Care system
A care system describes the planned, systematic and methodical structuring of work processes within professional health and sick care as well as elderly care . The systems are researched in nursing science and are a sub-area of work organization nursing management . With regard to their basic orientation, the care systems can be divided into patient or task-related care systems. The choice of care facility with regard to the form of work organization has a direct effect on the quality of care and the satisfaction of those in need of care and of the caregivers. The decision of a care facility for a certain system is often set out in the care or corporate mission statement.
The term care system is also used in a different understanding in the self-care deficit theory according to Dorothea Orem , the term is occasionally used to describe the individual aspect of care within the health system or the financing of the health system.
Distinguishing features
The different care systems differ in terms of the type of work distribution, the hierarchical structure , the relationships between the nursing staff as well as with regard to the areas of responsibility, the scope for action and the decision-making authority of the individual nursing staff. Depending on the care system, the human image and the understanding of the interaction with the person in need of care can also be a distinguishing feature. The work organization does not follow the principles of nursing philosophy , but is adapted to the structural and personnel requirements.
Basic types
Task-related systems
The system of task or activity-oriented maintenance, known as functional maintenance, includes a strong defragmentation of the maintenance process and a clear hierarchical structure. The care measures are assigned to individual care workers according to their competence and routinely carried out on all those in need of care. Examples of this are the continuous bed making in all rooms or the administration of insulin to all diabetics in a ward at a certain time by a nurse.
Patient-centered systems
Reference care
In the area of so-called primary care , a group of people in need of care is assigned a constant caregiver. The allocation can be based on spatial or care-relevant criteria. All patient-oriented systems are based on a holistic view of man.
- Area care: Assignment to a carer based on spatial conditions
- Room Care: assignment is based on the room or apartment, can also be a form of individual maintenance denote
- Group care: Allocation takes place on the basis of care-relevant criteria, for example the care level or an illness
Primary nursing
The primary nursing care system developed in the United States of America goes beyond the European understanding of primary nursing , even if these terms are often equated in translations. One nurse, the primary nurse , is fully responsible for all nursing processes around the clock and plans the entire care . The responsible nurse is supported by an assistant nurse , the associate nurse , who, however, has no room for maneuver or decision-making powers of her own.
Individual care
The care system assigns a person in need of care around the clock to a carer who originally lived with the person being cared for. In addition to the associated restrictions in the privacy of the person concerned, the high costs have meant that this care system is only still used in individual cases, for example in outpatient intensive care. Occasionally, inpatient room care is also referred to as individual care, provided that the caregiver does not leave the person in need of care within their working hours.
A special form of individual care is the seat guard , which is used for seriously ill, dying or psychiatric patients.
Mixed systems
Mixed systems are used in many hospitals and care facilities. This is usually based on a patient-oriented model. Often, activities remote from the patient are functionalized, for example the ordering of care products is assigned to a specific nurse, while near-patient basic and treatment care measures are carried out according to the principles of a reference system.
literature
- Susanne Schewior-Popp et al .: Thiemes Pflege: the textbook for nurses in training. Stuttgart 2012
- Marie Manthey: Primary nursing: a personal care system. Bern 2011
- Uwe K. Preusker: The German care system in 100 key words. Heidelberg 2012