Effect of the Primary Nursing Model on Nurse and Patient Outcomes

Overview

The aim of this study was to determine the effects of the primary nursing model on nurse and patient outcomes. In the study, primary nursing education was provided to the nurses in the experimental group, and the primary nursing model was implemented in the clinics where they worked. Evaluations were conducted with nurses and patients before the implementation and at the third and sixth months after the implementation. The study aimed to evaluate the effects of the primary nursing model on missed nursing care, nurses' job satisfaction, nurses' roles and competencies, and patient satisfaction with nursing care. Hypotheses of the study: H1-1: There is a significant difference between the evaluations of nurses in the experimental group regarding missed nursing care before the primary nursing implementation and at the 3rd and 6th months after the implementation. H1-2: There is a significant difference between the job satisfaction evaluations of nurses in the experimental group before the implementation and at the 3rd and 6th months after the implementation. H1-3: There is a significant difference between the role and competency evaluations of nurses in the experimental group before the implementation and at the 3rd and 6th months after the implementation. H1-4: There is a significant difference between the evaluations of patients receiving care from nurses in the experimental group regarding missed nursing care before the implementation and at the 3rd and 6th months after the implementation. H1-5: There is a significant difference between the evaluations of patients receiving care from nurses in the experimental group regarding satisfaction with nursing care before the implementation and at the 3rd and 6th months after the implementation.

Nursing care services constitute one of the fundamental components of health services. Organizing nursing care effectively in hospitals and ensuring continuous care for patients are essential responsibilities of nursing management. Nursing care delivery methods provide a framework for organizing and assigning nursing responsibilities in clinical settings. These methods are closely related to organizational philosophy, nursing management approaches, available resources, and the structure of healthcare services. Various nursing care delivery models have been developed over time to improve the quality and continuity of nursing care. Traditional nursing care delivery models include total patient care, functional nursing, team nursing, and primary nursing. Among these approaches, the primary nursing model emphasizes accountability, continuity of care, and professional autonomy of nurses. The primary nursing model assigns a primary nurse to each patient, who is responsible for planning, coordinating, and evaluating the patient's care throughout the hospitalization period. This model promotes continuity of care, improves communication within the healthcare team, and supports nurses' professional autonomy and responsibility. Previous studies have suggested that the primary nursing model may improve nurse-related outcomes such as job satisfaction, role clarity, and professional competence, as well as patient-related outcomes such as satisfaction with nursing care and reduced missed nursing care. Despite the potential benefits of the primary nursing model, there are limited studies examining its effects in clinical settings, particularly in national healthcare systems. Therefore, evaluating the impact of this nursing care delivery model is important for improving nursing care quality and organizational outcomes. This study examined the effects of implementing the primary nursing model on nurse and patient outcomes using a quasi-experimental research design. The primary nursing model was implemented in the experimental group units, while the control group continued with the existing nursing care delivery method. Data were collected from nurses and patients before the implementation and at the third and sixth months after the implementation. The study evaluated the effects of the primary nursing model on missed nursing care, nurses' job satisfaction, nurses' roles and competencies, and patient satisfaction with nursing care.