Discussion
This systematic review was undertaken to assess the efficacy
of the various models of nursing care delivery on patient,
nursing and organisational outcomes. The initial search identified
an array of designs and methods; however, this review
has only focused on quantitative studies that included
various levels of nurses. Following assessment of methodological
quality, only 14 studies were eligible for inclusion in
this review. Except for the study design, all studies scored
highly on the quality scale. This is understandable given the
difficulties inherent in randomisation, allocation and blinding
associated with such interventions.
Although the quality scores were modest, aspects of good
design including sample size estimation and disclosure of
follow-up data need to be considered within future studies.
The outcome measures were diverse limiting the metaanalysis
of data. In addition, the instruments used to
measure outcomes and audit patient records could have not
been sensitive enough to detect changes. This considerable
heterogeneity reflects the context within which this review
was undertaken.