INTRODUCTION

• Nursing care can be carried out through a variety of organizational methods.
• The model of nursing care used varies greatly from one facility to another and from one set of patient circumstances to another.. 

TEAM NURSING

• Originated in the 1950s and 1960s.
• Involves use of a team leader and team members to provide various aspects of nursing care to a group of patients.
• In team nursing, medications might be given by one nurse while baths and physical care are given by a nursing assistant under the supervision of a nurse team leader.
• Skill mixes include experienced and specially qualified nurses to nursing orderlies.
• The quality of patient care with this system is questionable, and fragmentation of care is of concern.

PRIMARY NURSING

• Primary nursing refers to comprehensive, individualized care provided by the same nurse throughout the period of care.
• Primary nursing is a method of nursing practice which emphasizes continuity of care by having one nurse provide complete care for a small group of inpatients within a nursing unit of a hospital.
• This type of nursing care allows the nurse to give direct patient care.
• The primary nurse accepts total 24-hour responsibility for a patient’s nursing care.
• Nursing care is directed toward meeting all of the individualized patient needs.
• The primary nurse communicates with other members of the health care team regarding the patient’s health care.
• This care method is rejected by many institutions as too costly.

PROGRESSIVE PATIENT CARE

• PPC is a system of nursing care in which patients are placed in units on the basis of their needs for care as determined by the degree of illness rather than on the basis of a medical specialty.
• Organization of medical and nursing care according to the degree of illness and care requirements in the hospital.
• Progressive patient care is the systematic grouping of patients according to their degree of illness and dependency on the nurse rather than by classification of disease and sex.It is a method of planning the hospital facilities, both staff and equipment, to meet the individual requirements of the patient. (Raven. RW, 1960)
• PPC has been defined as "the right patient, in the right bed, with the right services, at the right time" (Haldeman JC, 1964).
• Elements of PPC are (Raven RW, 1960)
  1. Intensive care units for critically ill patient
  2. Self-care units for convalescent patients or those requiring investigation.
  3. Intermediate care units for those patients not requiring to be housed in either of the foregoing, and who would constitute approximately 60%, of all patients in hospital.
  4. Beds attached to out-patient departments for " one day" patients.
• The elements can also be named as intensive care, intermediate care, self-care, long-term care, and organized home care.

Major concepts of PPC

• PPC is defined as better patient care through the organization of hospital facilities, services and staff around the changing medical and nursing needs of the patient

• PPC is tailoring of hospital services to meet patients needs

• PPC is caring for the right patient in the right bed with the right services at the right time

• PPC is systematic classification of patients based on their medical needs

References

1. Smeltzer SC, Bare BG. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 10th Edition. Lippincott Williams and Wilkins.  Philadelphia. 2003.
2. Raven RW. Progressive patient care. British Medical Journal, 1960. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1959304/pdf/brmedj02849-0077.pdf
3. Pearson, DA. , Rove DS., Golberg B.,Seigel E. Elements of progressive patient care In the Yale Health Plan HMO. Public Health Reports, Vol. 90, March-April 1975, pp. 119-125.
4. Haldeman, J. C.: Elements of progressive patient care. In Progressive patient care-an anthology, edited by L. E. Weeks and J. R. Griffith. University of Michigan Press, Ann Arbor, 1964