Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care ward settings: a systematic review protocol

Abstract

Review question/objective: The objective of this systematic review is to critically appraise and synthesize the best available evidence on the effectiveness of team nursing compared to total patient care on staff wellbeing when organizing nursing work in acute care ward settings. This review will seek to answer the following question: Is a team nursing or a total patient care approach the most effective model of care when organizing nursing work to achieve desired staff wellbeing (defined by outcomes of staff satisfaction, stress, burnout, absenteeism and turnover) in a general ward setting? Inclusion criteria: Types of participants This review will consider studies that include all nurses working on general wards in the acute care hospital sector. This includes registered general nurses or the international equivalent such as staff nurses and professional nurses, enrolled nurses or the international equivalent such as licensed vocational nurses or licensed practical nurses and unlicensed personnel such as nursing assistants or the international equivalent such as nurse's aides and auxiliary nurses. This will review will exclude: Nursing staff working on specialized wards and areas for example intensive/critical care areas, oncology wards, pediatrics, midwifery, mental health, primary care and aged care sectors, as they utilize specific models of care for their scope of practice. Types of intervention(s): This review will consider studies that investigate the use of a team nursing model when organizing nursing work. The comparator will be utilization of a total patient care model. Types of outcomes: The outcome of interest to this review will be staff wellbeing. Methodology for data collection will be grouped from the primary research papers based on the types of outcomes measures or tools that were used to promote homogeneity of pooled data. Data collection tools that have been used in initial searches of papers have included questionnaires for the collection of responses for staff satisfaction. The measurement tools considered for inclusion must be validated and reliable, examples of these tools are the Nursing Work Index tool which measures nursing values in relation to job satisfaction and productivity. This tool has been modified and used in various countries including Australia where it is referred to as the Nursing Work Index - Revised: Australian Tool, (NWI-R:A tool).23 Another reliable tool is the McCloskey/Mueller Satisfaction Scale (MMSS) which is a multidimensional questionnaire designed for hospital staff nurses. There are 31 items; the response format is a five-point Likert scale. The Nurse Satisfaction Scale (NSS) is also a validated tool which measures job satisfaction among nurses. The questionnaire is multidimensional and has 24 items. The response format is a seven-point Likert scale.24 Maslach Burnout Inventory tool has been utilized to measure staff burnout and stress levels other tools that measure staff burnout and stress will be considered for inclusion, providing it is a validated and tested tool for measuring staff burnout and stress levels. Nursing turnover and absenteeism rates will be extracted from included papers. Patient clinical outcomes will be excluded from the review.