Function maintenance
Functional care or functional care system describes an activity-oriented procedure within the work organization of sick and elderly care , in which the care measure structures the work process within a care unit, for example a ward. The essential principle of functional maintenance is the fragmentation of complex nursing tasks into individual activities that are assigned to individual nursing staff .
This care system is in contrast to the holistic approach of the process-oriented way of working in reference care .
Activity orientation
In functional care , certain basic or treatment-related individual activities are carried out one after the other on all patients or residents or within a certain group. The focus is on the function. Examples of this are insulin injections that are given by a nurse to all patients or residents who need the drug, one at a time; or making all the beds, while the individual needs of the person being cared for, who in this example may not want to get up until later, is subordinated to the organizational structure.
advantages
The advantages of functional maintenance lie in the routine, a clear hierarchical structure and the unambiguous assignability of the contact person for the person in need of care , since only the ward management or the shift management has a different task than the nursing staff.
This goes hand in hand with the lowering of the necessary individual qualifications of the carers. In this way, even less qualified employees can be better deployed, as individual activities of different degrees of difficulty can be assigned to them. Familiarization times for nurses, auxiliary staff and trainees are shorter because instruction and knowledge can be imparted more quickly. A smaller proportion of specialist nursing staff is required for functional nursing, since the treatment nursing tasks can be assigned to them in isolation, which is why it is more cost-effective compared to reference nursing.
Another advantage - in terms of psychological relief for the individual employee - can be the less intensive dialogue with the person in need of care; especially in areas in which the psychological stress is very high, for example in the care of the seriously ill.
disadvantage
For the patient or the resident, it can be difficult to adapt to the daily structure of the care, constantly changing caregivers make it difficult to personal contact and to establish a trusting relationship with the carer.
The coordination effort is high and the documentation and the planning of individual activities sometimes have to take place several times. This leads to an additional burden on the station or shift lines due to a lack of support for the increased effort involved in coordination. In addition, the functional maintenance interrupts the process cycle of care planning , care implementation and evaluation with unchanged order management and makes care documentation as well as the flow of information and a comprehensive understanding of the care staff for the care process more difficult.
In particular, the fact that the nursing staff is under-challenged by uniform activities, the lack of opportunities to apply the complex knowledge they have learned and the restriction of the individual's scope for decision-making and action reduce the experience of individual performance. The time required for functional maintenance is often higher than for reference nursing, since travel times and process-related waiting times also increase.
literature
- Michael Ammende: Handbook for ward and function management: New challenges as opportunities for practice. Georg Thieme Verlag, 2003, pages 149–150, ISBN 3131250321
- Michael Brater, Anna Maurus: The Lean Home: Lean Management in Inpatient Elderly Care , Vincentz Network GmbH & Co KG, 1999, pages 86–87, ISBN 3878706111
- Thomas Elkeles, Barbara Bromberger, Hans Mausbach, Klaus-Dieter Thomann: Work organization in nursing: To criticism of functional care , Mabuse-Verl, 1990, ISBN 3925499415
- Liliane Juchli , Ursula Geißner, Edith Kellnhauser , Martina Gümmer, Susanne Schewior-Popp, Franz Sitzmann: Thiemes Pflege , Georg Thieme Verlag, pages 80–81, ISBN 3135000109