A hospital utilizes the functional nursing care delivery system and the client satisfaction scores have been decreasing in each quarter of the past year. The decrease in client satisfaction could be due to the: Select all that apply

Question

1. Fragmentation of the nursing care.
2. Lack of confidence in the caregivers.
3. Lower health care costs.
4. Utilization of advanced practice nurses.
5. Efficiency of the nursing staff.

Answer 1

1. Fragmentation of the nursing care.
2. Lack of confidence in the caregivers.

Rationale:
Fragmentation of the nursing care. Functional nursing is a type of industrial model of efficiency that resembles the assembly-line tasking and fragmentation of tasks among the nursing staff and results in an appearance of lack of accountability and increased frustration. Lack of confidence in the caregivers. Reduced patient satisfaction is linked to fragmented care and results in the lack of confidence in caregivers. Lower health care costs. Facilities choose the functional nursing model in an effort to be efficient and to lower labor costs by hiring lower-paid workers such as unlicensed assistive personnel. Lower health care costs, however, do not usually result in a decrease in client satisfaction. Utilization of advanced practice nurses. Advanced practice nurses are possibly used as health care provider extenders and not in the role of providing coordinated care. This is not usually associated with a decrease in client satisfaction. Efficiency of the nursing staff. Clinical decision making rests with the charge nurse, and the registered nurse is responsible for delegating tasks to personnel in congruence with the state nurse practice act. Efficiency of skill is a desired outcome for management. This is not usually associated with a decrease in client satisfaction.