It is obvious from any study concerning the nursing profession that it is, as a whole, drastically different than 50 years ago and one can only imagine what it will have evolved to in another 50 years. Through the centuries, nursing has taken on a variety of themes and definitions. Included in these are the thoughts that nursing is caring, adaptive, individualized, holistic, and also interrelated with family and community. There are theories that indicate that it involves not only teaching but services, both direct and indirect and also evidence that nursing is a science, as well as an art, concerned with health promotion, maintenance, restorations, and care of the dying (Kozier, Erb, Olivieri, 1991). Regardless of how one defines nursing, it is certain that nursing encompasses a vast body of knowledge and requires a great deal of competency and skill. It is also a demanding profession that involves a high level of interaction. Throughout this interaction, nurses must b!
             e conscious of factors that influence not only the well being of their patient, but also the well-being of others and how their care plays a role in the 'big picture' surrounding their profession (Kozier, Erb, Olivieri, 1991).
             It is reasonable that the most efficient ways to keep a clear focus on all of these factors is through continuous quality improvement efforts. There are many divisions that would be important areas of concentration for quality efforts but in order to keep a handle on the practice of nursing, one of the most logical applications is the actual delivery of nursing care. As with definitions of nursing, delivery has also evolved through the years. The result is a variety of models, some of which seem to be more popular and some would argue, more effective, than others (Kozier, Erb, Olivieri, 1991). The key to successful delivery is finding a model that matches both caregiver and patient needs to local constraints. Therefore, as the au...