title: Relationship-based nursing practice: transitioning to a new care delivery model in maternity units.
abstract: In a fast-paced, high-volume maternity unit, the goal for nursing care delivery is to provide care that is perceived by patients as personal and caring, is rewarding to nurses, and is in an environment of maximum patient safety. A care delivery model is the organizing structure that can facilitate this goal. Relationship-Based Nursing Practice is a care delivery model designed to transition nursing care from task-focused to relationship-based. A shared vision of the registered nurse as a professional member of the healthcare team, working in an optimally safe and family-centered care environment, inspired the model design. Three relationships-the nurse with the patient, the nurse with colleagues, and the nurse with self-provided the foundation for the creation of guiding principles. Guiding principles were operationalized to support 1 or more of the 3 relationships, contribute to improved patient safety, and actualize the role of the professional registered nurse, in daily patient care. Outcomes include improvement in patient safety, increased patient satisfaction, and perception of improved teamwork among nurses. The process for sustainability and ongoing evaluation of the model is discussed.
authors.affiliation: Center for Nursing Excellence, Lucile Packard Children's Hospital, 4700 Bohannon Drive No. 150, Menlo Park, CA 94025, USA. chedges@lpch.org
authors.forename: Cathleen C
authors.initials: CC
authors.lastname: Hedges
authors.forename: Amy
authors.initials: A
authors.lastname: Nichols
authors.forename: Lourdes
authors.initials: L
authors.lastname: Filoteo
mesh_terms: D003696:Delivery Rooms / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D016294:Models, Nursing; D017283:Neonatal Nursing / Q000458:organization & administration*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D009746:Nursing, Team / Q000458:organization & administration; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D017009:Professional Autonomy; D015397:Program Evaluation