Mary Jane Garlejo

Method of assignment: Team Nursing

Team nursing

• a decentralized system in which the care of a patient is distributed among

the members of a group working in coordinated effort. The charge nurse
delegates authority to a team leader who must be a professional nurse.
This nurse leads the team-usually of 4 to 6 members-in the care of
between 15 and 25 patients. The team leader assigns tasks, schedules care,
and instructs team members in details of care. A conference is held at the
beginning and end of each shift to allow team members to exchange
information and the team leader to make changes in the nursing care plan
for any patient.
•
• is based on philosophy in which groups of professional and non-
professional personnel work together to identify, plan, implement and
evaluate comprehensive client-centered care. The key concept is a group
that works together toward a common goal, providing qualitative
comprehensive nursing care.

Objective of team nursing:

The objective of team nursing is to give the best possible quality of patient care
by utilizing the abilities of every member of the staff to the fullest extent and by
providing close supervision both of patient care and of the individual who give it.

Line of organization of team nursing

A clear line of organization structure is needed for team nursing to provide a

mechanism for horizontal and vertical communication, and an organized pattern is
employed.

Functioning of team nursing

The two important points of functioning are:

The head nurse must know at all times the condition of the patients and the plan
for their care and must be assured that assignments and workmanship contribute
to quality nursing
The team leader must have freedom to use her initiative and the opportunity to
nurse, supervise, and teach unencumbered by the responsibility for administrative
detail.

Functions of RN

• In the team nursing RN functions as a team leader and coordinates the

small group (no more than four or five) of ancillary personnel to provide
care to a small group of patients.
• As coordinator of the team, the RN must know the condition and needs of
all patients assigned to the team and plan for the individualized care for
each patient.
• The team leader is also responsible for encouraging a cooperative
environment and maintaining clear communication among all team
members.
 • The team leader’s duties include planning care, assigning duties, directing
and assisting team members, giving direct patient care, teaching and
coordinating patient activities.
• The team leader assigns each member specific responsibilities dependent
on the role.
• The members of the team report directly to the team leader, who then
reports to the charge nurse or unit manager.

Communication is enhanced through the use of written patient assignments, the

development of nursing care plans, and the use of regularly scheduled team
conferences to discuss the patient status and formulate revisions to the plan of
care.
However, for team nursing to succeed, the team leader must have strong clinical
skills, good communication skills, delegation ability, decision-making ability, and
the ability to create a cooperative working environment.

Channels of communication in team nursing

• Reports
• Work or assignment conference
• Patient care conference
• Written nursing care plan

The greatest single distinguishing feature of team nursing is the team conference.
In general, there are three parts to the conference;
• Report by each team member on her patients.
• Planning for new patients and changing plans as needed for others.
• Planning the next day’s assessment.

It is essential that the conference be well planned, brief but comprehensive and
interesting. The team leader is the chair person for the conference. They offer
opportunity for all personnel to evaluate patient care and solve the problems
through team discussion.

Advantages:
1. High quality comprehensive care can be provided despite a relatively high
proportion of ancillary staff.
2. Each member of the team is able to participate in decision making and
problem solving.
3. Each team member is able to contribute his or her own special expertise or
skills in caring for the patient.
4. Improved patient satisfaction.
5. Organizational decision making occurring at the lower level.
6. Cost-effective system because it works with expected ratio of unlicensed
to licensed personnel.
7. Team nursing is an effective method of patient care delivery and has been
used in most inpatient and outpatient health care settings.

Other advantages:
1. Feeling of participation and belonging are facilitated with team members.
2. Work load can be balanced and shared.
3. Division of labor allows members the opportunity to develop leadership
skills.
4. Every team member has the opportunity to learn from and teach
colleagues
5. There is a variety in the daily assignment.
 6. Interest in client’s wellbeing and care is shared by several people,
reliability of decisions is increased.
7. Nursing care hours are usually cost effective.
8. The client is able to identify personnel who are responsible for his care.
9. Continuity of care is facilitated, especially if teams are constant.
10. Barriers between professional and non-professional workers can be
minimised, the group efforts prevail.
11. Everyone has the opportunity to contribute to the care plan.

Disadvantages:
1. Establishing a team concept takes time, effort and constancy of personnel.
Merely assigning people to a group does not make them a ‘group’ or
‘team’.
2. Unstable staffing pattern make team nursing difficult.
3. All personnel must be client centered.
4. There is less individual responsibility and independence regarding nursing
functions.
5. Continuity of care may suffer if the daily team assignments vary and the
patient is confronted with many different caregivers.
6. The team leader may not have the leadership skills required to effectively
direct the team and create a “team spirit”.
7. Insufficient time for care planning and communication may lead to unclear
goals. Therefore responsibilities and care may become fragmented.

Modifications: In an attempt to overcome some of its disadvantages, the team

nursing design has been modified many times since its original inception, and
variations of the model are evident in other methods of nursing care delivery such,
as modular nursing.
Head Nurse: Mary Jane Garlejo Team Nursing
Date: January 15,2011

PLAN OF ACTIVITIES
TIME: ACTIVITIES:

3:00-3:30 - Endorsement
-Delegation of patients to student staff nurses

3:30-4:00 - Nurse-Patient Interaction (NPI)

- Initial Vital Signs taking
- Chart browsing
- Prescribing ordered meds in the prescription
pad
- Bedside care
- Check availability of drugs/ IVF
- Check for IVF patency
- V/S, TPR plotting
- Preparation of 4 pm meds

4:00-4:30 - Chart reading

- Administration of 4pm meds

4:30-5:30 - Assess patient

- Chart reading
- Bedside conference prior to administration of
Meds (Drug study)
- Checking of laboratory orders
- Follow up & secure lab orders
- carrying out of doctor’s order
- Kardex update

5:00-5:30 - Transcribing meds

- Preparation of 6pm meds

5:30-6:30 - NPI
- Interpret laboratory results
- Sample charting
- Sample drug computation

6:30-7:30 - Break
- Checking of sample charting
- Nursing rounds

7:30-8:00 - Preparation of 8pm meds

8:00-8:30 - Administration of 8pm meds

- Bedside conference prior to administration of
Meds (Drug study)
- Check for IVF patency

8:30-9:00 - Charting

9:00-9:30 - Student staff nurse to student head nurse

Endorsement
9:30-10:00 - Student head nurse to nurse on duty
Endorsement
10:00-10:30 - Student staff nurse to incoming student staff
Nurse
- Student head nurse to incoming student head nurse

10:30-11:00 - Post conference

- Sign out