Primary nursing vs. Team nursing (part 2)

Primary nursing has its antecedent in the United States in the 1960s and refers to a model of care where patients are allocated to individual nurses thus fostering strong nurse-patient relationships (Dobson & Tranter, 2008). The patient allocation is based on the nurse’s abilities and the patient’s needs with the allocated nurse assuming responsibility and accountability for the care provided to the patient on a 24-hour bases for the duration the patient stays in the hospital (Tiedeman & Lookinland, 2004). The driving forces for this model of care included the clamour for a patient-centred approach to care provision and the need to return to a model where a registered nurse (RN) could offer direct care to the patient, with increasing complexity of cases requiring care (Tiedeman & Lookinland, 2004).

In team nursing, a concept that evolved in the 1950s, individuals with different skills are assigned to a team charged with caring for a group of patients during a shift with the team being under the leadership of a registered nurse (Tiedeman & Lookinland, 2004). Team nursing was designed to address the disadvantages noted with functional nursing (e.g. increased rates of errors and omissions) by efficient use of nursing resources to address patients’ needs comprehensively  (Tiedeman & Lookinland, 2004). Accordingly, the model recognized that a RN could delegate tasks to Licensed Practical Nurses (LPNs) and nursing assistants while remaining accountable for such tasks to ensure the quality of care was not compromised (Tiedeman & Lookinland, 2004).

Based on their theoretical underpinnings, it would thus be expected that primary nursing is advantageous over team nursing with respect to quality of care, but may attract significantly higher human resource costs, due to the need for higher numbers of RNs. The current paper thus purposes to evaluate whether primary nursing is more effective than team nursing with respect to quality of care, staff and patient satisfaction by evaluating relevant literature. Continue to literature review.

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