Patient care delivery model improves nurse job satisfaction.
ABSTRACT Nurse job satisfaction was identified as an outcome measure for a project to develop and implement a patient care delivery model in an acute psychiatric setting.
Seventy registered nurses were surveyed during 3 years, utilizing the Index of Work Satisfaction.
Nurse job satisfaction has improved significantly (14%) since model development began. Analysis of variance showed significant (p < .05) increases in all component mean scores in the second and third surveys.
The relationship-based nursing model empowers nurses who know the patient best to decide how to provide care. It affirms the values that are the foundation of nursing practice, creating an environment where nurses feel they make a difference.
SourceAvailable from: Ruth Hansten
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ABSTRACT: Objective This review investigated the effect of the various models of nursing care delivery using the diverse levels of nurses on patient and nursing outcomes. Methods All published studies that investigated patient and nursing outcomes were considered. Studies were included if the nursing delivery models only included nurses with varying skill levels. A literature search was performed using the following databases: Medline (1985-2011), CINAHL (1985-2011), EMBASE (1985 to current) and the Cochrane Controlled Studies Register (Issue 3, 2011 of Cochrane Library). In addition, the reference lists of relevant studies and conference proceedings were also scrutinised. Two reviewers independently assessed the eligibility of the studies for inclusion in the review, the methodological quality and extracted details of eligible studies. Data were analysed using the RevMan software (Nordic Cochrane Centre, Copenhagen, Denmark). Results Fourteen studies were included in this review. The results reveal that implementation of the team nursing model of care resulted in significantly decreased incidence of medication errors and adverse intravenous outcomes, as well as lower pain scores among patients; however, there was no effect of this model of care on the incidence of falls. Wards that used a hybrid model demonstrated significant improvement in quality of patient care, but no difference in incidence of pressure areas or infection rates. There were no significant differences in nursing outcomes relating to role clarity, job satisfaction and nurse absenteeism rates between any of the models of care. Conclusions Based on the available evidence, a predominance of team nursing within the comparisons is suggestive of its popularity. Patient outcomes, nurse satisfaction, absenteeism and role clarity/confusion did not differ across model comparisons. Little benefit was found within primary nursing comparisons and the cost effectiveness of team nursing over other models remains debatable. Nonetheless, team nursing does present a better model for inexperienced staff to develop, a key aspect in units where skill mix or experience is diverse.International Journal of Evidence-Based Healthcare 12/2012; 10(4):324-337. DOI:10.1111/j.1744-1609.2012.00287.x
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ABSTRACT: To examine nurses' perceptions of job satisfaction, empowerment, and care effectiveness following a change from team to a modified total patient care (TPC) delivery model. Empirical data related to TPC is limited and inconclusive. Similarly, evidence demonstrating nurses' experience with change and restructuring is limited. A mixed method, longitudinal, descriptive design was used. Registered nurses and licenced practical nurses in two acute-care nursing units completed quantitative and qualitative surveys. Lewin's change theory provided the framework for the study. No significant change in job satisfaction was observed; however, it was less than optimal at all three time-periods. Nurses were committed to their jobs but relatively dissatisfied with their input into the goals and processes of the organization. Client care was perceived to be more effective under TPC. Job satisfaction remained consistent following the transition to TPC. However, nurses perceived that client care within the modified TPC model was more effective than in the previous model. Nursing administration must work collaboratively with nurses to improve processes in nursing practice that could enhance nurses' job satisfaction and improve client care delivery.Journal of Nursing Management 09/2011; 19(6):777-85. DOI:10.1111/j.1365-2834.2011.01292.x · 1.14 Impact Factor