title: Perceiving patient assignment methods through a conceptual framework.
abstract: For several decades, the nursing process has been the central issue for numerous nursing discussions. Definitions, meanings, sequences and steps as well as their significance have been presented within the context of given clinically oriented conceptual frameworks. On the other hand, the nursing process could be largely influenced by the organizational context in which it is exercised. This article shows how analyzing patient assignment methods through a conceptual framework permits a better understanding of the ways organizational factors impact upon nursing process quality. Nursing care is the central issue of nursing modalities which characterize the organization and provision of its delivery. In this analysis, these modalities are renamed patient assignment methods. They refer to the tasks, roles, policy and structure for allocating nursing personnel to patients for the provision of nursing care in a hospital unit (Kérouac, Duquette & Sandhu, 1990; Nunson, Beckman, Clinton, Kever & Simms, 1980). The synonyms for patient assignment method found in the literature are: nursing assignment patterns, nursing assignment systems, and organization mode of nursing care (McLennan, 1983). Whatever its name, a given modality does not occur by chance but, rather is a product of specific characteristics. Some of these characteristics pertain to the nursing process. These characteristics can be identified and better understood through a conceptual framework. Historically, patient assignment methods have been extensively described in the literature. The descriptions usually focus on their merits and limitations or their comparisons with one and another. To the best of our knowledge, they have not been analysed using a conceptual framework. This article demonstrates how patient assignment methods could be better understood through an analysis using a conceptual framework. This analysis aims to systematically examine the commonly used patient assignment methods: case, functional, team, primary and modular. Particular attention is paid to the variables that influence the patient assignment methods, for instance, patient characteristics, nursing resources and organizational support. Furthermore, the variables related to nursing process quality, such as, comprehensiveness, accountability, continuity, and coordination of care are also examined. This article is addressed to all nurses who wish to examine through new lenses some of the ways they deliver patient care. Knowing more about the patient assignment method one uses implies understanding the contribution of the organizational factors applicable to the nursing process. Moreover, it is a sure way of enhancing quality care when one has the knowledge of the philosophy, values, beliefs and meanings inherent in each assignment method.(ABSTRACT TRUNCATED AT 400 WORDS)
authors.forename: B K
authors.initials: BK
authors.lastname: Sandhu
authors.forename: A
authors.initials: A
authors.lastname: Duquette
authors.forename: S
authors.initials: S
authors.lastname: Kérouac
mesh_terms: D016294:Models, Nursing; D009732:Nursing Care / Q000458:organization & administration*; D009746:Nursing, Team / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D011321:Primary Nursing / Q000458:organization & administration*