Primary patient care in a chronic outpatient hemodialysis unit

Primary care is defined as a care delivery system in which a registered nurse (RN) has total responsibility and autonomy for the assessment, planning, implementation, evaluation, and outcomes of an assigned group of patients. This method of patient care delivery has been practiced for many years but is not always practiced in chronic outpatient hemodialysis settings. Functional care delivery, in which it is not unusual to have a different assignment each day is practiced in many units. In a functional unit, general care is supervised by the charge nurse and/or nurse manager. The following is an account of the development and outcomes of primary nursing care teams at a chronic outpatient hemodialysis unit at Holy Name Hospital, Teaneck, NJ.