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The aim of this study was to determine the effects of the primary nursing model on nurse and patient outcomes. In the study, primary nursing education was provided to the nurses in the experimental group, and the primary nursing model was implemented in the clinics where they worked. Evaluations were conducted with nurses and patients before the implementation and at the third and sixth months after the implementation.
The study aimed to evaluate the effects of the primary nursing model on missed nursing care, nurses' job satisfaction, nurses' roles and competencies, and patient satisfaction with nursing care.
Hypotheses of the study:
H1-1: There is a significant difference between the evaluations of nurses in the experimental group regarding missed nursing care before the primary nursing implementation and at the 3rd and 6th months after the implementation.
H1-2: There is a significant difference between the job satisfaction evaluations of nurses in the experimental group before the implementation and at the 3rd and 6th months after the implementation.
H1-3: There is a significant difference between the role and competency evaluations of nurses in the experimental group before the implementation and at the 3rd and 6th months after the implementation.
H1-4: There is a significant difference between the evaluations of patients receiving care from nurses in the experimental group regarding missed nursing care before the implementation and at the 3rd and 6th months after the implementation.
H1-5: There is a significant difference between the evaluations of patients receiving care from nurses in the experimental group regarding satisfaction with nursing care before the implementation and at the 3rd and 6th months after the implementation.
Nursing care services constitute one of the fundamental components of health services. Organizing nursing care effectively in hospitals and ensuring continuous care for patients are essential responsibilities of nursing management. Nursing care delivery methods provide a framework for organizing and assigning nursing responsibilities in clinical settings. These methods are closely related to organizational philosophy, nursing management approaches, available resources, and the structure of healthcare services.
Various nursing care delivery models have been developed over time to improve the quality and continuity of nursing care. Traditional nursing care delivery models include total patient care, functional nursing, team nursing, and primary nursing. Among these approaches, the primary nursing model emphasizes accountability, continuity of care, and professional autonomy of nurses.
The primary nursing model assigns a primary nurse to each patient, who is responsible for planning, coordinating, and evaluating the patient's care throughout the hospitalization period. This model promotes continuity of care, improves communication within the healthcare team, and supports nurses' professional autonomy and responsibility. Previous studies have suggested that the primary nursing model may improve nurse-related outcomes such as job satisfaction, role clarity, and professional competence, as well as patient-related outcomes such as satisfaction with nursing care and reduced missed nursing care.
Despite the potential benefits of the primary nursing model, there are limited studies examining its effects in clinical settings, particularly in national healthcare systems. Therefore, evaluating the impact of this nursing care delivery model is important for improving nursing care quality and organizational outcomes.
This study examined the effects of implementing the primary nursing model on nurse and patient outcomes using a quasi-experimental research design. The primary nursing model was implemented in the experimental group units, while the control group continued with the existing nursing care delivery method. Data were collected from nurses and patients before the implementation and at the third and sixth months after the implementation. The study evaluated the effects of the primary nursing model on missed nursing care, nurses' job satisfaction, nurses' roles and competencies, and patient satisfaction with nursing care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group nurses | Experimental | Nurses in the experimental group will receive training on the primary nursing care delivery model and will implement the primary nursing method in their clinical units during the study period. |
|
| Usual Nursing Care | No Intervention | Nurses in the control group will continue providing care using the existing nursing care delivery method without implementation of the primary nursing model. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Primary Nursing Care Delivery Model | Behavioral | Nurses in the experimental group will receive education on the primary nursing care delivery model. Following the training, the primary nursing method will be implemented in the participating clinical units for six months. |
| Measure | Description | Time Frame |
|---|---|---|
| Missed Nursing Care measured by the MISSCARE Survey | Missed nursing care will be assessed among nurses working in the intervention and control units using the MISSCARE Survey to evaluate the impact of the primary nursing care delivery model. | Baseline, 3 months, and 6 months after implementation |
| Nurse Job Satisfaction measured by the Clinical Nurses Job Satisfaction Scale | Nurse job satisfaction levels will be assessed among nurses working in the intervention and control units using the Clinical Nurses Job Satisfaction Scale. | Baseline, 3 months, and 6 months after implementation |
| Patient Satisfaction with Nursing Care measured by the Newcastle Satisfaction with Nursing Care Scale | Patient satisfaction with nursing care will be assessed among hospitalized patients in the intervention and control units using the Newcastle Satisfaction with Nursing Care Scale. | Baseline, 3 months, and 6 months after implementation |
| Nurse Role and Competency measured by the Nurses' Role and Competency Scale | Nurses' professional roles and competencies will be assessed among nurses working in the intervention and control units using the Nurses' Role and Competency Scale. | Baseline, 3 months, and 6 months after implementation |
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Nurse Participants Inclusion Criteria
Exclusion Criteria
Patient Participants Inclusion Criteria
Exclusion Criteria
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| Name | Affiliation | Role |
|---|---|---|
| Demet Yurtsever, RN, PhD | Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| İstanbul Kanuni Sultan Süleyman Education and Research Hospital | Istanbul | Küçükçekmece | 34303 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D017060 | Patient Satisfaction |
| ID | Term |
|---|---|
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
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In this quasi-experimental study, primary nursing education was provided to nurses in the experimental group and the primary nursing model was implemented in the clinics where they worked. The control group continued with the existing nursing care delivery system. Evaluations were conducted with nurses and patients before the implementation and at the third and sixth months after the implementation.
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