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.
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.
Keywords:
mode of care delivery; nurses; nursing care delivery models; quality and safety of patient care delivery; skill-mix; team nursing; total patient care
Authors: Ammar Abusamra; Ahmad Hussien Rayan; Rana F Obeidat; Shaher H Hamaideh; Manal Hassan Baqeas; Mohammed ALBashtawy Journal: SAGE Open Nurs Date: 2022-09-01
Authors: Cynthia D Beckett; Inga M Zadvinskis; Jennifer Dean; Jackeline Iseler; Julie M Powell; Betty Buck-Maxwell Journal: Worldviews Evid Based Nurs Date: 2021-08 Impact factor: 2.931