title: The introduction of a new system of care delivery into a surgical ward in Sweden.
abstract: Action research is used to implement a change in the system of care delivery on a surgical ward in Sweden. Couched within a Lewinian framework the stages of change, the problems faced by staff and their solutions are described. The effects of the change to a system of care more closely resembling the Loeb model of primary nursing, in which accountability is for the duration of the shift, were closely monitored. Observation of registered nurses showed a three-fold increase in the time spent giving direct patient care. A significant increase in scores on a measure of "Intrinsic Job Satisfaction" was also found (P less than 0.01) together with increased scores on a measure of "Patient Focus" (P less than 0.001). These findings were sustained over time. The problems of evaluating a system of care which is based on a different philosophy are addressed.
authors.affiliation: Enheten for vårdforskning och utveckling, Landstinghets, Högskola, Kristianstad, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Degerhammar
authors.forename: B
authors.initials: B
authors.lastname: Wade
mesh_terms: D006801:Humans; D007588:Job Satisfaction; D016294:Models, Nursing; D015401:Nursing Administration Research; D009738:Nursing Service, Hospital / Q000458:organization & administration*; D009742:Nursing Theory; D011321:Primary Nursing / Q000458:organization & administration*; D013503:Surgery Department, Hospital / Q000458:organization & administration*; D013548:Sweden