From awareness to action: investigating the impact of big-five teamwork model awareness on rationing of nursing care and patient-centered care.

Abstract

Background: Nurses are the cornerstone of healthcare delivery, playing a pivotal role in ensuring safe, high-quality, and patient-centered care. However, the significant demands on their time and resources often lead to the rationing or omission of essential nursing care activities, undermining patient outcomes. As frontline caregivers, nurses' ability to collaborate effectively within teams is critical to overcoming these challenges. The Big Five Teamwork Model, which emphasizes trust, communication, and leadership, offers a transformative approach to strengthening teamwork and addressing barriers to comprehensive nursing care.

Aim: This study aimed to assess the impact of the Big Five Teamwork Awareness Sessions (Big 5TWAS) on the rationing of nursing care and patient-centered care.

Methods: A quasi-experimental pre-post-test design was conducted in critical care units at an Egyptian university hospital. A convenience sample of 60 nurses and 31 admitted patients participated in the study. Big 5TWAS interventions were implemented for nurses, and study variables were measured using nursing teamwork surveys, the Rationing of Nursing Care Observational Checklist (RONCO), and patient-centered care questionnaires before and after the intervention. Data were analyzed using descriptive and inferential statistics.

Results: The Big 5 Teamwork Awareness Sessions (Big 5TWAS) demonstrated a significant impact on the study variables. Post-sessions, there was a significant decrease in rationing of nursing care scores and significant increases in nursing teamwork and patient-centered care scores (p ≤ 0.001). In addition to the significant correlation values, regression analysis revealed that overall teamwork accounted for approximately 22% of the variance in rationing of nursing care (R² = 0.224, p = 0.015), with trust as the significant predictor. Furthermore, teamwork explained approximately 80% of the variance in patient-centered care (R² = 0.801, p < 0.001), with trust, backup, and team leadership emerging as significant predictors.

Conclusion and recommendations: The study underscores the critical role of teamwork in reducing the rationing of nursing care and enhancing patient-centered care in critical care units. The Big 5TWAS was effective in fostering improved team dynamics, trust, and leadership, which translated into better care delivery. These findings highlight the need for ongoing inter-professional training and teamwork-enhancing strategies led by nurse managers to sustain and amplify these improvements. By focusing on teamwork, healthcare institutions can ensure high-quality patient outcomes and minimize missed nursing care practices.