Changing model of nursing care from individual patient allocation to team nursing in the acute inpatient environment
Greg Fairbrother
Research and Clinical Policy, Prince of Wales Hospital; Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney NSW
Aaron Jones
Nursing Executive Officer, Royal Prince Alfred Hospital, Sydney NSW
Ketty Rivas
Quality Manager, Prince of Wales Hospital, Sydney NSW
PP: 202 - 220
Abstract
Agreement was reached with 12 acute medical and surgical wards/units at Sydney's Prince of Wales Hospital to participate in a trial of team nursing (TN). Six units employed action research principles to undertake a change to a team nursing model and six remained with the pre-existing individual patient allocation (IPA) model.
Task-based teaming was widely discarded by the team nursing units in favour of allocating patients within the team and introducing more supportive and communicative processes aimed at fostering responsibility sharing. Localised team-based models of care arose in the change wards and were outlined, implemented and refined using social action research principles.
A 12-month prospective experimental comparison of job satisfaction and staff retention between the TN and IPA groups indicated statistically significant job satisfaction benefits and practically important staff retention benefits associated with moving away from an IPA model of nursing care delivery towards a team-based model of care delivery. Perhaps not surprisingly, job satisfaction gains were most marked among new graduate nurses, who reported real benefits from a teaming inspired shift in model of care in the acute inpatient environment.
Keywords
models of care; nursing; acute care; team nursing; nursing models; job satisfaction; nurse retention
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