Team or primary nursing care?

This study was undertaken to help nursing administration make policy decisions regarding the initiation of primary care nursing and the need to hire RNS. The work involved an experimental design using 11 units in a 350-bed facility. The results show no significant differences between the two methods regarding quality, cost, job satisfaction, patient satisfaction, or patient education. Moreover, the 16-hour model produces more stress and more sick leave days than team nursing. It is also apparent that apart from salaries, the cost of nursing care is a function of the diagnoses of the patients in the hospital, which may account for some of the inconsistencies found in the literature. If the ratio of RN to non-RN staff had been increased, the results might have been different; however, Giovanetti's comparison study of primary and team nursing, which considered the same factors but used a 70-percent-RN staff, produced similar results. It appears that individual RN's dedication and preparation for patient care may be more important than the method used to organize that care. Research to determine how to select the most appropriate nurse for a specific role would be a more productive approach to assist policy determination in the future.