Effects of a Decentralized Nursing Model on Patient Outcomes in Two Rural Community Hospitals

Area of Science:

• Healthcare Management
• Nursing Practice
• Patient Outcomes

Background:

• Decentralized nursing models are increasingly adopted to improve patient care by placing nurses closer to patients.
• Hypotheses suggest benefits for patient outcomes, yet empirical evidence remains limited.

Purpose of the Study:

• To evaluate the impact of decentralized nursing unit designs on adult inpatient outcomes.
• To compare patient length of stay and satisfaction before and after transitioning from centralized to decentralized models.

Main Methods:

• A pre-post, cross-sectional study design was employed.
• Regression and interrupted time series analyses were used on patient records and satisfaction surveys.
• Data from two rural hospitals before and after a 2015 transition to decentralized nursing units were analyzed.

Main Results:

• Length of stay decreased at one hospital but remained unchanged at the other.
• Patient satisfaction showed mixed changes; improvements in quietness and overall rating at one site, but a decline in prompt assistance at the other.
• Many positive satisfaction trends began before the model change, with no significant post-transition improvement at either hospital.

Conclusions:

• The study yielded mixed results regarding the effectiveness of decentralized nursing models.
• Positive outcomes were observed at one hospital, but not the other, highlighting the influence of factors beyond nursing unit design.
• Further research is needed to identify other critical factors influencing patient outcomes in different hospital settings.