Healthcare organizations have several ways to approach how nurses deliver patient care. Primary care is one of those care delivery methods that is often misunderstood but can benefit nurses and patients alike. This model does not refer to primary care providers but describes the nurse as the primary point of contact and caregiver during an acute episode of care. The University of Texas at Arlington online Doctor of Nursing Practice (DNP) program furthers your nursing education and knowledge of historical and current care delivery trends and models.
Defining Primary Care Nursing Model
Nursing care delivery models are forms of care in response to demographic, organizational or healthcare environments. Over time, four approaches evolved: total patient care, functional care, team nursing care and the primary care nursing model. Initially, primary care nursing referred to a single primary nurse responsible for several patients throughout their treatment. Today, primary nursing is more of a philosophy of care focusing on the relationship between the nurse and patient and continuing care.
Magnet hospitals often use critical components of primary care by empowering nursing input into daily practice. The term “Magnet recognition” is an official designation awarded by the American Nurses Credentialing Center (ANCC) that signifies a high standard of excellence in professional nursing practice. Excellent nurse leaders in magnet and non-magnet facilities incorporate five core components of nursing excellence.
- Structural Empowerment – Support for nursing input into daily practice, often through a shared governance model using various councils or committees.
- Transformational Leadership – Ensure a nursing voice for any process that intersects with a patient or nursing care.
- Exemplary Professional Practice – Encourage professional growth by providing workplace professional development and supporting professional organizational involvement.
- New Knowledge, Innovation and Improvements – Provide quality improvement initiatives and evidence-based practice opportunities.
- Empirical Quality Results – Use of data-driven outcome measurements.
Incorporating the Primary Care Approach Into Team Staffing
The nursing shortage and the COVID-19 pandemic required organizations to re-evaluate patient care delivery. Many organizations, like NewYork-Presbyterian, created new care delivery models using an integrated team staffing approach focused on patient-centered care. This team model relies on the “rich skill mixes” of team members. Instead of the person with the most education, highest degree or credentials becoming the team leader, the person with the highest skill level becomes the team leader. For these critically ill patients, it was often the intensive care nurse.
Although the pandemic is transitioning to a post-pandemic state, the lessons learned from the quick launch of this new care delivery model will assist nurse leaders in future rapid responses. Post-COVID recovery workforce strategies may include five critical actions: reflect, recommit, re-engage, rethink and reboot.
Modifying Primary Care Through Nurse Navigation
Many organizations use the principles of primary care nursing with a navigator as the primary point of contact for the patient. In addition, nurse navigation facilitates effective communication with patients and caregivers, interdisciplinary departments and other care facilities. “The navigator, by spending time speaking with the patient and caregiver(s), understanding family dynamics and patient wishes, and completing a significant number of follow-ups regarding treatment planning, side effects, and psychosocial concerns, becomes a key differentiator for both practitioners and patients,” says Lisa Hartman, Director of Certification for the Academy of Oncology Nurse & Patient Navigators (AONN+) Foundation for Learning (FFL).
Navigators can assist patients in the community, along the care continuum or during a specific time in disease management. For example, surgical breast cancer navigators help coordinate care from the time of diagnosis through post-mastectomy or lumpectomy care. In addition, oral oncolytic nurse navigators have a designated clinical role in overseeing patients receiving self-administered oral anti-cancer medications. “My role is to help patients from start to finish to ensure no patients fall between the cracks,” explains Katie Grotzinger, an oral oncolytic nurse navigator at Advent Health in Hendersonville, North Carolina.
Navigation programs ensure that patients get to the right level of care, reserving admissions for the most acute patients. Each organization creates programs and positions for its organizational needs. They may focus on various aspects of care, such as financial navigation, telemedicine and virtual navigation, clinical trial navigation, community outreach or resource location.
DNPs have opportunities to lead healthcare systems and make decisions that impact care delivery throughout a facility. The University of Texas at Arlington’s online DNP program prepares graduates to provide innovative practice solutions for the workplace. The program also readies nurses for leadership in clinical practice to meet the challenges of a complex healthcare system. Graduates learn how to use historical and real-time data to create effective workflow solutions to improve patients’ outcomes and the cost of medical treatment.