Impact of Primary Nursing on Nursing-sensitive Outcomes in Inpatients Units: a Multicentre Pre-Post Study

Summary

The aim of this quasi-experimental before-after study is to evaluate whether the implementation of the Primary Nursing (PN) pattern of care improves nursing-sensitive outcomes in adult inpatients and nurse-related outcomes across hospital wards in Northern Italy.

The main questions it aims to answer are:

1. What is the impact of the PN on inpatients' nursing-sensitive outcomes, including healthcare-associated infections, falls, pressure injuries, functional status, and patient satisfaction?
2. What is the impact of the PN on nurse-related outcomes, including burnout, missed nursing care, job satisfaction, and intention to leave?

This study follows a multicentre, uncontrolled before-after design: in the pre-intervention phase, wards operated according to their existing nursing care models (functional or team nursing); this was followed by the implementation of the PN across all participating wards.

The PN assigns each patient to a single reference nurse who is responsible for planning, delivering, and evaluating nursing care throughout the entire hospital stay. In the primary nurse's absence, an associate nurse ensures continuity by following the individualised care plan.

Conditions

• Accidental Falls
• Cross Infection (Hospital-Acquired Infections)
• Acute Care Unit

Interventions

OTHER

Primary Nursing

Primary Nursing is a care delivery model in which each patient is assigned to a single reference nurse who assumes responsibility for planning, delivering, and evaluating nursing care throughout the entire hospital stay. In the primary nurse's absence, an associate nurse ensures continuity by following the individualised care plan. The model emphasises the nurse-patient therapeutic relationship, individual accountability, and active patient participation in care planning.

Sponsors & Collaborators

• Azienda Ospedaliero Universitaria Maggiore della Carita

  collaborator OTHER

• Humanitas Gradenigo - Torino

  collaborator UNKNOWN

• Ospedale San Luigi Gonzaga, Orbassano

  collaborator UNKNOWN

• Azienda Sanitaria Locale CN1 Cuneo

  collaborator OTHER_GOV

• Azienda Unità Sanitaria Locale Ferrara

  collaborator UNKNOWN

• Università degli Studi del Piemonte Orientale Amedeo Avogadro

  lead OTHER

Principal Investigators

• Cristina Torgano, RN, MSN · AOU Maggiore della Carità, Novara

Study Design

Allocation

NA

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-11-22

Primary Completion

2025-06-30

Completion

2025-06-30

Countries

• Italy

Study Locations