smart phones will be used for real time
communication.
After consultation with and permission from the local community leaders in the migrant
communities, the bus is scheduled to drive to and spend 1-2 days/week at each migrant
community. Some folding chairs and a tarp will be carried in the bus so small covered
outdoor or indoor health education sessions can be provided.
Regular team members on the bus will consist of a nurse practitioner, registered nurse,
and receptionist/translator. Other team members will rotate in and out of the scheduled
bus times on a regular basis. For example, you could include a social worker and
dentist, (describe their specific functions/purposes for this migrant population) as rotating
team members. A nurse midwife could also be included in the bus rotation for managing
low risk pregnancies. A consultant and referral relationship with a physician or
physicians could be established for more complicated health care problems. Commonly
prescribed medications can often be obtained through pharmacies at reduced costs or
free from donors.
Evaluation? Some outcomes looked at could be increased immunization rates,
increased knowledge related to common chronic diseases, child safety, etc. (by using
pre & post tests), reduced visits to the local ERs for minor illnesses), earlier prenatal
care, or other outcomes of interest. You could also use surveys to determine patient and
community leader satisfaction with the model.
c) In-text citations and a reference list MUST be found in your paper. See the Nursing
Student Writing Guidelines Checklist for APA formatting.
d) UPLOAD completed paper (file) into the Assignment TURNITIN folder by the due date.
e) WRITING EVALUATION: See rubric on Course Content page
Paper: Innovative Nursing Care Delivery (750 words min)
Innovative Nursing Care Model; Development/Implementation Team for Innovative
Nursing Care Model; Evaluation of Model: Outcome Measurement