Nursing teamwork and unit size

Area of Science:

• Healthcare Management
• Nursing Science
• Organizational Psychology

Background:

• Effective teamwork is crucial for quality patient care and nursing staff well-being.
• The impact of nursing unit size on teamwork dynamics remains an area requiring further investigation.
• Understanding these relationships can inform strategies for improving healthcare delivery.

Purpose of the Study:

• To examine the correlation between nursing unit size and the level of nursing teamwork.
• To identify specific components of unit size that influence overall teamwork and its subscales.
• To provide evidence-based recommendations for optimizing nursing team structures.

Main Methods:

• A quantitative study involving 2,265 direct care nursing providers across 53 units in four hospitals.
• Pearson correlation coefficients were used to analyze relationships between unit size variables and teamwork metrics.
• Unit size was measured by average daily census, number of registered nurses, number of nursing assistants, and total staff.

Main Results:

• A significant negative correlation was observed between overall nursing teamwork and both the number of nursing assistants and the average daily census.
• No significant correlations were found between teamwork and the number of registered nurses or total staff.
• Specific teamwork subscales (trust, team orientation, backup, shared mental model, leadership) were not significantly correlated with unit size variables.

Conclusions:

• Increasing the number of nursing assistants and higher patient census are associated with diminished nursing teamwork.
• Strategies aimed at optimizing nursing unit teamwork should prioritize reducing team size and potentially caseloads.
• Further research could explore interventions to mitigate the negative effects of larger unit sizes on teamwork.