Trialing collaborative nursing Models of Care: the impact of change.

OBJECTIVE The aim of the project was to develop and trial a nursing Model of Care (MoC) and devise a framework to investigate the impact of nursing staff mix on patient outcomes and job satisfaction (nurses). SETTING AND SUBJECTS In 2001-2002 a pilot project was undertaken to explore issues related to the delivery of patient care by nurses on two medical inpatient wards, one acute and one subacute, at a referral teaching hospital in New South Wales (NSW), Australia. The framework employed was an adaptation of, and based on, the Clinical Practice Improvement (CPI) model developed by NSW Health. PRIMARY ARGUMENT Countries across the world are seeking solutions to a shortage of registered nurses and their ability to sustain quality care services. It becomes imperative that organisations develop strategies to attract and retain nurses in the health care system. CONCLUSIONS Results of the project highlighted areas related to the quality of care delivery: clinical supervision; continuity of staffing; trust; employer of choice; more effective nurse to patient ratios; educational preparation; and recognition of prior experience.

[1]  Joanne Ritter-Teitel.  The Impact of Restructuring on Professional Nursing Practice , 2002, The Journal of nursing administration.

[2]  Joanne R Duffy.  Implementing the Quality-Caring Model in acute care. , 2005, The Journal of nursing administration.

[3]  J. P. Burns.  Performance improvement with patient service partners. , 1998, The Journal of nursing administration.

[4]  C Kovner,et al.  Nurse staffing levels and adverse events following surgery in U.S. hospitals. , 1998, Image--the journal of nursing scholarship.

[5]  R. Woodman,et al.  Effects of Team Development Intervention: A Field Experiment , 1980 .

[6]  E. Draper,et al.  Value and cost of teaching hospitals: A prospective, multicenter, inception cohort study , 1993, Critical care medicine.

[7]  Elizabeth A McGlynn,et al.  An observational study of antibiotic prescribing behavior and the Hawthorne effect. , 2002, Health services research.

[8]  Kim Killinger,et al.  The relationship between nurse staffing models and patient outcomes: a descriptive study. , 2002, Outcomes management.

[9]  K. McDonald,et al.  Making health care safer: a critical analysis of patient safety practices. , 2001, Evidence report/technology assessment.

[10]  P H Mitchell,et al.  Adverse outcomes and variations in organization of care delivery. , 1997, Medical care.

[11]  T Fyffe,et al.  Using training needs analysis to implement change. , 1998, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[12]  Joan Shinkus Clark.  An Aging Population With Chronic Disease Compels New Delivery Systems Focused on New Structures and Practices , 2004, Nursing administration quarterly.

[13]  H. Leino‐Kilpi,et al.  Testing the individualized care model. , 2004, Scandinavian journal of caring sciences.

[14]  P. R. Ponte,et al.  Reshaping the Practice Environment: The Importance of Coherence , 2004, The Journal of nursing administration.

[15]  Janice L. Dreachslin,et al.  Key indicators of nursing care team performance: insights from the front line. , 1999, The Health care supervisor.

[16]  A. McCallin,et al.  Interdisciplinary practice--a matter of teamwork: an integrated literature review. , 2001, Journal of clinical nursing.

[17]  A. McQueen.  Nurse–patient relationships and partnership in hospital care , 2000 .

[18]  Diane Doran,et al.  Nurse Staffing Models, Nursing Hours, and Patient Safety Outcomes , 2004, The Journal of nursing administration.

[19]  Lichtig Lk,et al.  Some impacts of nursing on acute care hospital outcomes. , 1999 .

[20]  E. Coakley,et al.  A Reflective Model for Organizational Assessment and Interventions , 2003, The Journal of nursing administration.

[21]  Paul R. Rosenbaum,et al.  Comparing the Contributions of Groups of Predictors: Which Outcomes Vary with Hospital Rather than Patient Characteristics? , 1995 .

[22]  T. Wan,et al.  Contextual and organizational correlates of the quality of hospital nursing care. , 1987, QRB. Quality review bulletin.

[23]  L. Aiken,et al.  Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. , 2002, JAMA.

[24]  E. Curtis,et al.  Resistance to change. Causes and solutions. , 2002, Nursing management.

[25]  K. Hitchings,et al.  A pragmatic approach to measuring and evaluating hospital restructuring efforts. , 1997, The Journal of nursing administration.

[26]  K. Spilsbury,et al.  Defining the nursing contribution to patient outcome: lessons from a review of the literature examining nursing outcomes, skill mix and changing roles. , 2001, Journal of clinical nursing.

[27]  M. Burman,et al.  Advanced Practice Nursing Model for Comprehensive Care With Chronic Illness: Model for Promoting Process Engagement , 2004, ANS. Advances in nursing science.

[28]  J. G. Adair,et al.  The Hawthorne effect: A reconsideration of the methodological artifact. , 1984 .

[29]  Number of nursing staff and falls: a case-control study on falls by stroke patients in acute-care settings. , 1993, Journal of advanced nursing.

[30]  M. Hassan,et al.  Staffing Intensity, Skill Mix and Mortality Outcomes: The Case of Chronic Obstructive Lung Disease , 1999, Health services management research.

[31]  G. Ingersoll,et al.  Nurse-sensitive outcomes of advanced practice. , 2000, Journal of advanced nursing.

[32]  P. Brennan,et al.  Nursing practice models: implications for information system design. , 1998, The Journal of nursing administration.