Effectiveness of Primary Nursing Assignment based on NTISS

(Neonatal Therapeutic Interventional Scoring System)

Shanthi Ravichandran

Deputy Nursing Officer, Sri Ramakrishna Hospital Coimbatore - 641044 Tamilnadu, India.

*Corresponding Author E-mail:

ABSTRACT:

Nursing   methods  have  evolved  over  times and has reached unimaginable bounds. However traditionally four nursing models have been described based on which the current nursing systems have been adopted. They are i) Team nursing ii) Functional Nursing both of which are task oriented and iii) Primary nursing and iv) Total patient care which are patient oriented.

Primary nursing is one where a single nurse or two to three nurses round a clock are assigned a patient from admission till recovery. The concept involves developing a one-to-one nurse-family relationship, empowering nurses to make care plan, monitor and follow up patients assigned to them, and patient assignment based on proficiency level of the nurse.

KEYWORDS: Primary   Nursing, NTISS- Baby Assignment, Empowerment, Round a clock, benefits.

INTRODUCTION:

Neonatal intensive care unit serves as the right ground for implementing primary nursing model in its envisaged form considering the long stay of neonates in ICU and the extent of family participation in daily care. We have modeled a modified primary nursing system within NICU where we formed small teams of 3-4 nurses of equal proficiency. This model was designed adopting two other main themes: group learning and teamwork.

The team of our primary nurses are assigned a set of neonates from admission till discharge when they get an opportunity to follow up the neonates through their sick stable and growing phases. Their care plan changes as their small patient goes through these phases.

MATERIALS AND METHODS:

The teams are trained through mock drills, clinical presentations where they put their efforts together and are tested together. We hypothesized that this will improve their case based learning as a group, increase their accountability as a team, promote continuum of care for the newborn and decrease conflicts with families.

Assigning a single nurse for the patient is almost impossible- as they have their scheduled breaks and leaves. Also, being solely responsible for a sick neonate will be emotionally tasking for anybody. In this model- the team will share responsibilities, can schedule their duties in such a way that at least one primary nurse is there for the baby day and night.

We have found innumerable benefits with this system where we see an extremely healthy relationship between parents and nurses. Our patient feedbacks have improved where parents able to recognize the efforts by the primary nurses.

RESULT:

We did a small in-house survey of our NICU nurses’ opinion on this model 4 months after implementation. 85% of them felt that they can understand specific disease management better, that handover time is less, that they are more confident in discussing care plan with physicians, which errors are less and that families are reacting more positively towards. All of them gave a positive feedback about the team system.

However few nurses felt that it was monotonous to see same babies daily. A rigorous duty schedule was a drawback everyone pointed unanimously. Regular bedside teaching was one suggestion given by most nurses .We look forward to carry forward this model with few modifications to improve patient care and   job satisfaction among nurses.

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Received on 09.08.2021         Modified on 28.11.2021

Accepted on 05.01.2022 ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2022; 10(1):39-41.

DOI: 10.52711/2454-2652.2022.00010