BACKGROUND: The Synergy Model describes nurses' work on the basis of the individual needs of patients and their families. OBJECTIVE: To generate data necessary to develop a nursing productivity system by using the Synergy Model as a conceptual framework. METHODS: Nurses from 3 different intensive care units participated. In phase 1, charge nurses in focus groups described patient and family indicators considered when making nurse-patient assignments. In phase 2, charge nurse data were used to construct a survey for experienced staff nurses, asking them to link the indicators to 3 levels of nursing workload. RESULTS: Thirty charge nurses considered all 8 patient dimensions of the Synergy Model when making nurse-patient assignments. Thirty-two experienced staff nurses completed 79 surveys ranking patients' stability as the most important dimension in patient care followed by complexity and predictability. Respondents linked a common set of unique indicators to each of the patient dimensions of the Synergy Model: fluctuation in vital signs was linked to stability; number and severity of diagnoses, to complexity; trajectory of illness, to predictability; lack of reserve, to resiliency; invasiveness of procedures, to vulnerability; family educational level and participation style, to family participation in decision making/care; and home environment, to resources. Sets of indicators were common across units and clustered around level of workload. CONCLUSION: The Synergy Model shows promise as a conceptual framework for a nursing productivity system. Using a model that centers nursing work on patients' needs may better capture what nurses do and enhance our capacity to quantify nursing resource allocation.
BACKGROUND: The Synergy Model describes nurses' work on the basis of the individual needs of patients and their families. OBJECTIVE: To generate data necessary to develop a nursing productivity system by using the Synergy Model as a conceptual framework. METHODS: Nurses from 3 different intensive care units participated. In phase 1, charge nurses in focus groups described patient and family indicators considered when making nurse-patient assignments. In phase 2, charge nurse data were used to construct a survey for experienced staff nurses, asking them to link the indicators to 3 levels of nursing workload. RESULTS: Thirty charge nurses considered all 8 patient dimensions of the Synergy Model when making nurse-patient assignments. Thirty-two experienced staff nurses completed 79 surveys ranking patients' stability as the most important dimension in patient care followed by complexity and predictability. Respondents linked a common set of unique indicators to each of the patient dimensions of the Synergy Model: fluctuation in vital signs was linked to stability; number and severity of diagnoses, to complexity; trajectory of illness, to predictability; lack of reserve, to resiliency; invasiveness of procedures, to vulnerability; family educational level and participation style, to family participation in decision making/care; and home environment, to resources. Sets of indicators were common across units and clustered around level of workload. CONCLUSION: The Synergy Model shows promise as a conceptual framework for a nursing productivity system. Using a model that centers nursing work on patients' needs may better capture what nurses do and enhance our capacity to quantify nursing resource allocation.
Authors: Federica Dellafiore; Rosario Caruso; Tiziana Nania; Francesco Pittella; Tiziana Fiorini; Maria Paola Caruso; Giovanni Zaffino; Alessandro Stievano; Cristina Arrigoni Journal: Int J Environ Res Public Health Date: 2022-05-05 Impact factor: 4.614