Davies 1994.
Methods | Controlled before and after study comparing NL pre / post implementation with 2 control wards Baseline Comparability: Not clear ‐ length of stay and quality of care reported for 2 (1) control wards. Lengths of stay differs markedly Blinded assessment: done for length of stay, not done for quality. Reliable assessment: done for length of stay unclear for quality, satisfaction Contamination: Unclear Follow up: sample size and follow up are unclear. | |
Participants | Elderly care 'rehabilitation'. Patients over 75 with a range of diagnoses (examples given CVA, MI, pneumonia and hip fracture). Sample size not specified but pre and post length of stay data presented from 6 month periods. Data is presented from 53 nurses relating to job satisfaction. | |
Interventions | Unit / setting: 18 bed unit in a satellite (non acute) hospital linked to (2 miles) a District General Hospital (UK).
Care management: Care managed in a single weekly interdisciplinary meeting chaired by a senior nurse. No routine medical assessment with primary nurse planning care and initiating medical involvement / referring to other disciplines.
Nursing Team: No detail given.
MD team: Included 'therapists' (Occupational Therapy and Physio) Social work and medics. No registrar / senior registrar input onto ward.
Education / preparation for staff: None described although the process of implementation is described as developing from within the unit (i.e. bottom up)
Other: Attempts to create less formal atmosphere (e.g. nurses did not wear uniforms). Control: .Two 'similar' wards with routine medical care management. |
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Outcomes | Length of stay quality of care nurse job satisfaction Process of interdisciplinary care | |
Notes | Quality score: N/A | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment? | Unclear risk | D ‐ Not used |