Nurse-led inpatient care: opening the 'black box'.
With recent evaluations contradicting early reports of improved outcomes from nurse-led inpatient care, the 'black box' of nurse-led care must be opened in order to examine the model of treatment. We present findings on the processes of care in one nurse-led unit (NLU), compared with an acute ward. Patterns and quality of nursing care were quantified using bar-code technology to measure type, frequency and duration of nursing activities and Quality Patient Care Scale to measure the quality of care. NLU quality matched, but did not exceed, quality on the acute ward. Patterns of care differed between wards, but activities associated with therapeutic nursing were no more frequent on the NLU. These findings support the hypothesis that disappointing outcomes in recent evaluations may be linked to failure to implement a therapeutic model of nursing.
Walsh
Bronagh
B
School of Nursing and Midwifery, University of Southampton, University Road, Southampton SO17 1BJ, UK. b.m.walsh@soton.ac.uk
Steiner
Andrea
A
Warr
Jerry
J
Sheron
Lisa
L
Pickering
Ruth
R
D000208:Acute Disease / Q000451:nursing; D003625:Data Collection; D003659:Decision Making, Organizational; D001330:Electronic Data Processing; D004739:England; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D007902:Length of Stay / Q000706:statistics & numerical data; D016294:Models, Nursing; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D017009:Professional Autonomy; D011787:Quality of Health Care; D019467:Subacute Care / Q000458:organization & administration*; D013996:Time and Motion Studies