A hospital utilizes the functional nursing care delivery system, and patient satisfaction scores have been falling in each quarter of the past year

Question

What is a likely reason for this decrease? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Utilization of advanced practice nurses on the unit
2. Efficient nursing staff
3. Lack of confidence in the caregivers
4. Lower health care costs
5. Fragmentation of the nursing care

Answer 1

3,5
Rationale 1: There is no indication that use of advanced practice nurses adversely impacts patient satisfaction.
Rationale 2: Functional nursing does result in tasks being done quickly and efficiently. This is not generally a reason patient satisfaction scores drop.
Rationale 3: Because care is distributed among so many different caregivers, the patient may not feel confident that care is individualized and appropriate. This can result in reduced patient satisfaction.
Rationale 4: Facilities choose the functional nursing model in an effort to be efficient and to lower labor costs by hiring lower-paid workers such as unlicensed assistive personnel. Lower health care costs, however, do not usually result in a decrease in patient satisfaction.
Rationale 5: Functional nursing is an industrial model of efficiency that resembles assembly-line tasking. The fragmentation of tasks among the nursing staff results in a perceived lack of accountability and increased frustration. This can result in low patient satisfaction.