An evaluation of nurse-led team care within a rehabilitation ward for elderly people

Abstract

This small exploratory study evaluated the effects of introducing a system of nurse-led team care on a ward providing intensive nursing and rehabilitation to elderly people. A quasi-experimental design compared three variables between the study ward and two similar wards within the unit. These were: quality of care, job satisfaction, length of patient stay. Quantitative data were complemented by semi-structured interviews with team members and by observation of team meetings. Quality of care scores showed an improvement on the study ward, but no difference on the main comparison ward. There were no differences between nurse job satisfaction between the study and comparison wards or in length of patient stay throughout the period of evaluation. Observation of team meetings suggested that communication was more structured and focused on the study ward and that patient goals were more clearly specified. Interviews suggested three main factors in successful implementation of the change to nurse-led team care: commitment of the team, open communication about difficulties, the support of managers and medical staff. The main effects noted were: partnership with patients, equality between team members, improved decision making and quality of care. Further studies of nurse-led team care are required, and the stress and anxiety for staff consequent on developing the nurse's role in this way should be considered.