The effect of nursing care delivery models on quality and safety outcomes of care: A cross-sectional survey study of medical-surgical nurses.

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Abstrakt

Tytuł:: The effect of nursing care delivery models on quality and safety outcomes of care: A cross-sectional survey study of medical-surgical nurses.
Autorzy:: Havaei F; School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
MacPhee M; School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
Dahinten VS; School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
Źródło:: Journal of advanced nursing [J Adv Nurs] 2019 Oct; Vol. 75 (10), pp. 2144-2155. Date of Electronic Publication: 2019 Apr 24.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Oxford : Blackwell Scientific Publications
Original Publication: Oxford, Blackwell.
MeSH Terms:: Nursing Care/*statistics & numerical data
Nursing Staff, Hospital/*statistics & numerical data
Patient Safety/*statistics & numerical data
Perioperative Nursing/*statistics & numerical data
Quality of Health Care/*statistics & numerical data
Workload/*statistics & numerical data
Adult ; British Columbia ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Models, Nursing ; Surveys and Questionnaires
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Grant Information:: Collaborative Alliances of Nursing Outcome
Contributed Indexing:: Keywords: mode of care delivery; nurses; nursing care delivery models; quality and safety of patient care delivery; skill-mix; team nursing; total patient care
Local Abstract: [Publisher, Chinese] 目的: 本研究探讨了护理服务模式的两个组成部分,护理服务模式和技能组合对以下方面的影响:(a)护理质量;以及(b)在控制了护士的人口统计、工作环境和工作量因素后,患者发生不良反应。设计: 利用二级数据进行了横断面探索性相关研究。方法: 采用分层多元回归分析了来自不列颠哥伦比亚省医疗-外科机构的416名直接护理注册护士的调查数据。大多研究数据收集自2015年。结果: 在基于团队的模式下工作的护士报告说,与在整体病人护理中工作的护士相比,其还有更多的护理任务没有完成。与没有执照护士的职业技能组合相比,在有执照护士的职业技能组合中工作的护士报告的患者不良事件发生率更高。在较高的敏锐度水平下,以团队为基础的护士报告的患者不良事件发生率高于整体患者护理中的护士。结论: 护理服务提供组成部分、模式和技能组合的模型影响质量和安全结果。在不列颠哥伦比亚省,一些以团队为基础的医疗外科护士没有发挥有效的团队作用。应该使用团队建设策略来加强他们之间的协作。影响: 重新设计护理服务的研究通常一次只关注一个护理服务组件。研究结果可能对护士和患者、护理领导和政策制定者,特别是在不列颠哥伦比亚省的外科医疗环境中产生影响。.
Entry Date(s):: Date Created: 20190319 Date Completed: 20200217 Latest Revision: 20200217
Update Code:: 20240105
DOI:: 10.1111/jan.13997
PMID:: 30883835
: Czasopismo naukowe

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Aims: This study examined the effect of two components of a model of nursing care delivery, the mode of nursing care delivery, and skill-mix on: (a) quality of nursing care; and (b) patient adverse events, after controlling for nurse demographics, work environment, and workload factors.
Design: A cross-sectional exploratory correlational study that drew on secondary data was conducted.
Methods: Survey data from 416 direct care registered nurses from medical-surgical settings across British Columbia were analysed using hierarchical multiple regression. Larger study data were collected in 2015.
Results: Nurses working in a team-based mode reported a greater number of nursing tasks left undone compared with those working in a total patient care. Nurses working in a skill-mix with licensed practical nurses reported a higher frequency of patient adverse events compared with those working in a skill-mix without licensed practical nurses. At higher levels of acuity, nurses in a team-based mode reported a higher frequency of patient adverse events than did nurses in a total patient care.
Conclusion: Models of nursing care delivery components, mode and skill-mix, influenced quality and safety outcomes. Some of the team-based medical-surgical nurses in British Columbia are not functioning as effective teams. Team building strategies should be used to enhance collaboration among them.
Impact: Research into redesigning care delivery has typically focused on only one care delivery component at a time. The study findings could have implications for nurses and patients, nursing leadership and policymakers particularly in medical-surgical settings in British Columbia.
(© 2019 John Wiley & Sons Ltd.)

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