Primary nursing compared with other models. One trial25
investigated job satisfaction among nurses using primary
nursing model of care. In this study,25 no significant difference
was demonstrated between primary and non-primary
nurses’ levels of intrinsic job satisfaction or intentions to stay
in nursing. Similarly, no significant difference was demonstrated
between primary and non-primary nurses’ levels of
extrinsic job satisfaction or perceptions of nursing as a
woman’s work.25
Effect of the model of care on
organisational outcomes
Cost effectiveness
Three studies12,23,24 reported the cost effectiveness of the
various models of nursing care. In the first study,12 cost
effectiveness in terms of nursing dollars per patient day and
nursing dollars per unit of workload was calculated for team
nursing, modular nursing, total patient care and primary
nursing care models. The results indicated that the team
model of care was the least expensive (US$58.73) when
compared with modular nursing (US$60.55), total patient
care (US$63.83) and primary nursing (US$68.22) care
model. Similarly, the nursing dollars per unit of workload was
the least expensive in the team model of care.12 In the
second study24 that compared team nursing model with
total patient care in North America, no significant difference
(P = 0.721) in variable costs (including staff salaries and
patient care costs) was reported following the implementation
of total patient care. The third study23 investigated the
average cost of nursing care between an all RN nursing staff
model (primary) and a mixed skill partnership model (team).
The cost required per patient hour for the mixed skill partnership
model increased from $28 at baseline to $33 Canadian
at the 12-month follow up. On the other hand, the cost
required per patient hour for the all RN model increased
from $30 to $37 Canadian at the 12-month follow up. These
differences were not statistically significant.