The impact of Primary Nursing care pattern: results from a before - after study

AIMS AND OBJECTIVES: The aim of this study was to explore the effect of "Primary Nursing" on nursing-sensitive patient outcomes, staff-related outcomes, and organization-related outcomes. BACKGROUND: Primary Nursing is one example of a care pattern that has recently been implemented in many countries. DESIGN: Before-after study METHODS: This study was conducted in an Italian hospital. We observed patient-related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of Primary Nursing and in 3,169 inpatients after its implementation. Staff-related outcomes (nursing competence and diagnostic thinking) and organization-related outcomes (empowerment and team climate) were collected from 369 nurses. From a subgroup of inpatients, we collected data regarding their satisfaction with the care provided. RESULTS: After the implementation of Primary Nursing, some nursing competencies and diagnostic thinking were improved, so were organization-related outcomes. Our data showed that the number of inpatients with urinary catheter infections (5.5% vs 4.3%) and venous catheter infections (peripheral: 2.2% vs 1%; central: 5.6% vs 1%) was significantly decreased; also, the numbers of falls (2.4% vs 1.9%) and pressure ulcers (4.8% vs 4%) decreased, although these decreases were not statistically significant. Overall, the implementation of Primary Nursing increased patient satisfaction with nursing care (193.57 vs 210.21). CONCLUSIONS: Primary Nursing improved staff-related outcomes, nursing-sensitive patient outcomes and organization outcomes