Care delivery models: Challenge to change.

AIM: The purpose of this project was to evaluate a partnership model of care delivery on nurse and patient satisfaction and clinical outcomes. BACKGROUND: Care delivery models result in practical staff assignment decisions based on perceived fairness. The division of labour lies in social interaction of participants. Research notes that partnership team models require effective communication skills and delegation abilities to sustain. METHOD: This project used multiple methods in two study sites. A convenience sample was used to assess measures. Institutional Review Board approval obtained. RESULTS: Nurse satisfaction statistically increased in one setting and statistically decreased in the other setting. One statistically significant difference in a clinical outcome was noted. Patient satisfaction, nurse turnover and vacancy rates failed to reveal anything of statistical significance. Observed operational care components improved in both settings. CONCLUSIONS: Care delivery models are determined by a variety of factors of resource availability, unit culture, and quality and patient safety priorities. Identification of preferential structural approaches to guide nursing workflow is needed. IMPLICATIONS FOR NURSING MANAGEMENT: Innovative models of care delivery must be predicated on new role skills of delegation and negotiation for nurses, purposeful oversight and mentoring for sustainable success. Staffing can influence the integrity of care delivery models.

Minimal impact of selective susceptibility reporting on the use of piperacillin-tazobactam for Escherichia coli and Klebsiella bacteremia.

Selective cascade reporting of antibiotic susceptibilities did not have a significant impact on de-escalation from piperacillin-tazobactam (PT), duration of PT use, length of stay, or rates of acute kidney injury and Clostridioides difficile infection in patients with positive monomicrobial blood cultures with either Escherichia coli or Klebsiella spp.