Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Nursing School, Biella Hospital, Biella, Italy.
J Clin Nurs. 2018 Mar;27(5-6):1094-1102. doi: 10.1111/jocn.14135. Epub 2018 Jan 17.
To explore the effect of "Primary Nursing" on nursing-sensitive patient outcomes, staff-related outcomes and organisation-related outcomes.
Primary nursing is one example of a care pattern that has recently been implemented in many countries.
Before-after study.
This study was conducted in an Italian hospital. We observed patient-related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of primary nursing and in 3,169 inpatients after its implementation. Staff-related outcomes (nursing competence and diagnostic thinking) and organisation-related outcomes (empowerment and team climate) were collected from 369 nurses. From a subgroup of inpatients, we collected data regarding their satisfaction with the care provided.
After the implementation of primary nursing, some nursing competencies and diagnostic thinking were improved, so were organisation-related outcomes. Our data showed that the number of inpatients with urinary catheter infections (5.5% vs. 4.3%) and venous catheter infections (peripheral: 2.2% vs. 1%; central: 5.6% vs. 1%) was significantly decreased; also, the numbers of falls (2.4% vs. 1.9%) and pressure ulcers (4.8% vs. 4%) decreased, although these decreases were not statistically significant. Overall, the implementation of primary nursing increased patient satisfaction with nursing care (193.57 vs. 210.21).
Primary nursing improved staff-related outcomes, nursing-sensitive patient outcomes and organisation outcomes.
Our results show that primary nursing has the potential to positively impact on inpatients, nurses and organisations. Moreover, the implementation of this care pattern is feasible.
探讨“初级护理”对护理敏感患者结局、与员工相关的结局和与组织相关的结局的影响。
初级护理是最近在许多国家实施的一种护理模式的示例。
前后研究。
本研究在一家意大利医院进行。我们观察了 2857 名住院患者在实施初级护理前和 3169 名住院患者在实施初级护理后的患者相关结局（压疮、跌倒、尿路感染和静脉导管感染）。从 369 名护士中收集了与员工相关的结局（护理能力和诊断思维）和与组织相关的结局（赋权和团队氛围）的数据。从住院患者的一个亚组中收集了他们对所提供护理的满意度的数据。
实施初级护理后，一些护理能力和诊断思维得到了改善，与组织相关的结果也是如此。我们的数据显示，尿路感染（5.5%对 4.3%）和静脉导管感染（外周：2.2%对 1%；中心：5.6%对 1%）的住院患者数量显著减少；跌倒（2.4%对 1.9%）和压疮（4.8%对 4%）的数量也有所减少，尽管这些减少没有统计学意义。总的来说，实施初级护理提高了患者对护理的满意度（193.57 对 210.21）。
初级护理改善了与员工相关的结果、护理敏感的患者结局和组织结果。
我们的结果表明，初级护理有可能对住院患者、护士和组织产生积极影响。此外，这种护理模式的实施是可行的。
