Title: The impact of a mixed skill care model on patients and medical teams
Abstract:
Background: A new nursing care model—the mixed-skill care model—has been promoted by the government in Taiwan. Unlike the traditional nursing care model, in which caregivers were independently hired by patients or their families and were not included in the nursing care team, the mixed-skill care model involves caregivers jointly hired to serve multiple patients and integrated as members of the medical team. Since caregivers in the mixed-skill care model are jointly hired to serve multiple patients, the hiring cost is reduced; however, caregivers no longer provide one-on-one companionship services to patients. This change may affect hospitalized patients, caregivers, and nurses.
Aim: Investigate the impact of the mixed-skill care model on patients, caregivers, and nurses.
Methods: We conducted a questionnaire survey among patients, caregivers, and nurses and compared differences between wards operating under the traditional nursing care model and those implementing the mixed-skill care model. These wards were medical wards in a medical center located in northern Taiwan. Regarding the content of the questionnaire, for patients, it included questions on satisfaction with hospitalization as well as satisfaction with caregivers and nurses. For caregivers and nurses, the questionnaire included items on job satisfaction and the Copenhagen Burnout Inventory (CBI).
Results: No significant differences were found between the traditional and mixed-skill care models in patients’ satisfaction with caregivers, nurses, and hospitalization. Similarly, no significant differences were observed between the two care models in caregivers’ satisfaction with collaboration with nurses, CBI scores, and job satisfaction. However, a significant difference was observed between the two care models in nurses’ satisfaction with collaboration with caregivers (traditional: 4.2 ± 0.8; mixed-skill: 3.4 ± 0.4; p < 0.05; score range: 1–5). In addition, nurses’ CBI scores (traditional: 63.5 ± 21.0; mixed-skill: 53.2 ± 26.2; p = 0.08; score range: 0–100) showed that nurses working in mixed-skill care model wards had lower scores than those in traditional wards, although the difference was only marginally significant. Furthermore, no significant differences were observed between the two care models in nurses’ workload or job satisfaction.
Conclusion: Our results show that the mixed-skill care model does not affect patients’ hospitalization satisfaction or the job satisfaction of caregivers and nurses. In addition, nurses were more willing to collaborate with caregivers in the mixed-skill care model, and the cost of patient hospitalization decreased. Therefore, the mixed-skill care model could be expanded and continued.
