The document discusses the healthcare delivery system and its various components. It defines the healthcare delivery system as the totality of services offered by all health disciplines. It then describes the different levels of healthcare as primary, secondary, and tertiary. Primary prevention aims to prevent disease before it occurs, secondary prevention focuses on early detection and treatment, and tertiary prevention aims to reduce disability from ongoing illnesses. The document concludes by outlining various members of the healthcare team, including their roles, such as nurses, physicians, physical therapists, and social workers.

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Fundamental of Nursing
Healthcare delivery system
Dr; mosa alfageh

2. Learning outcomes
Define Health care delivery system
Health system requirement
Classification of hospitals
Explain the level of health care
Explain the level of prevention
Health team members
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3. 3
The health-care delivery system provides a variety of services
across various settings to meet the health-related needs of the
members of society.
Definition of Health care delivery system
Is totality of services offered
by all health disciplines
Health care delivery system

4. 4
1. Distribution and Coverage &
Staffing.
2. Hospitals
3. Health centers & Basic Health
Units
4. finance

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According to ownership or control:
1. Government (public).
2. Non-government (private).
According to specialty or service provided.
1. General, medical surgical etc.
2. Special, psychiatric, pediatric, Maternity, Orthopedic. etc.
111- Acute or chronic:
1. Acute for short-term
2. Chronic for long-term
A primary characteristic of hospital care is its focus on the current problem,
rapid assessment, stabilization or treatment, and then discharge to home
care or to long-term care.
Classification of hospitals

6. Two terms used frequently to describe today’s modern
hospital services are:
1. Inpatient care: Individuals are termed "inpatient" when they
have been admitted for the purpose of staying more than 24
hours .
2. Outpatient care: The "outpatient" comes to the hospital for
services but is expected to stay less than 24 hours.
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1. Primary health care level (first level) :PHC Units
(primary health care units).
2. Secondary healthcare level (second level) : first referral
( district hospital)
3. Tertiary healthcare level (third level) : specialized care &
teaching hospitals
 health care services Usually organized in three levels (primary, secondary,
and tertiary. )
 Each level is supported by higher level to which the patient is referred.

8. A. Primary health care level (first level):
The first level of contact between the individual and the health system
 It refers to points at which the individuals , the family , and community normally
make the first contact with the health services where most of their health problems
can be deal with and resolved
 In rural area it may be a health center , in urban area it could be a medical clinic
, health center , or the out patient department of a hospital
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9. B. Secondary healthcare level (second level) : (Frist
referral) General hospitals , rural (district hospitals)
 At this level the more difficult cases are dealt with and detailed evaluation , with more skilled care are
given .
 Comprises curative services
 The first referral level
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10. C. Tertiary healthcare level (third level) : specialized
hospitals & centers
This is a more specialized level than the secondary care level and required specific
facilities and highly specialized health workers. It is provided by regional or central level
institutions , specialized hospitals and centers
 Offers super specialist care
 Provided training programs
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12. Levels of Prevention:
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
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Levels of Prevention :
1. Primary prevention : those preventive measures that prevent
the onset of illness or injury before the disease process begins.
Examples include diet, immunization and taking regular exercise.
Aims to prevent disease or injury before it ever occurs
This is done by:
 Preventing exposure to hazards that cause disease or injury
 Altering unhealthy or unsafe behaviors that can lead to disease or injury
 Reducing exposure to disease causing agents and
 Increasing resistance to disease or injury should exposure occur

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2. Secondary prevention (those preventive measures that
lead to early diagnosis and prompt)
 Secondary prevention Aims to reduce the impact of a disease or injury that has
already occurred
 This is done by detecting and treating disease or injury at an early stage to halt
or slow its progress , such as by screening , takes place during the preclinical
phase of an illness , that is after the disease has developed , but before clinical
signs and symptoms have appeared
 This is encouraging personal strategies to prevent reinjury or recurrence, and
implementing programs to return people to their original health and function
to prevent long term problems
Levels of Prevention :

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2. Secondary prevention
Examples include
 Regular exams and screening test to detect disease in its earliest stages (e.g.
mammograms to detect breast cancer , human immunodeficiency virus testing,
blood pressure and cholesterol testing)
 screening for high blood pressure and breast self-examination. Screenings,
mammograms, family counseling.
 Daily, low dose aspirins and or diet and exercise programs to prevent further
heart attacks or strokes
Levels of Prevention:

16. 3. Tertiary prevention
Aim to soften the impact of an ongoing illness or injury that has lasting effects
This is done by helping people manage long term,
often complex health problems and injuries ( e.g. chronic diseases , permanent
impairments ) in order to improve as much as possible their ability to function ,
to expectancy to prevent complications of the illness , including death of the
patient
Examples include
 Disability limitation (prevention of delayed consequences , treatment
and prevention of complication)
 Rehabilitation (physical , mental , social and occupational) 16
Levels of Prevention :

17. Health Team Members:
Patient needs are multifaceted, complex, and require a multitude of people
from a variety of health- care disciplines with specific expertise to assist
patients to meet these needs. Nurses must know the members of the health
team and the services they provide to perform the role of coordinator
effectively. Although the nurse is the coordinator of the health team, the patient
is the center of the health team
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A. The Patient.
 The patient is the center of the health team.
 All members of the health team lend their expertise to assist the patient in
meeting health-care goals.

18. B . Nurse.
A nurse is a caregiver for patients and helps to manage physical needs, prevent
illness, and treat health conditions.
 The role of the nurse varies with the need of the situation. Nursing skills
should include:
1. Nurse administrators.
2. Clinical nurse specialist (CNS).
3. Registered nurse (RN).
4. Unlicensed assistive personnel (UAP).
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19. 1. Nurse administrators.
a. Establish and manage achievement of organizational goals, particularly
those of the department of nursing and other related agency departments.
b. Examples ; nursing supervisor, and nurse manager.
2. Clinical nurse specialist (CNS).
a. Functions as a resource to nurses caring for patients with complex nursing
needs.
b. Requires advanced education in a specific field.
c. Examples include infection control nurse, and medical-surgical nurse
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20. 3. Registered nurse (RN).
a. Coordinates services provided by members of the health-care team.
b. Provides direct nursing care.
c. Supervises unlicensed nursing personnel.
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4. Unlicensed assistive personnel (UAP).
A. Provides direct nursing care delegated by an RN.
B. Performs activities generally related to assisting patients with activities of
daily living and providing noncomplex tasks.

21. C. Other Professional Team Members:
1. Physician
A person who is licensed to practice medicine. Responsible for diagnosis of
illness & medical or surgical treatment. prescribing medications.
interpreting the results of laboratory & diagnostic test. performing procedure &
surgery
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2. Physical therapist or physiotherapist (PT).
Seeks to restore function or prevent further disability in patient after injury or illness.
PTs use various techniques to treat patients, including: Massage, Heat, Cold, Water,
Sonar waves, exercise & electrical stimulation.

22. 3. Respiratory therapist (RT).
(RT) is trained in techniques that improve pulmonary (lung) function &
oxygenation & administering a variety of tests that measure lung function &
educating the patient.
4.Occupational therapist (OT).
OT assist physically challenged patients to adapt to limitations. OTs a variety
of adaptive device & strategies to aid patient in carrying out the activities of
daily living.
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23. 5. Speech therapist (ST).
(ST) is trained to help hearing impaired patient speak more clearly, and to assist patients who
have had a stroke to relearn how to speak,
& to correct or modify a variety of speech disturbances in children & adults. Also diagnosed &
treated swallowing problems in patients who have head injury or stroke.
6.Dietitian.
Registered dietitian (RD) manages & plans for dietary needs of patients based on knowledge
about aspect of nutrition & supervise the dietary services of an entire facility.
7. Pharmacist is licensed to formulate and dispense medication.
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24. 8. A social worker counsels patient & family members,
social worker are involved in many activities such as counseling, reporting suspected drug
addiction or abuse, placing patient in long-term care.
9. Unlicensed assistive personnel (UAPs).
LAPS help nurses provide direct care to patient; UAPS may have the title of certified nursing
assistants, orderlies, attendant, or technicians.
10. Paramedical technology.
Paramedical means having some connection with medicine and include the following:
Laboratory technology. Radiologic technology . Nuclear technology.
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