Patient Assignments and Nursing Care Responsibilities Functional Nursing: Functional nursing is a care delivery model in which nursing tasks are divided among team members based on their specific skills and expertise. In this model, each member of the nursing team is assigned specific functions to perform for a group of patients. For instance, one nurse may be responsible for administering medications, while another nurse may focus on vital sign monitoring. This approach aims to promote efficiency by utilizing the specialized skills of each team member. However, it can also result in fragmented care and reduced continuity as different nurses handle different aspects of patient care. Team Nursing: Team nursing is a collaborative care delivery model that involves a team of healthcare professionals working together to provide comprehensive care to a group of patients. The team typically includes registered nurses, licensed practical nurses, and nursing assistants, among others. A registered nurse usually leads the team and coordinates care, delegating tasks to team members based on their abilities and scope of practice. This model encourages teamwork, shared decision-making, and a holistic approach to patient care. By leveraging the collective skills and knowledge of the team, team nursing aims to provide high-quality care while maintaining efficiency. Primary Nursing: Primary nursing is a patient-centered care delivery model in which a registered nurse takes full responsibility for coordinating and providing care to a specific group of patients. The primary nurse develops a therapeutic relationship with the patients, assesses their needs, creates individualized care plans, and provides direct care throughout their healthcare journey. This model emphasizes continuity of care and places a strong emphasis on the nurse-patient relationship. By having a dedicated primary nurse, patients benefit from personalized attention, improved communication, and a sense of continuity in their care. Case Management: Case management is a care delivery model that focuses on coordinating healthcare services for patients with complex medical conditions or multiple healthcare needs. A case manager, often a registered nurse, plays a key role in this model by working closely with the patient, their family, and other healthcare professionals to ensure seamless transitions between healthcare settings and to optimize resource utilization. The case manager assesses the patient's needs, develops and implements care plans, advocates for the patient, coordinates appointments and services, and collaborates with various healthcare providers. The goal is to provide comprehensive and efficient care while maximizing patient outcomes and resource allocation. Each of these care delivery models has its own strengths and weaknesses, and the choice of model depends on factors such as the healthcare setting, patient population, and available resources.

1. PATIENT
ASSIGNMENTS AND
NURSING CARE
RESPONSIBILITIES
Mr. Pradeep Abothu
Associate professor
Child Health Nursing

2. INTRODUCTION
Patient assignments and nursing care
responsibilities are fundamental aspects of delivering
optimal healthcare. Effective assignments ensure that
patients receive appropriate and timely care, while clear
nursing responsibilities promote collaboration and quality.
Understanding different care delivery models, such as
functional nursing, team nursing, primary nursing, and
case management, helps optimize resources and
personalize care.

3. FUNCTIONAL
NURSING
Functional nursing is a care delivery model where
nursing tasks are divided among various healthcare
professionals based on their specific skills and expertise.
In this model, each team member is responsible for
performing specific tasks or functions for a group of
patients. The care responsibilities are divided as follows:

4. UNIT OF 20 PATIENTS
INCHARGE NURSE
LPN
Oral
Medicatio
ns
RN
TREATMENT
AND
ADMISSIONS
NA
Hygiene
Supplies
NA
Vital
Signs
RN
Intravenous
Medication

5. HEAD NURSE / INCHARGE NURSE:
 Oversees the overall care delivery process.
 Coordinates and assigns tasks to the nursing team.
 Monitors the quality of care provided.
LICENSED PRACTICAL NURSES (LPNS)/LICENSED
VOCATIONAL NURSES (LVNS):
 Administer medications and perform basic nursing procedures.
 Assist with patient hygiene and comfort.
 Monitor vital signs and report any abnormalities to the
registered nurse (RN).

6. CERTIFIED NURSING ASSISTANTS (CNAS)/NURSING
ASSISTANTS (NAS):
 Assist with activities of daily living (ADLs), such as bathing,
dressing, and feeding.
 Help with turning, positioning, and transferring patients.
 Maintain cleanliness and tidiness of the patient’s
environment.

7. ADVANTAGES:
Task specialization: Each team member focuses on specific tasks, allowing
for efficient and streamlined care delivery.
Cost-effective: By assigning tasks according to skill level, organizations
can optimize resource allocation and reduce labor costs.
Clear role definition: Roles and responsibilities are well-defined,
minimizing confusion among team members.
DISADVANTAGES:
Fragmented care: Patients may interact with multiple healthcare
professionals, potentially leading to a fragmented and less personalized care
experience.
Communication challenges: Coordinating care among different team
members can be challenging, leading to potential communication gaps and
errors.
Limited holistic care: The focus on task completion may overshadow the
comprehensive assessment and holistic care approach.

8. Team nursing is a collaborative care delivery model
where a team of healthcare professionals, including registered
nurses (RNs), licensed practical nurses (LPNs)/licensed
vocational nurses (LVNs), and nursing assistants
(NAs)/certified nursing assistants (CNAs), work together to
provide comprehensive care to a group of patients. The
responsibilities in team nursing are as follows:
Registered Nurse (RN):
 Assumes the role of team leader.
 Performs initial patient assessments and develops care plans.
 Coordinates and delegates tasks to team members.
 Provides ongoing evaluation and supervision.
TEAM NURSING

10.  Licensed Practical Nurses (LPNs)/Licensed Vocational Nurses
(LVNs):
 Administer medications and perform selected nursing procedures.
 Assist with patient education and health promotion.
 Communicate patient updates and concerns to the RN.
 Certified Nursing Assistants (CNAs)/Nursing Assistants (NAs):
 Assist with ADLs and personal care.
 Support patient mobility and ambulation.
 Monitor and report changes in the patient’s condition to the RN.

11. ADVANTAGES:
Collaboration and teamwork: Team members work together to provide
comprehensive care, fostering collaboration and shared decision-making.
Efficient use of resources: The workload is distributed among team
members based on their expertise, optimizing resource utilization.
Enhanced communication: Regular team meetings and communication
channels promote effective information sharing and coordination.
DISADVANTAGES:
Potential role ambiguity: The division of responsibilities among team
members can lead to confusion or conflicts regarding individual roles and
accountability.
Delayed decision-making: Collaborative decision-making may take longer,
potentially impacting timely interventions or responses.
Variability in quality: The quality of care may vary based on the
competency and skills of different team members involved in the care.

12.  Primary nursing is a patient-centered care model where a registered
nurse (RN) takes full responsibility for the total care of assigned
patients throughout their stay. The primary nurse is accountable for
coordinating and delivering all aspects of care, including:
Patient Assessment and Care Planning:
 Conducting comprehensive assessments upon admission and
throughout the patient’s stay.
 Developing individualized care plans based on the patient’s needs and
goals.
Direct Patient Care:
 Administering medications and treatments.
 Providing emotional support and patient education.
 Monitoring the patient’s condition and reporting changes.
 Collaborating with other healthcare professionals as needed.
PRIMARY NURSING

14. Continuity of Care:
 Ensuring smooth transitions between healthcare settings.
 Facilitating communication and information sharing among
interdisciplinary teams.
 Following up with patients after discharge to promote continuity
and prevent readmissions.
ADVANTAGES:
 Continuity and relationship-based care: The primary nurse
maintains a consistent presence and develops a therapeutic
relationship with the patient, promoting trust and better patient
outcomes.
 Individualized care planning: The primary nurse takes into
account the patient’s unique needs, preferences, and goals when
developing the care plan.

15. Enhanced patient satisfaction: Patients often appreciate the
personalized care and having a dedicated point of contact for their
healthcare needs.
DISADVANTAGES:
Higher staffing requirements: Primary nursing may require a higher
nurse-to-patient ratio, potentially straining staffing resources.
Limited scalability: Primary nursing may be challenging to
implement in high-volume or acute care settings due to the need for
individualized attention.
Increased workload for primary nurses: Being responsible for the
total care of assigned patients can be demanding and may lead to
increased stress and burnout.

16. Case management is a care delivery model focused on
coordinating and managing the care of patients with complex
healthcare needs. The case manager, often a registered nurse (RN),
assumes the responsibility of:
Assessment and Care Coordination:
 Assessing the patient’s needs and developing an individualized
care plan.
 Coordinating and arranging necessary services, appointments, and
consultations.
 Facilitating communication between healthcare providers,
patients, and families.
CASE MANAGEMENT

17. COLLABORATES WITH
PATIENT AND FAMILY
NURSE CASE MANAGER
Assesses, plans, implements, co-
ordinates, monitors, and evaluates
patient care options and services to meet
health needs
Resolution
of illness
Co-ordinates services:
home care, hospice,
extended/ long-term care,
ambulatory care services
Collaborates with
nursing: physical/
speech/ occupational
therapies, dietary and
axcillary services
Onset of
illness

18. Advocacy and Resource Management:
 Advocating for the patient’s rights and ensuring access to
appropriate care.
 Collaborating with insurance providers and social services to
optimize resource allocation.
 Monitoring and managing utilization of healthcare resources to
promote cost-effective care.
Evaluation and Outcomes:
 Monitoring the patient’s progress and outcomes.
 Identifying and addressing barriers to achieving desired health
outcomes.
 Adjusting the care plan as needed to promote optimal patient well-
being

19. ADVANTAGES:
Care coordination and continuity: Case managers ensure seamless transitions
between care settings, reducing gaps and improving continuity of care.
Improved resource utilization: Case managers optimize resource allocation,
preventing unnecessary hospitalizations and reducing healthcare costs.
Patient advocacy: Case managers advocate for patients’ rights and ensure they
receive appropriate care and support throughout their healthcare journey.
DISADVANTAGES:
Time-intensive: Case management requires thorough assessment, planning,
coordination, and ongoing evaluation, demanding significant time and resources.
Limited direct patient care: Case managers may have less involvement in direct
patient care due to their focus on coordination and management tasks.
Communication and collaboration challenges: Coordinating care among
multiple providers and stakeholders can be complex, potentially leading to
communication gaps and delays in decision-making.