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The impact of primary and modular nursing delivery systems on perceptions of caring behavior
A K Carruth1, S Steele, B Moffett
1School of Nursing, Southeastern Louisiana University, Hammond, LA., USA.
Purpose/Objectives:
To determine if differences existed in patients' and family members' perceptions of caring behaviors after the transition from a primary to a modular care delivery system.
Design:
Descriptive, comparative, and correlational.
Setting:
Urban, inpatient, acute-care hospital.
Sample:
A convenience sample of 42 patients with cancer hospitalized for chemotherapy administration or complications arising from their diagnoses and 27 of their family members. Ninety-four data sets were collected--62 from the patients and 32 from the family members.
Methods:
Subjects were asked to evaluate their nurse's caring attributes using the Caring Perception index. Caring scores of patients receiving primary nursing care were compared to caring scores of patients receiving modular nursing care.
Main Research Variable:
Patients' and family members' perception of caring.
Findings:
Mean caring scores did not differ significantly between patients receiving primary care (mean = 35.9, SD = 5.4) and patients receiving modular care (mean = 36.2, SD = 5.3). Patient and nursing delivery characteristics were used to predict and explain variance in the dependent variable care. Number of days hospitalized accounted for 14% of the variance, with those patients hospitalized longer rating nurses as more caring.
Conclusions:
The longer a patient stays in the hospital, the greater the likelihood the patient and family members will feel nurses exceeded exceptions for caring. The findings support other studies that have compared quality care indicators across different types of delivery systems.
Implications For Nursing Practice:
Measures to evaluate quality care should be used when transitioning to new delivery models. Nurses need to recognize that not all patients value the same nurse qualities equally. When receiving care over an extended period of time from same nurse, patients and family members are more likely to rate the nurse as exceeding expectations.