Nursing Care Model Research Articles

Incorporating value-informed advanced nursing practice into APRN education

Value-informed advanced practice nursing capitalizes on the high-value nursing model of care to meet population health needs and address rising healthcare costs. However, nurse practitioners (NPs) often lack knowledge about value-based care, which limits their ability to lead systems-based changes to improve outcomes and lower costs. Identifying the key domains for value-informed advanced nursing practice can support curricular alignment with competency-based education. A review of the peer-reviewed and gray literature identified an initial list of domains that impact the success of value-based NP care. These domains were then confirmed and validated through interviews with eight NP practice owners. The final seven key domains of value-informed advanced nursing practice – Leadership/High Value Culture, Quality and Analytics, Care Coordination, Collaboration and Community Connections, Financial Management, Care Redesign, and IT Infrastructure and Interoperability – align with the sub-competencies established by the American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculty. Learning activities are offered to facilitate NP understanding of value-informed nursing practice and meet selected sub-competencies. Incorporating the key domains for value-informed advanced nursing practice into NP and Doctor of Nursing Practice education prepares emerging and seasoned NPs to lead systems-level change and improve care delivery.

Evaluate the Differential Effectiveness of the Case Management and Primary Nursing Models in the Implementation of Discharge Planning.

This study aims to compare the effectiveness of the case management model and the primary nursing care model by focusing on hospital stay length, readmission, follow-up resource utilisation and survival. To improve patient continuity of care, a discharge planning team has been established at the hospital to implement the service concept of long-term medical care. The team works with a multidisciplinary medical team to provide case management, which ensures high-quality patient care. Retrospective case-control study. This study collected data from the medical record information system database and the Ministry of Health and Welfare's care service management information system to explore medical and follow-up care utilisation of patients discharged between 2017 and 2018. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, with the checklist used to ensure transparent and complete reporting of the methodology and results. To ensure comparability between the case management model group and the primary nursing model group, propensity score matching was used. After matching, 660 individuals from the case management model group and 2876 individuals from the primary nursing model group were selected for further analysis. In this study, patients were primarily involved in the research as participants, providing data through their medical records for analysis. However, no direct involvement from the public or patients was used in the planning or design stages of the research. The study found that factors such as activities of daily living (ADL) score ≤ 60 points, catheterisation, poor chronic disease control and inadequate primary caregiver capacity can lead to longer hospitalisations. Males and patients with catheters have a higher risk of readmission within 30 days, and men, those aged ≥ 75 years, those with ADL score ≤ 60, catheterisation, pressure sores or unclean wounds, financial problems, insufficient primary caregiver capacity and those readmitted within 14 days after discharge had significantly increased mortality after discharge. Although the case management model group had higher hospitalisation days, they had lower readmission rates and higher survival rates than the primary nursing model group. Early consultation with the case manager for discharge planning can help patients to continue to receive care and utilise relevant resources after returning home. Identifying and addressing patient-specific factors can significantly improve patient outcomes by reducing hospitalizations and readmissions, and lowering mortality rates. The case management model is more effective than the primary nursing care model in reducing readmission rates and increasing survival rates. Early consultation with case managers for discharge planning is crucial to ensuring patient care continuity and resource utilization.

Impact of Collaborative Nursing Care on Health Outcomes of Mental Health Day Hospital Users: A Mixed Methods Study.

Given that recovery-oriented care focuses on empowering individuals with mental health challenges, collaborative care can be an effective tool for nurses in mental health day hospitals. To deepen knowledge about the impact of collaborative nursing care for improving health outcomes of mental health day hospital users. A sequential and transformative mixed methods study was designed. In the first phase of this mixed methods study, quantitative data were collected from 144 users of mental health day hospitals. In phase two, a group of users underwent an intervention based on collaborative nursing care, through participatory action research, and qualitative data were collected. Finally, quantitative data were again collected from all users. The users who participated in the intervention group improved quantitatively in terms of the quality of the therapeutic relationship. They also improved at different stages of the recovery process, thus the qualitative results confirmed that collaborative nursing care was an essential component in their recovery process. The findings highlight the critical role of collaborative nursing care in health outcomes. The therapeutic relationship was identified as a key factor in facilitating patient empowerment. The study supports implementing collaborative nursing care models in mental health settings to enhance patient outcomes. ClinicalTrials.gov identifier: NCT04814576.

Stuart Stress Adaptation and Nola Pender's Model on Mental Nursing Care of Patients Schizophrenia: Case Study

To describe the application of the Stuart Stress Adaptation and Nola Pender Models in mental nursing care for a patient with schizophrenia and risk of violent behavior. This research method used case studies. The sample is one patient with schizophrenia. Data collection is done through direct observation, interviews, and patient medical records. The results showed that the client showed a major nursing problem in the form of risk of violent behavior. Predisposing factors included passive childhood experiences and socio-cultural issues, while precipitation included feeling disrespected by the husband's family. Nursing interventions provided to the patient included logotherapy, forgiveness therapy, and psychoeducation to the family. Family psychoeducation forms a supportive system in the client's recovery process. The results of this study indicate that there is a reduction in symptoms of violent behavior in schizophrenia patients. The importance of integrating the Stuart Stress Adaptation and Nola Pender Model in the psychiatric nursing care of patients with paranoid schizophrenia.

Study on the Application of Integrated Medical and Nursing Care Model in the Postoperative Period of Patients with Sclerotherapy for Esophageal Varicose Veins

Objective: To explore the application effect of medical and nursing integration management mode in the postoperative period of patients treated with sclerotherapy for esophageal varices. Methods: Randomly divided 64 cases of esophageal varices patients admitted to our hospital from October 2022 to October 2023 who underwent surgical treatment into two groups, and gave 32 cases of patients in the control group postoperative implementation of basic nursing care, and 32 cases of patients in the research group postoperative implementation of healthcare integration management mode, and compared the effect of the nursing care of the two groups of patients. Results: There are differences in nursing satisfaction, incidence of postoperative rebleeding, complication rate, and patients’ knowledge of disease-related common grip scores between the two groups of patients with esophageal varices after nursing care (P < 0.05), which is statistically significant. Conclusion: The implementation of integrated medical and nursing management mode for postoperative patients with sclerotherapy for esophageal varices has a significant effect on the prognosis of patients, reduces the occurrence of complications, and shortens the length of hospital stay.

The effect of TCM triple rehabilitation and ear acupoint bean pressing on laparoscopic surgery for gastric cancer.

To explore the clinical value of the triple pre-rehabilitation nursing model in laparoscopic radical surgery for gastric cancer. Eighty-two gastric cancer patients admitted to a certain hospital from May 2020 to May 2023 are included in this study. Patients were divided into control group (CG) and treatment group according to different nursing methods. Comparisons were made by comparing perioperative indicators, immune indicators, sleep quality, nutritional indicators, and anxiety before and after patient care, as well as whether or not to utilize the acupoint patch combined with ear acupoint bean pressing burial in Chinese medicine care. Under the conditions of the triple pre-rehabilitation nursing model, the observation group (OG) patients had their first exhaust time, first bed activity time, first bowel movement time, and hospitalization time of 62.15 ± 5.93, 18.67 ± 7.55, 2.05 ± 0.58, and 7.21 ± 1.05, respectively. The postoperative values of ALB in the CG and OG were 31.59 ± 7.65 and 36.08 ± 8.27, respectively, while the postoperative values of prealbumin were 0.19 ± 0.05 and 0.27 ± 0.09, respectively. The sleep quality of the CG before nursing was 22.57 ± 3.66, and after nursing was 14.36 ± 3.72. The satisfaction rate of the OG was 56.10%, while that of the CG was 46.34%. Patients can better adapt to the treatment process, reduce anxiety, and improve the treatment effect and quality of life after the triple pre-rehabilitation nursing care model and acupoint paste combined with ear acupoint bean pressing burrowing in traditional Chinese medicine nursing.

Factors influencing nurse practitioner panel size in team-based primary care: a qualitative case study

BackgroundLack of access to health care is a worldwide public health crisis. In primary care it has led to increases in the implementation of nurse practitioners and heightened interest in their patient panel capacity. The aim of this study was to examine factors influencing nurse practitioner patient panel size in team-based primary care in Ontario, Canada.MethodsWe used a multiple case study design. Eight team-based primary care practices including rural and urban settings were purposively selected as cases. Each case had two or more nurse practitioners with a minimum of two years experience in the primary care setting. Interviews were conducted in-person, audio recorded, transcribed and analysed using content analysis.ResultsForty participants, including 19 nurse practitioners, 16 administrators (inclusive of executives, managers, and receptionists), and 5 physicians were interviewed. Patient, provider, organizational, and system factors influenced nurse practitioner patient panel size. There were eight sub-factors: complexity of patients’ health and social needs; holistic nursing model of care; nurse practitioner experience and confidence; composition and functioning of the multidisciplinary team; clerical and administrative supports, and nurse practitioner activities and expectations. All participants found it difficult to identify the panel size of nurse practitioners, calling it— “a grey area.” Establishing and maintaining a longitudinal relationship that responded holistically to patients’ needs was fundamental to how nurse practitioners provided care. Social factors such as gender, poverty, mental health concerns, historical trauma, marginalisation and literacy contributed to the complexity of patients’ needs. Participants indicated NPs tried to address all of a patient’s concerns at each visit.ConclusionsNurse practitioners have a holistic approach that incorporates attention to the social determinants of health as well as acute and chronic comorbidities. This approach compels them to try to address all of the needs a patient is experiencing at each visit and reduces their panel size. Multidisciplinary teams have an opportunity to be deliberate when structuring their services across providers to meet more of the health and social needs of empanelled patients. This could enable increases in nurse practitioner panel size.

Application of Integrated Medical and Nursing Care Model in the Perioperative Period of Endoscopic Precision Surgery

Objective: This study aims to evaluate the application effects of the integrated medical and nursing care model in the perioperative period of endoscopic precision surgery, to improve surgical efficiency and patient satisfaction. Methods: A prospective randomized controlled study design was adopted. From January 2023 to December 2023, 240 patients who underwent endoscopic precision surgery in our hospital were selected and randomly divided into an experimental group (120 patients) and a control group (120 patients). The experimental group implemented an integrated medical and nursing care management model, while the control group used traditional perioperative management. The surgery time, hospital stay, postoperative complication rate, and patient satisfaction of the two groups were compared. Results: The average surgery time of the experimental group was 15% shorter than that of the control group (P<0.05), and the average hospital stay was reduced by 20% (P<0.01). The postoperative complication rate of the experimental group was 5%, compared to 15% for the control group (P<0.05). In the patient satisfaction survey, the satisfaction score of the experimental group (9.2±0.8) was significantly higher than that of the control group (7.5±1.2) (P<0.001). Conclusion: The integrated medical and nursing care model can significantly improve the efficiency and quality of perioperative management in endoscopic precision surgery, shorten surgery time and hospital stay, reduce the incidence of complications, and enhance patient satisfaction. It is recommended that the integrated medical and nursing care model be widely used in perioperative management of endoscopic precision surgery.

Nurses' Roles in Artificial Intelligence Implementation: Results from a Mixed-Methods Study.

We aimed to understand nursing informaticists' perspectives on key challenges, questions, and opportunities for the nursing profession as it prepares for an era of healthcare delivery enriched by artificial intelligence (AI). We found that nursing practice is currently, and will continue to be, directly influenced by AI in healthcare. Educating and training nurses so that they may safely and effectively use AI in their clinical practice and engage in implementation planning and evaluation will help overcome predicted challenges. Defining the key tenets of AI literacy for nurses and re-envisioning nursing models of care in the context of AI-enriched healthcare are important next steps for nursing informaticists. If embraced, AI has the potential to support the existing nursing workforce in the context of major shortages and augment the safe and high-quality care that nurses can deliver.

The continuity psychiatric nursing care model to enhance medication adherence in schizophrenia patients in Indonesia: Participatory action research.

To develop a continuity of psychiatric nursing care model to enhance medication adherence in schizophrenia patients. The Participatory Action Research study was conducted from 2017 to 2018 in Pekanbaru, Riau, Indonesia, after approval form the ethics review committee of the Faculty of Nursing, Prince of Songkla University, Thailand. The sample included schizophrenia inpatients at a mental hospital, their family members and nursing staff. Qualitative data were gathered through in-depth interviews, observations, field notes, and photo records. Data was subjected to content analysis, while trustworthiness of the model was also determined. Of the 57 subjects, 22(38.6%) were schizophrenia patients, 22(38.6%) were family members, and 13(22.8%) were nurses. The continuity of psychiatric nursing care model consisted of three components: preparing for readiness to live a normal way of life; creating a supportive environment; and, sustaining the continuity of care until the community level care. The continuity of psychiatric nursing care model facilitated holistic nursing care aspects.

Incidence and Factors Associated with Falls in Older People in a Long-Term Care Facility: A Prospective Study in Taiwan.

The effectiveness of applying a fall-risk assessment to prevent falls in residents of long-term care facilities has not been investigated. This prospective study enrolled elderly residents in a long-term care facility in Taiwan. Caregivers were provided with a health-status assessment and fall-risk data to enhance their fall-prevention practices. A multivariate analysis was performed to identify the factors associated with falls. A total of 123 subjects, including 68 and 55 for general and nursing-care models, respectively, were assessed. Their health status and risk of falls were provided to the care units to enhance their fall-prevention practices. Subjects in the nursing-care model had more dementia and more prescribed medications, worse physiologic conditions, and higher fall risk. Of them, 28 (23%) had subsequent falls. A univariate analysis showed that those with and without falls were similar in demographic characteristics, prescribed medications, physiologic function, and fall risk. There was a tendency for more falls in the nursing-care model residents (accounting for 61% of those who fell; p = 0.053). A regression analysis showed that gender (beta = 1.359; 95% confidence interval = 0.345-2.374; p = 0.010) and NPI score (beta = 0.101; 95% CI = 0.001-0.200; p = 0.047) were associated with the risk of falls. Residents at the long-term care facility had a significant risk of falls despite knowledge of their fall risk and the implementation of preventive measures. In this context of being aware of the risk, gender, and psychiatric symptoms were significantly associated with falls. Caregivers at long-term care facilities should implement further measures to prevent falls based on behavioral and psychological symptoms.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used; while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05); after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

Missing nurses cause missed care: is that it? Non-trivial configurations of reasons associated with missed care in Austrian hospitals – a qualitative comparative analysis

BackgroundErrors of omissions affect the quality of nursing care in hospitals. The Missed Nursing Care Model explains that the reasons for missed care are linked with 1) demand for patient care, 2) labor resource allocation, 3) material resource allocation, and 4) relationship and communication factors. Scientific evidence points to a lack of adequate nursing staffing as the most important factor triggering missed care. However, it remains unclear how the different theoretical reasons for missed care are interlinked with reports on missed care from the perspective of nurses in acute care settings. The aim of this study was to explore non-trivial configurations of reasons for missed care that are associated with missed care interventions from the perspective of nurses working in general units in Austrian hospitals.MethodsA cross-sectional study was conducted. Data collection was performed using the revised MISSCARE-Austria questionnaire. Our sample consisted of 401 nurses who provided complete data. Data were analyzed using qualitative comparative analysis. Configurational models of contextual factors, reasons for missed care, and missed nursing interventions were analyzed.ResultsIn our study contextual factors were not consistent precursors of the reasons for missed care. Missed care was consistently present when the demand for patient care was high. A lack of labor resources, in combination with the other known reasons for missed care, was consistently observed when missed care occurred. Different configurations of reasons were found to be non-trivially associated with different types and frequencies of missed care.ConclusionsTo understand the complexity of the causal mechanisms of missed care, complexity theory may be necessary. Accordingly, a theoretical framework that acknowledges that complex systems, such as missed care, are composed of multiple interacting causal components must be further developed to guide new methodical approaches to enlighten its causal mechanisms.

Patient perceived quality of cirrhosis care– adjunctive nurse-based care versus standard medical care: a pragmatic multicentre randomised controlled study

BackgroundCirrhosis treatment implies prevention and alleviation of serious disease events. Healthcare providers may, however, fail to meet patients’ expectations of collaboration and specific needs of information and support. Individualised nursing care could meet patients’ needs. The aim was thus to measure patient-perceived quality of care after adjunctive registered nurse-based intervention Quality Liver Nursing Care Model (QLiNCaM) compared with standard medical care.MethodsThis pragmatic multicentre study consecutively randomised patients to either adjunctive registered nurse-based care, or standard medical care for 24 months (ClinicalTrials.gov NCT02957253). Patients were allocated to either group at an equal ratio, at six Swedish outpatient clinics during 2016–2022. Using the questionnaire ‘Quality of care from the patient’s perspective’, patients rated their perceived lack of quality for the adjunctive registered nurse-based intervention compared with the control group at 12 and 24 months, respectively.ResultsIn total, 167 patients were recruited. Seven out of 22 items in the questionnaire supported the finding that ‘lacking quality’ decreased with adjunctive registered nurse-based care (p < 0.05) at 12 months follow-up; however, these differences could not be established at 24 months.ConclusionAdditional structured registered nurse-based visits in the cirrhosis outpatient team provided support for improved patient-perceived quality of care during the first 12 months. Registered nurses increase patient involvement and present easy access to cirrhosis outpatient care. Patients express appreciation for personalised information. This study reinforces registered nurses’ role in the outpatient cirrhosis team, optimising patient care in compensated and decompensated cirrhosis.Trial registrationRegistered at Clinical Trials 18th of October 2016, [https://www.clinicaltrials.gov], registration number: NCT02957253.

The Impact of Modular Professional Nursing Care Model (Modification of The Primary-Team Model) on Patient Satisfaction in Health Services: A Literature Review

Optimal health services are considerably increasing patient satisfaction. Optimization of health services could be implemented using the Modular Professional Nursing Care Method (MAKP Modular). MAKP Modular provides a clear division of tasks and responsibilities for nurses in accordance with the distribution of nursing staff. This literature review aimed to identify the effect of MAKP Modular in increasing patient satisfaction through the optimization of health services. The research design is a literature review. The journal article was conducted on the Google Scholar journal database website and 10 journal articles were selected according to inclusion criteria. The results of the review show that the application of MAKP Modular affects the quality of implementation of nursing care standards. The performance of nurses manifested in the implementation of MAKP Modular also influences patient satisfaction. However, there are still some deficiencies in the application of modular MAKP in the health service setting. These deficiencies are influenced by factors of knowledge, attitudes, and motivation of nurses. The application of MAKP Modular to the healthcare system is conducted by combining the team method and the primary method. The combination of these two methods allows for a more effective and efficient process of providing nursing care. Evaluation of the implementation of MAKP Modular in clinical and hospital settings needs to be engaged on an ongoing basis to determine the effectiveness of implementation.

Optimization of nursing interventions for postoperative mental status recovery in patients with cerebral hemorrhage.

Hypertensive cerebral hemorrhage (HCH), the most common chronic diseases, has become a topic of global public health discussions. To investigate the role of rehabilitative nursing interventions in optimizing the postoperative mental status recovery phase and to provide clinical value for future rehabilitation of patients with HCH. This randomized controlled study included 120 patients with cerebral HCH who were contained to our neurosurgery department between May 2021-May 2023 as the participants. The participants have randomly sampled and grouped into the observation and control groups. The observation group received the rehabilitation nursing model, whereas the control group have given conventional nursing. The conscious state of the patients was assessed at 7, 14, 21, and 30 d postoperatively. After one month of care, sleep quality, anxiety, and depression were compared between the two groups. Patient and family satisfaction were assessed using a nursing care model. The results showed that the state of consciousness scores of the patients in both groups significantly increased (P < 0.05) after surgical treatment. From the 14th day onwards, differences in the state of consciousness scores between the two groups of patients began to appear (P < 0.05). After one month of care, the sleep quality, anxiety state, and depression state of patients were significantly better in the observation group than in the control group (P < 0.05). Satisfaction with nursing care was higher in the observation group than in the control group (P < 0.05). The rehabilitation nursing model has a more complete system compared to conventional nursing, which can effectively improve the postoperative quality of life of patients with cerebral hemorrhage and improve the efficiency of mental state recovery; however, further analysis and research are needed to provide more scientific evidence.

Measuring the PULSE of Nursing: Development of a Dashboard to Evaluate and Monitor Nursing Care Models.

Critical nursing shortages have required many health care organizations to restructure nursing care delivery models. At a tertiary health care center, 150 registered practical nurses were integrated into acute inpatient care settings. A mechanism to continuously monitor the impact of this staffing change was not available. Leveraging current literature and consultation with external peers, metrics were compiled and categorized according to Donabedian's Structure Process Outcome Framework. Consultation with internal subject matter experts determined the final metrics. The Patient care, Utility, Logistics, Systemic Evaluation (PULSE) electronic dashboard was developed, capturing metrics from multiple internal databases and presenting real-time composites of validated indicators. The PULSE dashboard is a practical means of enabling nursing leadership to evaluate the impact of change and to make evidence-informed decisions about nursing care delivery at our organization.

Professional difficulties of a nursing worker in the department of obstetrics and gynecology

With the continuous improvement of living standards, most patients have increasingly high demands on the quality of health care services. As for nursing, the high-quality nursing care model has gradually replaced the traditional nursing model and has been recognized by many patients. Throughout the entire period of the formation of medicine, all kinds of measures have been taken to improve the provision of therapeutic and preventive care to pregnant women, women in labor, women in childbirth, newborns and gynecological patients, since this type of care has certain specifics, differing from general medical practice. One of the possible tools to improve the quality of work of nursing professionals is to study the problems of the work process and timely elimination of difficulties faced by midwives and nurses in the course of their professional activities.

The development of an islamic nursing care model to improve patient satisfaction

Introduction: This study aimed to the development of an Islamic nursing care model to improve patient satisfaction. Methods: Cross-sectional design random sampling technique on 134 respondents, consisting of patients and nurses in the surgical inpatient room, internal medicine inpatient room, and postpartum and gynecology inpatient rooms, using simple random techniques. The variables of this study were the nursing factors, Islamic nursing care, and patient satisfaction and were collected using questionnaire. The data were collected using questionnaire in December 2021 at Islamic Hospital, Indonesia, and processed using a Smart Partial Least Squares (SmartPLS) analysis and Sommers' correlation test. Results: The Sommers' test results show significant relationship between nursing factor (nurse knowledge, nurse’s attitude, nurse competence, nurse personality) and patient satisfaction; nurse knowledge (p=0.000); nurse attitude (p=0.000); nurse competence (p=0.000); nurse personality (p=0.000; α&lt;0.05). SmartPLS test results show the nurse factor with Islamic nursing care has a strong significant influence (p value 0.000; β value 0.539; t value&gt; 1.96). Then for Islamic nursing care with patient satisfaction, it has a very strong significant effect (p value 0.000; β value 0.753; t value&gt; 1.96). Conclusions: Islamic nursing care as a mediator of nurse factors with patient satisfaction can be described in this study model because Islamic nursing care is a real form of care by nurses that is felt by the patient and the application of Islamic values so that the form of nursing care makes patients feel satisfied.

STRENGTHENING OF PROFESSIONAL NURSING CARE METHODS (MAKP) TEAM NURSING METHOD IN RSUD DR. R. KOESMA TUBAN

Hospitals is health service organization unit by providing comprehensive health services that include promotive, preventive, curative and rehabilitative for all levels of society, often experience problems related to community dissatisfaction with the quality of hospital services which are considered unsatisfactory. Nursing service is one of the factors that determines the good and bad quality and image of the hospital. In addition to the form of service which has special characteristics, namely the implementation of continuous 24-hour service, it is also one of the most numerous health professional workers in hospital. The Professional Nursing Care Model (MAKP) which is currently becoming a trend in Indonesian nursing is the MAKP with comprehensive method of providing nursing care. MAKP is method of providing nursing care in which a professional nurse leads group of nursing staff in providing nursing care to patients through cooperative and collaborative efforts. According to an interview conducted by the residency team to one of the Heads of Room at RSUD Dr. R. Koesma, Tuban Regency, the application of MAKP uses the team method. However, in practice it is still more likely to use functional methods. After the implementation was carried out in the form of providing Socialization of MAKP Strengthening Team Methods to nurses in the Lily Room at RSUD, found the following evaluation results: The Room Nurse will apply the Team MAKP method continuously and consistently. Then, supervision will be carried out periodically so there are no more findings that result in MAKP Team's method not running optimally