title: Changing the model of care delivery: nurses' perceptions of job satisfaction and care effectiveness.
abstract: OBJECTIVE
  To examine nurses' perceptions of job satisfaction, empowerment, and care effectiveness following a change from team to a modified total patient care (TPC) delivery model.
  
  
  BACKGROUND
  Empirical data related to TPC is limited and inconclusive. Similarly, evidence demonstrating nurses' experience with change and restructuring is limited.
  
  
  METHODS
  A mixed method, longitudinal, descriptive design was used. Registered nurses and licenced practical nurses in two acute-care nursing units completed quantitative and qualitative surveys. Lewin's change theory provided the framework for the study.
  
  
  RESULTS
  No significant change in job satisfaction was observed; however, it was less than optimal at all three time-periods. Nurses were committed to their jobs but relatively dissatisfied with their input into the goals and processes of the organization. Client care was perceived to be more effective under TPC.
  
  
  CONCLUSIONS
  Job satisfaction remained consistent following the transition to TPC. However, nurses perceived that client care within the modified TPC model was more effective than in the previous model.
  
  
  CONCLUSIONS
  Nursing administration must work collaboratively with nurses to improve processes in nursing practice that could enhance nurses' job satisfaction and improve client care delivery.
authors: Western Regional School of Nursing, Corner Brook, NL, Canada. jwells@swgc.mun.ca
authors: Judith
authors: J
authors: Wells
authors: Madonna
authors: M
authors: Manuel
authors: Glenda
authors: G
authors: Cunning
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007588:Job Satisfaction; D008137:Longitudinal Studies; D016294:Models, Nursing; D009741:Nursing Staff, Hospital / Q000523:psychology*; D018802:Patient-Centered Care / Q000458:organization & administration*; D011209:Power, Psychological; D011787:Quality of Health Care