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Diagram to Illustrate Roles of Nurses and AP

At Different Points of Client Competence/Self Care Continuum

A Visual Model of the Continuum of Care Table

The above diagram provides a visual model of the Continuum of Care table that describes the roles of the licensed nurse and assistive personnel (AP) based on variances in client need. The axis for this diagram reflect client competency and client self-care status.

The original concept for the categories of the licensed nurse's roles shown in this diagram is based on Dorothea Orem's nursing system theory. The task force began with her supportive-educative, partially compensatory and wholly compensatory systems, then further defined nursing education and support to include a consultation role. Reflecting today's health care environment of integrated health care and multiple settings for health care, the partially compensatory system is called care coordination. Wholly compensatory care is called total care management, and would be provided for those clients unable to control their movement and position, have greatly diminished response to stimuli and who are incompetent to make care decision.

Assistive personnel (AP) may be used across the continuum of care. The AP role is represented by a triangle outlined by a heavy dark line and falls within the nurse's role. The vertical heavy dark line that bisects the AP role delineates those care situations which are client directed from those where the activities must be delegated by the nurse. The purpose of developing this diagram was to assist in identifying those situations when a client can effectively self-direct care activities, and to distinguish from those where nurse delegation is needed.

Revised April 1998