How unit level nursing responsibilities are structured in US hospitals.

Minnick AF, Mion LC, Johnson ME, Catrambone C
J Nurs Adm. 2007 37 (10): 452-8

PMID: 17914292 · DOI:10.1097/01.NNA.0000285147.87612.96

OBJECTIVES - To describe (1) the extent to which acute and intensive care units use the elements of nursing models (team, functional, primary, total patient care, patient-focused care, case management) and (2) the deployment of non-unit-based personnel resources.

BACKGROUND - The lack of current data-based behavioral descriptions of the extent to which elements of nursing models are implemented makes it difficult to determine how work models may influence outcomes.

METHODS - Nurse managers of 56 intensive care units and 80 acute care adult units from 40 randomly selected US hospitals participated in a structured interview regarding (1) day-shift use of patient assignment behaviors associated with nursing models and (2) the availability and consistency of assignment of non-unit-based support personnel.

RESULTS - No model was implemented fully. Almost all intensive care units reported similar assignment behaviors except in the consistency of patient assignment. Non-intensive care units demonstrated wide variation in assignment patterns. Patterns differed intra-institutionally. There were large differences in the availability and deployment of non-unit-based supportive resources.

CONCLUSIONS - Administrators must recognize the differences in work models within their institutions as a part of any quality improvement effort. Attempts to test new work models must be rigorous in the measurement of their implementation.

MeSH Terms (23)

Case Management Delegation, Professional Hospital Units Humans Intensive Care Units Models, Nursing Nurse's Role Nurse Administrators Nursing, Practical Nursing, Team Nursing Administration Research Nursing Assistants Nursing Staff, Hospital Outcome Assessment (Health Care) Patient-Centered Care Personnel Staffing and Scheduling Philosophy, Nursing Primary Nursing Professional Autonomy Surveys and Questionnaires Total Quality Management United States Workload

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