What is the effect of implementation of primary nursing on patient satisfaction and nurse satisfaction.

摘要

Background. The patient care delivery system or modality used by a hospital is the organizing structure for the provision of care to patients and families. Historically, decisions about patient care delivery have been based on economic and technological changes in society.;Purpose. The specific aims of this study were to compare patient satisfaction and nurse job satisfaction pre- and post- implementation of primary nursing.;Method. The study had a quasi-experimental, pre-post test design using an in-patient oncology unit at a large university medical center. Instruments included a patient satisfaction questionnaire, a patient questionnaire that audits pain management, a nurse job satisfaction questionnaire, a nurse short answer primary nursing questionnaire and a demographic form for nurses. The pre-implementation data were collected just prior to implementation of primary nursing as a part of a study comparing knowledge and care of nurses with specialty certification to nurses without specialty certification. After informed consent was obtained, the P.I. and trained research assistants collected post- implementation data from nurses and patients. Descriptive statistics were used to describe the sample and data distributions. Analysis of group differences was done using independent samples t-tests to examine the relationship between Primary Nursing Care and Patient-Focused Care; and patient satisfaction and nurse job satisfaction.;Results. There was not a statistically significant difference, at the 0.05 level, between Nurse Satisfaction before implementation of primary nursing and four months into the implementation process (t (51) = -.173, p = 0.863). However, the nurse responses on the questionnaires were mostly positive and supportive. Overall, patients were more satisfied after primary nursing was implemented than they were before implementation. There was a statistically significant difference, at the 0.05 level in four of the five measures.;Conclusions. Further study is needed in order to investigate the hypothesis that primary nursing contributes to increased nurse job satisfaction. Patient satisfaction with care in general increases when they are cared for by a primary nurse. Patient satisfaction with pain management as well as knowledge related to pain management may be improved when primary nursing is practiced. It is important to make evidence based decisions about patient care delivery.