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Print ISSN: 2735-3974 Menoufia Nursing Journal
Online ISSN: 2735-3982 Faculty of Nuring
DOI: ------------------------------------- Menoufia University

Relationship between Nursing Care Delivery Systems and

Patients' Satisfaction in Medical Units
Hanady M. Abd Allah1, Nermin M. Eid2, Aya G. Hasanin3
1
B.Sc. Nursing Science, 2Professor of Nursing Administration, Faculty of Nursing, Menoufia
3
University, Lecturers of Nursing Administration, Faculty of Nursing, Benha University

Abstract: The nursing care delivery system is a very important asset that affects both patient
satisfaction and organizational outcome. The purpose of the study was to determine the
relationship between nursing care delivery system and patients` satisfaction at Benha University
Hospital. Descriptive correlative research study was utilized to conduct this study. The sample of
this study included 116 staff nurses and 375 patients at Medical Units in Benha University
Hospital. Instruments: two Instruments were used for data collection of this study. The first
instrument: Nursing care delivery system questionnaire, the second instrument: Patients'
satisfaction questionnaire. The result showed that there was a statistical significant relation
between patient's satisfaction and methods of nursing care delivery system, the case method was
the most frequently at this units and the level of patient's satisfaction was highly. Conclusion: It is
higher level of nursing care delivery systems were associated with highly level of patients`
satisfaction. Recommendation: The staff nurses should adopt a practice model that addresses the
necessity to match patient needs with nurse competencies.
Keywords: Nursing Care Delivery System, Patient Satisfaction.

Introduction
A nursing care delivery system defines nursing care. The five well-known means
how work is organized, how nursing staff of organizing nursing care for patient care
are deployed, and who does what in delivery are total patient care, functioning
providing nursing care. It identify who has nursing, team and modular nursing,
the accountability for nursing care and primary nursing, and case management.
clinical outcomes and provide the Each of these basic types has undergone
organization, rules and structure that many modifications, often resulting in
define responsibility and accountability new terminology. The choice of an
(who does what) (Hayajneh,2013). organizational model involves staff skills,
Nursing care delivery models, also called availability, resources, patient acuity, and
care delivery systems or patient care the nature of the work to be performed
delivery models, detail the way task (Danielle, 2012).
assignments, responsibility, and authority By defining the components of the nursing
are structured to accomplish patient care. care delivery system, the foundation of
The nursing care delivery model describes professional nursing practice is described.
what health care worker is going to The professional practice model aligns and
perform which tasks, who is responsible, integrates nursing practice with the
and who has the authority to make mission, vision, values and philosophy of
decisions. The purpose of any delivery nursing. The framework of our
system is to provide high quality care, professional practice model guides the
efficiently and effectively nursing strategic plan, identifying clear
(Barbara,2016). goals and expectations for all professional
A patient care delivery model is the nurses to achieve optimal outcomes as
method or system of organizing delivery defined in our nursing goals; Best People

MNJ, Vol. 2, No. 1, May 2017, PP: 27-42 27

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

and Practice Environment, Best Patient management. Wards that used a hybrid
Experience, Best Quality, and Best model that was a combination of patient
Financial Stewardship. The essential allocation and team nursing models
components of nursing care delivery demonstrated significant improvement in
system are responsibility, accountability, quality of patient care (Ritin,2012).
clinical decision making and making
assignment (Ann, 2017). Purpose of the study
Patient satisfaction is an important and
The purpose of the study was to determine
commonly used indicator for measuring
the relationship between nursing care
the quality in health care. Patient
delivery system and patients' satisfaction
satisfaction affects clinical outcomes,
in medical units at Benha University
patient retention, and medical malpractice
Hospital .
claims. It affects the timely, efficient, and
patient-centered delivery of quality health Research Question
care. Patient satisfaction is thus a proxy
but a very effective indicator to measure 1. What are the types of nursing care
the success of doctors and hospitals delivery systems used in medical units
(Prakash,2010). at Benha University Hospital?
In addition to being a requirement of 2. What is the level of patients'
accreditation, patient/customer satisfaction satisfaction in medical units at Benha
is important to the success of health care University Hospitals?
organizations as businesses. Satisfied 3. Is there a relation between nursing care
patients will share their positive delivery system used in medical units
experience .Because the cost of obtaining and level of patients' satisfaction at
a patient is high, losing a patient is a Benha University Hospital?
substantial loss of investment. Patient may
have been attracted through advertising or Methods
an insurance contract. There is evidence of Research design
a reciprocal relationship between patient
Descriptive correlational research study
satisfaction and continuity of care.
was utilized to conduct this study.
Conversely, dissatisfaction and complaints
Research setting
can mean not only loss of
The study was conducted at Benha
business/investment, but also increased
University Hospital in Medical Units
risk of malpractice lawsuits Accreditation
because different nursing care delivery
business improvement, and risk
method are used in these units as patients
management are not the only reasons
stay long periods of time. The medical
patient satisfaction is important
units include 6 units: (medical unit 1,
(Rodriguez,2009).
medical unit 2,medical unit 3, medical unit
Patient satisfaction, Four studies
4, medical unit 5 and medical unit 6).
investigated patient satisfaction between
the various models of care; however, data Sampling
were presented in only two studies. In
these two studies, no statistically  The first group were the staff nurses :
significant difference in patient
They included all staff nurses working at
satisfaction between team nursing and
primary nursing models and total patient the above mentioned study setting. Their
care models. In the remaining two studies, total number was 117 but 1 nurse refused
patients were satisfied with their nursing to participate in the study, so 116 nurses
care overall irrespective of whether the were included in the study and were
model of care was team nursing, case distributed as following: Number of staff

28 Menoufia Nursing Journal, Vol. 2, No. 1, May 2017

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

nurses in medical units from 1 to 6 was years of experiences, gender, social

(18, 20, 19, 20, 2,17 respectively). status, qualification, unit,etc.
 The second group were the patients :  Part (2):This part was designed to
A convenience sample of 375 patients who describe the assignment procedures and
selected from the above mentioned study the obstacles hindering this process .It
setting during study time. consisted of 15questions.
The sample size was determined based on  Part (3):This part was used to
the following equation: determine the nursing care delivery
system it consisted of five questions .(a
= 0.76).
The second instrument:
Where ‘n’ is sample size Patients' satisfaction questionnaire:
‘N’ is total number of patients' in medical It was used to measure the patients'
units satisfaction .It was developed by El
Attended to previously mentioned setting khouly (2015) and modified by the
‘e’ is Coefficient factor = 0.05% researcher after reviewing there related
The inclusion criteria: the patient should literature (Demir 2002, Matis 2009,
be: Ahsan2012). It consisted of two parts:
 Consciousness.  Part(1):It included the demographic
 Educated. characteristics of the patient such as age ,
unit, gender, education, job, marital
 Stay at hospital from 2:5 days.
status,etc.
 Not isolated.  Part(2): This part was used to measure
The exclusion criteria: the level of patient satisfaction .It
 Unconsciousness. included 36items divided under five
categories (Patient reception and
 Not educated.
administration of physical care 9 items,
 Stay at hospital less than 2 days. administration of medication 4 items,
 Isolated. preparation of investigation4 items,
psychological support and keeping
Instruments
privacy 11 items, administration of
To collect data for this study the following
health education to patient8 items).( a =
tools were used:
0.86).
The first instrument:
Scoring system:
Nursing care delivery system
Subjects' responses were scored on
questionnair: three point likert scale as follow,
It was developed by Abd-El Gawad(2011) 2(satisfied), 1(to some extent) and 0
and modified by the researcher after (dissatisfied). The score of each dimension
reviewing there related literature summed up and converted to percent score
(Tashonna, 2011) It was consisted of three High satisfaction >58%
parts: Moderate satisfaction 36%-58%
low satisfaction <36%
 Part(1):It included social
characteristics of nurses such as age, Pilot study

Menoufia Nursing Journal, Vol. 2, No. 1, May 2017 29

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

Pilot study was conducted in July 2017 to the research study at any time in case of
assess tool clarity and applicability. It has violation of his rights.
also served in estimating the time needed Anonymity and confidentiality
for filling the form .The study was tested The respondent will be assured that the
on 10 % of total subjects, it was done on data will be treated as strictly confidential;
11 staff nurses and 37 patients from Benha furthermore, the respondent anonymity
University Hospital .No modification was will be maintained as they will not require
needed, so these staff nurses and patients mentioning their names.
were included in the main subject. The Scientific honesty
necessary clarification for some statements To ensure scientific honesty, the researcher
related to their translation to Arabic was used backetting and intuiting to avoid bias.
done.
IV. Statistical analysis:
Validity of the study tools: Data were verified prior to entry into
Face and content of study tools were computer. Statistical package for social
validated by jury group which consisted of science (SPSS, Version twenty) was used
five Experts from Nursing Administration for that purpose, followed by data analysis
Department. Three Assistant Professors of and tabulation. Descriptive statistics were
Nursing Administration Department at applied quantitative data (eg. arithmetic
Faculty of Nursing Tanta University, one mean, standard deviation, frequency and
Assistant Professor of Nursing percentage). A significance level value was
Administration Department at Faculty of considered when p-value ≤ 0.05 and a
Nursing Zagazig University, one Professor highly significance level was considered
of Nursing Administration Department at when p-value ≤ 0.001, while p- value > 0.05
Faculty of Nursing Zagazig University. It indicated non- significance results.
took one month (May) 2017, minor
modifications were done based on jury Procedure:
opinions. 1. An official permission was issued from

Ethical Considerations Dean of the Faculty of Nursing to the

Director of Benha University Hospital to
The study was conducted with careful
attention to ethical standards of research obtain the approval for data collection,
and rights of the participants: the objectives and the nature of the study
Informed consent
were explained and then it was possible
The respondent rights will be protected by
ensuring voluntary participation, so the to carry out the study with minimum
informed consent will be obtained by resistance.
explaining purpose, nature time of
2. The data collection instrument was
conducting the study, potential benefits of
the study, how data will be collected, no developed after review of the national
invasive procedure, expected outcomes and and international related literature using
the respondent rights to withdrawing from journals, periodicals, textbooks,
internet and theoretical knowledge of

30 Menoufia Nursing Journal, Vol. 2, No. 1, May 2017

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

the various aspects concerning the topic beginning of July / 2017 to the end of
of the study for modifying the tools and September /2017, the researcher
translating the tools into Arabic applied interview for study sample for
language and back translation to check three days per a week.
its accuracy. 6. The time needed to complete
3. Each head nurse was interviewed after questionnaire sheet 13 minutes.
explaining the purpose of the study and 7. The appropriate time of data collection
getting agreement of head nurses to was according to type of work and
participate in the research. workload of each department,
4. Data has been collected from head sometimes it was in the middle of the
nurses in above mentioned study at shift and other time before the end of
Benha University Hospital. the shift.
5. Collection of data took three months at Results
Benha University Hospital from

Table(1): Distribution of the Studied Nurses According to their Personal

Characteristics (n =116)
Personal Characteristics No %
Age (years)
25 <30 39 33.6
30 <35 30 25.9
35 <40 15 12.9
≥ 40 32 27.6
X-±SD 34.4±7.1
Social status
Married 93 80.2
Un married 23 19.8
Qualification
Nursing diploma 71 61.2
Technical institute 34 29.3
B.Sc. Nursing 10 8.6
Master degree 1 .9
Unit
Medical unit 1 18 15.5
Medical unit 2 20 17.2
Medical unit 3 19 16.4
Medical unit 4 20 17.2
Medical unit 5 22 19.0
Medical unit 6 17 14.7
Years of experience
1>5 4 3.4
5 > 10 36 31.0
10 >15 30 25.9
≥ 15 46 39.7
X-±SD 14.3±7.3

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 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

Table 1 illustrates distribution of the qualification , more than three fifth of

studied nurses. According to their personal studied nurses (61.2%) had nursing diploma
characteristics in Benha University . According to their units , (19.0%) of them
Hospital . The study showed that more than work in medical unit 5 . As regarding to
one third of the studied nurses (33.6% ) had their years of experience, less than one third
age from 25 to less than 30years old with a of studied them (31.0%) had years of
mean age of (34.4±7.1) years. As regarding experience from 5 to 10 years and
to their marital status, the most of them from15years and more respectively , with a
(80.2%) were married. As for as to their mean years experience of (14.3±7.3) .

Table(2): Distribution of Studied Patients According to their Personal

Characteristics(n=375).

Personal Characteristics No %
Unit
Medical unit 1 62 16.5
Medical unit 2 66 17.6
Medical unit 3 63 16.8
Medical unit 4 58 15.5
Medical unit 5 61 16.3
Medical unit 6 65 17.3
age
<40 100 26.7
40-50 83 22.1
50-60 93 24.8
>60 99 26.4
X-±SD 49.2±14.2
Gender
Male 176 46.9
Female 199 53.1
Marital status
Single 38 10.1
Married 222 59.2
Divorced 36 9.6
Widowed 79 21.1
Educational level
Illiterate 114 30.4
Reads and writes 80 21.3
Basic education 38 10.1
Secondary and equivalent 26 6.9
Diploma above average 56 14.9
Bachelors degree 61 16.3
Work
government employee 55 14.7
private sector employee 34 9.1
Literal 86 22.9
does not work 200 53.3
Number of hospital admission
Once 135 36.0
Twice 119 31.7
Three times 53 14.1
More than three times 68 18.1
X-±SD 49.2±14.2

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 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

Table 2 illustrates distribution of the gender, more than half of them (53.1%)
studied patients according to their personal were female. In relation to their marital
characteristics at Benha University status, about three fifth of them (59.2%)
Hospital. The study showed that, (17.6% were married. As for as to their
&17.3%) of patients enters medical unit 2 educational level , about one third of
and medical unit 6 respectively. According them(30.4%) were illiterate .According to
to their age, more than quarter of them their work, more than half of them(53.3%)
(26.7%) were less than 40 years old and didn`t work. As regarding to number of
more than quarter of them (26.4%) were hospital admission, more than one third of
more than 60 years old with a mean age of them (36.0%) admitted to hospital for first
(49.2±14.2) years. As regarding to their time.
Table(3):Assignment Procedures as Reported by Staff Nurses(n=116)
Assignment procedures No %

Presence of the assignment sheet

Yes 116 100.0
No 0 0.0
Form of assignment sheet
Oral 0 0.0
Written 116 100.0
Place of assignment sheet
Hang on the wall 99 85.3
Given to every staff nurse 17 14.7
Responsible for preparing work assignment sheet
The nursing supervisor 95 81.9
The head nurse 18 15.5
Assistant of the head nurse 1 .9
Any nurse in the department 2 1.7
The length of the assignment sheet
Every shift 12 10.3
Daily 36 31.0
Weekly 4 3.4
Monthly 64 55.2
Nurse's opinion was taken before making assignment sheet
Yes 80 69.0
No 36 31.0

Table 3 shows that the assignment sheet was posted on the wall. Regarding
procedures as reported by staff nurses. It the length of performing assignment sheet
can be noticed that all staff nurses reported ,more than half of staff nurses (55.2%)
that assignment sheet was present in reported that assignment sheet was done
written form. The highest percentage monthly. According to if the opinion of
(81.9%) of staff nurses reported that staff nurses was taken before putting the
assignment sheet was made by nursing assignment or not ,more than two thirds of
supervisor. According to the place of staff nurses(69.0%) reported that their
assignment sheet, the majority of staff opinion were taken before putting the
nurses (94.8%)reported that assignment assignment sheet.

Menoufia Nursing Journal, Vol. 2, No. 1, May 2017 33

Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

68.1
70.0
60.0
50.0
40.0
30.0 17.2
14.7
20.0
10.0 0.0
0.0
Case methods Function Team methods Primary case
methods methods

Figure (1): Methods of Nursing Care Delivery System as Reported by Staff

Nurses.

Figure 1 demonstrate that ,the most by team method ,and function method,
common method of assignment used by the otherwise primary case method was not
studied nurses was case method, followed used at all among studied nurses.
81.9
90
80 59.5 57.8
70 47.4
60 43.1
50 31.0 33.6
40
30 9.5 8.6 9.5 9.5 8.6 Head nurse
20
10
0 Staff nurse
staff nurse and head nurse

Figure (2): Activities Related to Patients Care as Reported by Staff Nurses

(N=116).

Figure 2 clarifies the activities related to reported that nurses were responsible for
patients care as reported by staff nurses, writing nursing note. Regarding to patient
the study showed that the responsible for condition, about three fifth of staff nurses
decision making related to patient (59.5%) reported that nurses will be
condition, less than one half of staff palmed in case of error. According to the
nurses(47.4%)reported that nurses were person responsible for the discussion of
responsible for decision making related to patients care with the doctor, less than
patient condition. According to three fifth of staff nurses (57.8%) reported
responsible for writing nursing note, the that nurses were responsible for the
highest percentage of staff nurses (81.9%) discussion of patients care with the doctor.

34 Menoufia Nursing Journal, Vol. 2, No. 1, May 2017

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

8.5
22.9
Highly satisfied
Moderate satisfied
68.5
Low satisfied

Figure (3): Total Patient Satisfaction Level as Reported by Studied Patients.

Figure 3 showed that (68.5%) more than satisfaction level. While (8.5%) had
two third of the patients had moderate highly satisfaction level.
satisfaction level and (22.9%) had low

Table (4): Relation between Patient Satisfaction and their Socio-Demographic

Characteristics (n=375).

Patient Satisfaction

Socio-Demographic Low Satisfied (n Moderate Highly Satisfied (n X2 p-value

Characteristics =34) Satisfied(n=94) =247)

No % No % No %
Unit
Medical unit 1 10 29.4 14 14.9 38 15.4
Medical unit 2 6 17.6 18 19.1 42 17.0
Medical unit 3 5 14.7 16 17.0 42 17.0 0.21
13.11
Medical unit 4 3 8.8 12 12.8 43 17.4
Medical unit 5 9 26.5 15 16.0 37 15.0
Medical unit 6 1 2.9 19 20.2 45 18.2
Age
<40 3 8.8 17 18.1 80 32.4
40-50 5 14.7 26 27.7 52 21.1 23.91 0.001**
50-60 9 26.5 31 33.0 53 21.5
>60 17 50.0 20 21.3 62 25.1
Gender
Male 17 50.0 47 50.0 112 45.3 0.73 0.69
Female 17 50.0 47 50.0 135 54.7
Marital status
2 5.9 8 8.5 28 11.3 25 0.000**
Single
27 79.4 70 74.5 125 50.6
Married
0 0.0 7 7.4 29 11.7
Divorced
5 14.7 9 9.6 65 26.3
Widowed
Table (4Continued): Relation between Patient Satisfaction and their Personal
Characteristics (N=375).

Menoufia Nursing Journal, Vol. 2, No. 1, May 2017 35

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

Patient Satisfaction
Socio-Demographic Low Satisfied (n =34) Moderate Highly Satisfied (n X2 p-value
Characteristics Satisfied(n=94) =247)
No % No % No %

Educational level
-Illiterate 12 35.3 26 27.7 76 30.8
-Reads and writes 9 26.5 23 24.5 48 19.4
-Basic education 3 8.8 9 9.6 26 10.5
22.02 0.01*
-Secondary and 1 2.9 9 9.6 16 6.5
equivalent
-Diploma above average 7 20.6 21 22.3 28 11.3
-Bachelors degree 2 5.9 6 6.4 53 21.5
Work
-Government employee 3 8.8 12 12.8 40 16.2
-Private sector employee 0 0.0 7 7.4 27 10.9 11.92 0.06
-Literal 14 41.2 23 24.5 49 19.8
-Does not work 17 50.0 52 55.3 131 53.0
Number of hospital
admission
Once 12 35.3 46 48.9 77 31.2
Twice 6 17.6 26 27.7 87 35.2 18.35 0.005*
Three times 4 11.8 9 9.6 40 16.2
More than three times 12 35.3 13 13.8 43 17.4
*A statistical significant difference (P ≤ 0.05) **A highly statistical significant
difference (P ≤ 0.001)

Table 4 shows that there was highly satisfaction level and their educational
statistical significant difference between level and number of hospital admission.
patients satisfaction level and their age and While there was no significance difference
marital status, there was a statistical between patients satisfaction level and their
significance difference between patients units, gender and work.
Table(5):Relation between Methods of Nursing Care Delivery System and Patients Satisfaction
Patient satisfaction
X2 p-value
Nursing care delivery Low Moderate High
system
no % No % no %
10 55.6 25 80.6 44 65.7
Case methods

7 38.9 4 12.9 6 9.0

Function methods
16.04 0.003*
1 5.6 2 6.5 17 25.4
Team methods

Primary methods 0 0.0 0 0.0 0 0.0

*A statistical significant difference (P ≤ 0.05) **A highly statistical significant
difference (P ≤ 0.001)

Table 5 showed that there was a statistical delivery system and level of patient's
relation between methods of nursing care satisfaction.

36 Menoufia Nursing Journal, Vol. 2, No. 1, May 2017

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

Discussion
 Personal Characteristics of the Study of the participants was 37 years. About
Sample. half of the participants were female and
the highest percentage of patients were
The results of the present study illiterate. On the other hand, this finding
indicated that the highest percentage of dis-agreed with Vanessa,Villarruz
staff nurses had age ranged between 25- ,Antonio ,Dansand , and Mark(2009)
30 years old. In relation to marital who conducted a study about
status, the majority of them were "measuring satisfaction with nursing
married. As regarding to educational care of patients admitted in the medical
qualification, the highest percentage of wards of the Philippine general
them had diploma in nursing. According hospital" and showed that age of studied
to their units, (19.0%) of them work in patients calculated at 50 years ranging
medical unit 5 . As regarding to years from 18 to 93 years old. There was an
of experience, the highest percentage of almost equal distribution between males
them had years of experience ranged and females, two thirds of whom were
from15years and more. This finding is married. A little over half had previous
consistent with (Li-ming, etal. ,2013) hospitalization.
who conducted a study about "Hospital
nursing, care quality and patient  Type of Nursing Care Delivery
satisfaction "and reported that the Systems as Reported by Staff Nurses.
average age of nurses was 29 years and
they had been working as nurses for As regarding to the assignment
11years.This finding is agreement with procedures, the findings of the current
(Abdullah,2014) who conducted a study study revealed that the units perform the
about "The effect of nursing care assignment procedure and the highest
delivery system on nurses' job percentage of the studied nurse reported
satisfaction" and reported that, the that assignment sheet was done in
highest percentage of nurses were written form and it had posted on the
married and they had been holding wall. From the researcher opinion, the
nursing diploma. effective assignment sheet should be in
The results of the present study revealed write form and put in suitable place
that the highest percentage of studied visible to all staff. These findings were
patient had age less than 40 years old. consistent with the American nursing
In relation to marital status, the majority association report (2007) as it reported
of studied patients were married. As that characteristics of effective
regarding to educational level, the assignment were to be clear, definite,
highest percentage of them were signed, posted in advance. This finding
illiterate, in relation to their gender, is also congruent with Sjetne and
more than half of them were female. As Veenstra(2010) who conducted a study
regarding to number of hospital about "classifying nursing organization
admission, more than one third of them in wards in Norwegian hospitals "and
admitted to hospital for first time. This indicated that nursing assignment sheet
finding is consistent with made by head nurse in written form and
Tashonna,Jeannie ,Mantopoulos it should be revised daily if necessary to
Elizabeth, and Jackson(2011):who assure continuity of care.
conducted a study about "A brief The findings of the present study
questionnaire for assessing patient revealed that the case method was the
healthcare experiences in low-income most frequently used method in medical
settings " and showed that the mean age units. From the researcher opinion, this

Menoufia Nursing Journal, Vol. 2, No. 1, May 2017 37

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

might be due to number of staff nurses recording those observation and

in each unit is suitable to needs of consulting with physicians.
patient from care. In this respect, Barker
(2011) who conducted a study about Patients Satisfaction
"Perceived level of mental, physical and
The finding of this study illustrated that
total fatigue, and also acute and chronic
more than two thirds of studied patients
fatigue states, among registered nurses"
had high level of satisfaction. From the
indicated that the case method was the
researcher opinion, this might be due to
most frequently used model in medical
the patient treat as a human with respect
units. On the other hand, this finding
to their dignity and consider their needs
disagree with Hansten and Jackson
, the nurses reception and administration
(2013) who conducted a study about "
of physical care to the Patient ,give
delivery of nursing care in acute setting
health education and give them
,success in practical /vocational nursing
psychological support and keeping
from student to leader" and indicated
privacy effectively. In this respect,
that in the specialized units(ICU) the
Kumar ,Anwarul ,Hassan, and Tehrani
highest percentage of head nurse used
(2012) who conducted a study about"
case method, the reverse was observed
high satisfaction rating by users of
in non- specialized units, the head nurse
private-for-profit healthcare providers-
reported the use of the functional
evidence from a cross-sectional survey
method.
among inpatients of a private tertiary
The finding of the present study also
level hospital of north india", it is
revealed that the highest percentage of
apparent that the was high level of
nurses reported that the nurse is the
patient satisfaction from preparation of
person who has the responsibility of
investigation and administration of
take patient care decision, writing
medication.
nursing note, punished in case of errors
in patient care and discuss patient care Relation between Study Variable
with doctors. From the researcher point
of view, this is could be related to the According to the current study there
fact that the head nurses were very was highly statistical significant
occupied with secretarial work or difference between patients satisfaction
administrative duties so they delegate level and their age and marital status,
the patient care responsibilities to the there was a statistical significance
staff nurses, the nurses provide direct difference between patients satisfaction
care and always in contact with them so level and their educational level and
they must write nursing note as they are number of hospital admission. While
aware of patient conditions, they are there was no significance difference
responsible for discussion with doctors between patients satisfaction level and
about patient condition and they will be their units, gender and work.
plamed in case of any error. This This results disagreed with Atallah,Al-
finding was in agreement with the Sayed,Ayman,Mansour, and
Occupational employment statistics Aboshaiqah (2013) who conducted a
(2010) who conducted a study about " study about "Patients' satisfaction with
licensed practical nurse: job description the quality of nursing care provided:
"and reported that when caring for The Saudi experience" and showed that
patient, registered nurse establish care there were no significant differences
plan ,plan may include numerous between patients’ satisfaction (overall
activities such as administrating satisfaction) with regard to age, gender
medication ,observing the patient and and marital status , whereas there was a

38 Menoufia Nursing Journal, Vol. 2, No. 1, May 2017

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

significant difference in overall patients’ care delivery system in the hospital,

satisfaction level related to educational
to understand the model of
level and number of admissions to
hospital . organizing patient care.
According to the present study there
2) Providing adequate staff nurse to
was a statistical relation between
methods of nursing care delivery reduce the work pressure and
system and level of patients`
decrease error during care given.
satisfaction. From the researcher
opinion, this might be due to when there 3) Developing assignment sheet to
is assignment sheet exist and advertised
accommodate the method used.
for all this leads to the organization of
work and save time for the benefit of 4) Implementing incentive system for
the patient, leading to patient
good performance and distributed
satisfaction. This result disagreed with
Ritin et al.,(2015) who conducted a fairly among hospital staff nurses.
study about "Models of care in nursing:
5) Advocating for the patient by
a systematic review "and showed that
there was no statistically relation in ensuring that nurse knowledge and
patient satisfaction between team
competencies match the patient’s
nursing and primary nursing models and
total patient care models . identified needs to allow for delivery

Conclusion of safe care.

6) Encouraging utilization of the entire
The present study was conducted to
determine the relationship between health care team to enhance the
nursing care delivery system and efficiency and effectiveness of
patient` satisfaction in Benha
nursing care delivery.
University hospitals. It is concluded that
the majority of staff nurses reported that 7) Adopting a practice model that
assignment sheet was made by nursing addresses the necessity to match
supervisor in written form, more than
patient needs with nurse
two thirds of staff nurses used case
method and more than two thirds of competencies.
patients had a high satisfaction level. 8) Establishing contingency
Additionally, there was a statistical plans/resources for unexpected
relation between methods of nursing
care delivery system and level of periods of increased activity and/or
patients` satisfaction. increased acuity.
9) Improving hospital clinical care
Recommendations
environments for enhancing patient
In the lights of the findings obtained
from the present study these points are satisfaction with care.
recommended:  Educational level:
 Nursing level: 1) Providing education to registered
1) Establishing definitions of nursing nurses related to patient satisfaction

Menoufia Nursing Journal, Vol. 2, No. 1, May 2017 39

 Hanady M. Abd Allah, Nermin M. Eid, Aya G. Hasanin" Relationship between Nursin …"

to consider when developing and American Nurses Association

evaluating staffing plans. Report(2007): Nursing Standards
,Reverted
2) Providing educational program for
http://currentnursing.com/nursing-
registered nurses on methodologies management/nursing-
by which to match nurse standerds.html,4-11-2017.

competencies to assessed patient Ann,R.(2017): UC Davis Medical

needs. Center , Retrieved from
https://www.ucdmc.ucdavis.edu/n
 Research level:
urse/practicemodel/index.html,5-
1) Making study about the effect of
11-2017.
nursing care delivery system on
quality of patient care. Atallah,M.,Al Sayed,A.,Ayman,M.,
Mansour,A. and
2) Repeating the current study on large
Aboshaiqah,B.(2013): Patients'
number of studied (nurses and Satisfaction with the Quality of
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Experience, International Journal
care setting.
of Nursing Practice 19(6),PP
3) Studying the organization factors and 584-59.
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B arbara,C. (2016): Staffing and
system.
Nursing Care Delivery Models,
Reverted from
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