Primary Vs. Team Nursing – Cost & conclusion


There were limited studies that evaluated the models of care with respect to associated costs via a primary evaluation. One such study compared the costs of primary nursing and those of team nursing based on a cost per patient day (PPD) by diagnostic related group (DRG). In this study, Gardner and Tilbury (1991) found out that primary nursing was less expensive when compared to team nursing. In a more recent review, Tiedeman and Lookinland (2004) find contradictory indications to the most cost-effective method when team and primary nursing are compared. Whereas some of the studies indicate team nursing to be more cost-effective compared to primary nursing, others note primary nursing to be the most cost-effective alternative, while others do not find the two models to differ in terms of cost (Tiedeman & Lookinland, 2004).   


Use of different models of care may lead to varying patient, staff and organizational outcomes. This paper compares primary nursing and team nursing to assess the model that offers a better alternative with respect to quality of care, patient and staff satisfaction and cost. The study employs evidence drawn from a review of literature drawn from searches on online databases.

From the reviewed literature, there lacks adequate evidence to support the superiority of any of the methods in any of the aspects of evaluated. For instance, with regard to quality of care, whereas some studies indicate primary nursing to offer better outcomes when compared with team nursing (e.g. Sjetne et al., 2009), others do not find either method to convey any significant quality benefits over the other (e.g. Nissen, Boumans & Landerweerd, 1997) especially when nurses are assigned to a fixed team (Tiedeman & Lookinland, 2004). Similar findings are also noted with respect to staff satisfaction, although, among the studies reviewed, most supported the contention that primary nursing did improve staff and patient satisfaction when compared with team nursing. With respect to cost, only few studies that evaluated cost were retrieved with one study based on a primary evaluation (Gardner & Tilbury1991) indicating primary nursing to be more cost-effective when compared to team nursing, while a literature review had mixed findings when the two models were compared with respect to cost. Accordingly, there lacks adequate evidence to establish the superiority of either model with respect to the three aspects assessed especially with limited primary evaluation of the topic in current studies.


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