Primary Nursing: A Cost and Quality Effective Patient Care Structure

Abstract

This descriptive study was undertaken to investigate differences in cost-effectiveness and quality patient care between primary nursing and team/functional nursing as practical in a 113 bed acute care community hospital. The sample was comprised of 80 hospitalized patients that were divided equally between a primary and team-functional nursing unit. Quality of Care was measured by the Rush- Medicus Nursing Care Quality System and cost effectiveness was determined by annual salaries. Using a t-test statistical analysis, no significant differences were obtained in quality of patient care when using a primary nursing care structure with less FTEs as compared to a team leading nursing structure using more FTEs. The employee salary relationship showed that primary nursing unit costs were 11.7% higher than the team-leading unit, but when orientation for new staff and additional personnel salaries are factored out, the total demonstrates that primary nursing unit costs were not different than those of the teamleading unit.