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Nierhaus A, de Heer G, Kluge S. [Concept for a department of intensive care]. Med Klin Intensivmed Notfmed 2014; 109:509-15. [PMID: 25270718 DOI: 10.1007/s00063-013-0345-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 09/02/2014] [Indexed: 02/16/2023]
Abstract
BACKGROUND Demographic change and increasing complexity are among the reasons for high-tech critical care playing a major and increasing role in today's hospitals. At the same time, intensive care is one of the most cost-intensive departments in the hospital. PREREQUISITES To guarantee high-quality care, close cooperation of specialised intensive care staff with specialists of all other medical areas is essential. A network of the intensive care units within the hospital may lead to synergistic effects concerning quality of care, simultaneously optimizing the use of human and technical resources. GOAL Notwithstanding any organisational concepts, development and maintenance of the highest possible quality of care should be of overriding importance.
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Affiliation(s)
- A Nierhaus
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland,
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Bednarz EM, Lisi AJ. A survey of interprofessional education in chiropractic continuing education in the United States. THE JOURNAL OF CHIROPRACTIC EDUCATION 2014; 28:152-6. [PMID: 24918483 PMCID: PMC4211588 DOI: 10.7899/jce-13-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Objective : The purpose of this study is to describe the state of chiropractic continuing education vis-à-vis interprofessional education (IPE) with medical doctors (MD) in a survey of a sample of US doctors of chiropractic (DC) and through a review of policies. Methods : Forty-five chiropractors with experience in interprofessional settings completed an electronic survey of their experiences and perceptions regarding DC-MD IPE in chiropractic continuing education (CE). The licensing bodies of the 50 US states and the District of Columbia were queried to assess the applicability of continuing medical education (CME) to chiropractic relicensure. Results : The majority (89.1%) of survey respondents who attend CE-only events reported that they rarely to never experienced MD-IPE at these activities. Survey respondents commonly attended CME-only events, and 84.5% stated that they commonly to very commonly experienced MD-IPE at these activities. More than half (26 of 51) of the licensing bodies did not provide sufficient information to determine if CME was applicable to DC relicensure. Thirteen jurisdictions (25.5%) do not, and 12 jurisdictions (23.5%) do accept CME credits for chiropractic relicensure. Conclusion : The majority of integrated practice DCs we surveyed reported little to no IPE occurring at CE-only events, yet significant IPE occurring at CME events. However, we found only 23.5% of chiropractic licensing bodies allow CME credit to apply to chiropractic relicensure. These factors may hinder DC-MD IPE in continuing education.
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104
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Diffusion of Enhanced Recovery principles in gynecologic oncology surgery: Is active implementation still necessary? Gynecol Oncol 2014; 134:570-5. [DOI: 10.1016/j.ygyno.2014.06.019] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 06/20/2014] [Accepted: 06/23/2014] [Indexed: 12/14/2022]
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Abstract
This type of collaboration is the way of the future; are you aware of its benefits for leaders?
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Affiliation(s)
- Dorothy Peterson Bethea
- At Winston-Salem State University in Winston-Salem, N.C., Dorothy Peterson Bethea is a professor and chair for the graduate department of Occupational Therapy; Cecil A. Holland Jr. is an associate professor and assistant dean of Admissions, Student Affairs, and Program Effectiveness for the division of Nursing; and Bobbie Kearns Reddick is an associate professor for the division of Nursing
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Bohnenkamp S, Pelton N, Rishel CJ, Kurtin S. Implementing Evidence-Based Practice Using an Interprofessional Team Approach: Part Two. Oncol Nurs Forum 2014; 41:548-50. [DOI: 10.1188/14.onf.548-550] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Aase I, Hansen BS, Aase K. Norwegian nursing and medical students' perception of interprofessional teamwork: a qualitative study. BMC MEDICAL EDUCATION 2014; 14:170. [PMID: 25124090 PMCID: PMC4139134 DOI: 10.1186/1472-6920-14-170] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 08/08/2014] [Indexed: 05/25/2023]
Abstract
BACKGROUND Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students' understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students' perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. METHODS The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). RESULTS The results show that traditional patterns of professional role perception still prevail and strongly influence students' professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. CONCLUSIONS This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit "huddles," or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students' assessments and criteria proposed in previous studies.
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Affiliation(s)
- Ingunn Aase
- Department of Health Studies, University of Stavanger, Stavanger N-4036, Norway
| | - Britt Sæthre Hansen
- Department of Health Studies, University of Stavanger and Stavanger University Hospital, Stavanger N-4036, Norway
| | - Karina Aase
- Department of Health Studies, University of Stavanger, Stavanger N-4036, Norway
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Bilodeau K, Dubois S, Pepin J. Interprofessional patient-centred practice in oncology teams: utopia or reality? J Interprof Care 2014; 29:106-12. [PMID: 25070427 DOI: 10.3109/13561820.2014.942838] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Studies on interprofessional practice usually report professionals' viewpoints and document organizational, procedural and relational factors influencing that practice. Considering the importance of interprofessional patient-centred (IPPC) practice, it seems necessary to describe it in detail in an actual context of care, from the perspective of patients, their families and health-care professionals. The goal of this study was to describe IPPC practice throughout the continuum of cancer care. A qualitative multiple case study was completed with two interprofessional teams from a Canadian teaching hospital. Interviews were conducted with patients, their families and professionals, and observation was carried out. Three themes were illustrated by current team practice: welcoming the person as a unique individual, but still requiring the patient to comply; the paradoxical coexistence of patient-centred discourse and professional-centred practice; and triggering team collaboration with the culmination of the patient's situation. Several influential factors were described, including the way the team works; the physical environment; professionals' and patients'/family members' stance on the collaboration; professionals' stance on patients and their families; and patients' stance on professionals. Finally, themes describing the desired IPPC practice reflect the wish of most participants to be more involved. They were: providing support in line with the patient's experience and involvement; respecting patients by not imposing professionals' values and goals; and consistency and regularity in the collaboration of all members.
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Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, Université de Montréal , Montreal, Quebec , Canada and
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109
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Bohnenkamp S, Pelton N, Rishel CJ, Kurtin S. Implementing Evidence-Based Practice Using an Interprofessional Team Approach. Oncol Nurs Forum 2014; 41:434-7. [DOI: 10.1188/14.onf.434-437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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110
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Bernardes A, G Cummings G, Gabriel CS, Martinez Évora YD, Gomes Maziero V, Coleman-Miller G. Implementation of a participatory management model: analysis from a political perspective. J Nurs Manag 2014; 23:888-97. [PMID: 24862294 DOI: 10.1111/jonm.12232] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 11/27/2022]
Abstract
AIM To analyse experiences of managers and nursing staff in the implementation of participatory management, specifically processes of decision-making, communication and power in a Canadian hospital. BACKGROUND Implementing a Participatory Management Model involves change because it is focused on the needs of patients and encourages decentralisation of power and shared decisions. METHODS The study design is qualitative using observational sessions and content analysis for data analysis. We used Bolman and Deal's four-frame theoretical framework to interpret our findings. RESULTS Participatory management led to advances in care, because it allowed for more dialogue and shared decision making. However, the biggest challenge has been that all major changes are still being decided centrally by the provincial executive board. CONCLUSIONS Managers and directors are facing difficulties related to this change process, such as the resistance to change by some employees and limited input to decision-making affecting their areas of responsibility; however, they and their teams are working to utilise the values and principles underlying participatory management in their daily work practices. IMPLICATIONS FOR NURSING MANAGEMENT Innovative management models encourage accountability, increased motivation and satisfaction of nursing staff, and improve the quality of care.
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Affiliation(s)
- Andrea Bernardes
- College of Nursing at Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | | | - Carmen Silvia Gabriel
- College of Nursing at Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | | | - Vanessa Gomes Maziero
- College of Nursing at Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Careau E, Brière N, Houle N, Dumont S, Vincent C, Swaine B. Interprofessional collaboration: development of a tool to enhance knowledge translation. Disabil Rehabil 2014; 37:372-8. [PMID: 24828392 DOI: 10.3109/09638288.2014.918193] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Interprofessional collaboration (IPC) is a complex and multidimensional process in which different professionals work together to positively impact health care. In order to enhance the knowledge translation and improve rehabilitation practitioners' knowledge and skills toward IPC, it is essential to develop a comprehensive tool that illustrates how IPC should be operationalized in clinical settings. Thus, this study aims at developing, validating and assessing the usefulness of a comprehensive framework illustrating how the interactional factors should be operationalized in clinical settings to promote good collaboration. METHODS This article presents a mixed-method approach used to involve rehabilitation stakeholders (n = 20) in the development and validation of an IPC framework according to a systematic seven-phase procedure. RESULTS The final framework shows five types of practices according to four components: the situation of the client and family, the intention underlying the collaboration, the interaction between practitioners, and the combining of disciplinary knowledge. CONCLUSION The framework integrates the current scientific knowledge and clinical experience regarding the conceptualization of IPC. It is considered as a relevant and useful KT tool to enhance IPC knowledge for various stakeholders, especially in the rehabilitation field. This comprehensive and contextualized framework could be used in undergraduate and continuing education initiatives. Implications for Rehabilitation The framework developed integrates the current scientific knowledge and clinical experience regarding the conceptualization of interprofessional collaboration (IPC) that is relevant to the rehabilitation field. It could be used in undergraduate and continuing education initiatives to help learners understand the multidimensional and dynamic nature of IPC. It could be useful to support practitioners and managers from the rehabilitation field in their efforts to optimize collaborative practice within their organization.
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Affiliation(s)
- Emmanuelle Careau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) , Quebec City, Quebec , Canada
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112
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Interdisciplinary Education for Genetic Counselors: Developing the Concept and Assessing the Need in Australasia. J Genet Couns 2014; 23:708-24. [DOI: 10.1007/s10897-014-9723-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
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Shimizu F, Katsuda H. Teachers' perceptions of the role of nurses: caring for children who are technology-dependent in mainstream schools. Jpn J Nurs Sci 2014; 12:35-43. [PMID: 24751200 DOI: 10.1111/jjns.12046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 11/20/2013] [Indexed: 01/08/2023]
Abstract
AIM This study explored special education teachers' perceptions of the role of nurses who specialize in providing nursing care to children who are technology-dependent in mainstream schools. METHODS Semistructured interviews with 11 teachers were conducted, and data were analyzed using inductive content analysis. RESULTS The teachers surveyed thought that the most important role of nurses was to maintain good health and safety, as well as to support children's education as members of the educational team. Teachers desired that nurses give advice based on their professional knowledge to maintain the children's good health and safety. In supporting education, nurses were required to support the children's autonomy and education, and to act as members of the educational team. CONCLUSION Study findings suggest that, for an optimal relationship with teachers, nurses who provide nursing care for children who are technology-dependent in mainstream schools need not only fulfill medical functions, but also support the education of children as members of the educational team.
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Affiliation(s)
- Fumie Shimizu
- School of Nursing, Senri Kinran University, Osaka, Japan
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Broadbent M, Moxham L. Collegiate presence: explaining homogenous but disparate nursing relationships. J Psychiatr Ment Health Nurs 2014; 21:226-33. [PMID: 23773165 DOI: 10.1111/jpm.12075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2013] [Indexed: 11/29/2022]
Abstract
This paper examines the notion of collegiate presence. Collegiate presence is defined as a mutual connection between two or more professional individuals or groups who share a common work focus and who are mindful of cultural differences. This concept emerged as a result of an ethnographic study of two groups of triage nurses; emergency department, and mental health nurses. Data analysis exposed a number of concepts and themes including collegiality and presence. These two concepts were seen to be so closely connected that the term collegiate presence was constructed. This paper explores the notion of collegiate presence and examines factors that affect this phenomenon between what are homogenous (nurses) but disparate cultural groups (emergency department nurses and mental health triage nurses) in a health-care organization. Findings indicate that culturally disparate groups are challenged to develop functional and collaborative working relationships without a deep understanding of, and appreciation for, each other's culture. Developing collegiate presence requires effective communication, social and professional conversations, and physical presence.
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Affiliation(s)
- M Broadbent
- Institute for Health and Social Science Research, Central Queensland University, Noosaville BC, Qld
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Interprofessional collaboration in the mental health services in norway. Nurs Res Pract 2014; 2014:849375. [PMID: 24724020 PMCID: PMC3958657 DOI: 10.1155/2014/849375] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/30/2013] [Accepted: 01/13/2014] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to describe and interpret interprofessional collaboration between healthcare professionals (HCPs) working at the district psychiatric centre (DPC) and employed in community mental health care (CMHC) using a dialogue-oriented co-operative approach. Data were collected by means of multistage focus groups and qualitative content analysis was performed. The main theme "development of interprofessional collaboration by means of organisational strategies and interactional styles" encompassed the following categories: "improved communication skills," "developing structures for coordination and responsibility" and " increased professional insight into the values and conditions necessary for decision-making." In conclusion, more attention should be paid to leadership in terms of coordination and feedback. The HCPs must be acknowledged, understood and strengthened in their work to improve the quality of CMHC. Finally, we recommend that a range of organisational and administrative models of care be used in order to support improvement work.
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117
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Colson S, Gentile S, Côté J, Lagouanelle-Simeoni MC. Spécificités pédiatriques du concept d'éducation thérapeutique du patient : analyse de la littérature de 1998 à 2012. SANTÉ PUBLIQUE 2014. [DOI: 10.3917/spub.139.0283] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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119
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Schadewaldt V, McInnes E, Hiller JE, Gardner A. Investigating characteristics of collaboration between nurse practitioners and medical practitioners in primary healthcare: a mixed methods multiple case study protocol. J Adv Nurs 2013; 70:1184-93. [DOI: 10.1111/jan.12269] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - Elizabeth McInnes
- Nursing Research Institute; Australian Catholic University; Darlinghurst New South Wales Australia
| | - Janet E. Hiller
- Australian Catholic University; Fitzroy Victoria Australia
- School of Population Health; University of Adelaide; Australia
| | - Anne Gardner
- Australian Catholic University; Fitzroy Victoria Australia
- James Cook University; Townsville Queensland Australia
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Jafari-Rouhi AH, Sardashti S, Taghizadieh A, Soleimanpour H, Barzegar M. The Emergency Severity Index, version 4, for pediatric triage: a reliability study in Tabriz Children's Hospital, Tabriz, Iran. Int J Emerg Med 2013; 6:36. [PMID: 24088367 PMCID: PMC3850684 DOI: 10.1186/1865-1380-6-36] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 09/16/2013] [Indexed: 11/30/2022] Open
Abstract
Background The Emergency Severity Index (ESI) has earned reliability and validity in adult populations but has not been adequately evaluated in pediatric patients. The aim of this study was to assess the reliability of the ESI version 4 and inter-rater reliability measures to evaluate the performance of nurses in the emergency ward. Methods Raters were part of the same team of pediatric emergency medicine team, including pediatric emergency medicine (PEM) physicians and pediatric triage (PT) nurses. Reliability and agreement rates were measured using kappa statistics. The measurements were compared with the admission rates, readmissions to the PEM division, location of admission and death as outcomes. Results Initially, PT nurses rated 20 case scenarios. Further in a prospective cohort study, 1104 children were assigned ESI scores by both nurses and physicians. The ratings of case scenarios showed a kappa value of 0.84. In actual patients, ratings showed high concordance with the physicians’ ratings with the kappa value of 0.82 being in a good agreement with the nurses’ ratings. The main area of discordance was detected in level 4 where 48 cases were triaged in higher levels and 25 were triaged in lower levels. The analysis showed the likelihood of admission clearly increased as the ESI score decreased (p<0.0001). There was a significant correlation between the admission status and triage level in both PT nurses’ and PEM physicians’ ratings (Spearman coefficient=0.374, 0.407; p<0.0001). Conclusion ESI scores assigned to the pediatric patients are reliable in the hands of experienced PT nurses and PEM physicians. The very good agreement between PT nurses and PEM physicians, demonstrated in this study, is essential in cooperative work in crowded referral emergency departments and helpful in challenging triage cases.
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Affiliation(s)
- Amir Hossein Jafari-Rouhi
- Pediatric Health Research Center, Tabriz Children's Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
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Abstract
PURPOSE This study was designed to explore the concept of virtual collaboration within the context of an online learning environment in an academic setting. METHOD Rodgers' method of evolutionary concept analysis was used to provide a contextual view of the concept to identify attributes, antecedents, and consequences of virtual collaboration. FINDINGS Commonly used terms to describe virtual collaboration are collaborative and cooperative learning, group work, group interaction, group learning, and teamwork. A constructivist pedagogy, group-based process with a shared purpose, support, and web-based technology is required for virtual collaboration to take place. Consequences of virtual collaboration are higher order thinking and learning to work with others. CONCLUSION A comprehensive definition of virtual collaboration is offered as an outcome of this analysis. Clarification of virtual collaboration prior to using it as a pedagogical tool in the online learning environment will enhance nursing education with the changes in nursing curriculum being implemented today. Further research is recommended to describe the developmental stages of the collaborative process among nursing students in online education and how virtual collaboration facilitates collaboration in practice.
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Affiliation(s)
- Henny Breen
- Linfield College Good Samaritan School of Nursing, Portland, OR
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122
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Haddara W, Lingard L. Are we all on the same page? A discourse analysis of interprofessional collaboration. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:1509-1515. [PMID: 23969354 DOI: 10.1097/acm.0b013e3182a31893] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Interprofessional collaboration (IPC) has become a dominant idea in both medical education and clinical care as reflected in its incorporation into competency-based educational frameworks and hospital accreditation models. This study examined the published literature to explore whether a shared IPC discourse underpins these current efforts. METHOD Using a critical discourse analysis methodology informed by Michel Foucault's approach, the authors analyzed an archive of 188 texts published from 1960 through 2011. The authors identified the texts through a search of PubMed and CINAHL. RESULTS The authors identified two major discourses in IPC: utilitarian and emancipatory. The utilitarian discourse is characterized by a positivist, experimental approach to the question of whether IPC is useful in patient care and, if so, what features best promote successful outcomes. This discourse uses the language of "evidence" and "validity." The emancipatory discourse is characterized by a constructivist approach concerned primarily with equalizing power relations among health practitioners; its language includes "power" and "dominance." CONCLUSIONS This study suggests that IPC is not a single, coherent idea in medical education and health care. At least two different IPC discourses exist, each with its own distinctive truths, objects, and language. The extent to which educators and health care practitioners may tacitly align with one discourse or the other may explain the tensions that have accompanied the conceptualization, implementation, and assessment of IPC. Explicit acknowledgment of and attention to these discourses could improve the coherence and impact of IPC efforts in educational and clinical settings.
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Affiliation(s)
- Wael Haddara
- Dr. Haddara is assistant professor, Division of Critical Care Medicine and Division of Endocrinology & Metabolism, Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Dr. Lingard is director, Centre for Education Research & Innovation, and professor, Department of Medicine, Schulich School of Medicine & Dentistry and Faculty of Education at Western University, London, Ontario, Canada
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Schadewaldt V, McInnes E, Hiller JE, Gardner A. Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care - an integrative review. BMC FAMILY PRACTICE 2013; 14:132. [PMID: 24007269 PMCID: PMC3846155 DOI: 10.1186/1471-2296-14-132] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 08/29/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND This integrative review synthesises research studies that have investigated the perceptions of nurse practitioners and medical practitioners working in primary health care. The aggregation of evidence on barriers and facilitators to working collaboratively and experiences about the processes of collaboration is of value to understand success factors and factors that impede collaborative working relationships. METHODS An integrative review, which used systematic review processes, was undertaken to summarise qualitative and quantitative studies published between 1990 and 2012. Databases searched were the Cochrane Library, the Joanna Briggs Institute Library, PubMed, Medline, CINAHL, Informit and ProQuest. Studies that met the inclusion criteria were assessed for quality. Study findings were extracted relating to a) barriers and facilitators to collaborative working and b) views and experiences about the process of collaboration. The findings were narratively synthesised, supported by tabulation. RESULTS 27 studies conducted in seven different countries met the inclusion criteria. Content analysis identified a number of barriers and facilitators of collaboration between nurse practitioners and medical practitioners. By means of data comparison five themes were developed in relation to perceptions and understanding of collaboration. Nurse practitioners and medical practitioners have differing views on the essentials of collaboration and on supervision and autonomous nurse practitioner practice. Medical practitioners who have a working experience with NPs express more positive attitudes towards collaboration. Both professional groups report concerns and negative experiences with collaborative practice but also value certain advantages of collaboration. CONCLUSIONS The review shows that working in collaboration is a slow progression. Exposure to working together helps to overcome professional hurdles, dispel concerns and provide clarity around roles and the meaning of collaboration of NPs and MPs. Guidelines on liability and better funding strategies are necessary to facilitate collaborative practice whether barriers lie in individual behaviours or in broader policies.
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Affiliation(s)
- Verena Schadewaldt
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Elizabeth McInnes
- Nursing Research Institute, Australian Catholic University and St Vincents and Mater Health, St Vincent’s Hospital, Sydney, Australia
| | - Janet E Hiller
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Anne Gardner
- Faculty of Health Sciences, Australian Catholic University, Canberra, Australia
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The role of the keyworker in breaking down professional culture barriers to providing high-quality palliative care: a literature review. JOURNAL OF RADIOTHERAPY IN PRACTICE 2013. [DOI: 10.1017/s1460396913000447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundPalliative cancer care is by definition multi-professional in nature. An interdisciplinary approach to disease management emphasising continuity of care results in increased quality of life for patients and families. Complex disease management demands the provision of a full spectrum of high-quality care; requiring both specialist and generalist services. Appointed keyworkers are knowledgeable about patient preferences enabling effective coordination of care and promotes collaborative team-working. The need for diversity in the provision of palliative care is recommended but can challenge effective interdisciplinary collaboration by creating tension and limiting the interdisciplinary team (IDT) from reaching its full potential resulting in adverse outcomes.PurposeThe purpose of this paper is to review the literature available regarding how IDTs and keyworkers influence high-quality palliative care; evaluate how professional culture barriers can influence team collaboration; discuss the keyworker role in minimising these barriers and clinical implications.MethodologyA review of the English literature from 2003 to 2013 was performed using the databases PubMed (NML), OVID Medline and Google Scholar.Results and conclusionKeyworkers can help overcome professional culture barriers that result from ineffective team communication. Facilitating improved communication regarding professional roles fosters mutual understanding among team members. The dissemination of relevant and timely information minimises fragmentation, prompting team decision-making and promotes continuity of high-quality palliative care.
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Johannessen AK, Steihaug S. The significance of professional roles in collaboration on patients' transitions from hospital to home via an intermediate unit. Scand J Caring Sci 2013; 28:364-72. [PMID: 23879767 DOI: 10.1111/scs.12066] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 07/02/2013] [Indexed: 10/26/2022]
Abstract
The increasing complexity of the healthcare system and of patients' conditions, as well as resource limitations, calls for collaboration between professionals and institutions. The objective of this study was to explore the significance of professional roles in collaboration on patients' transitions from hospital to home via an intermediate care unit. We studied collaboration in the intermediate unit and between healthcare providers in the unit, a hospital and four municipalities in the hospital catchment area. Data were drawn from interviews with thirty-eight healthcare providers within specialist and primary health care and from observations in six multidisciplinary meetings, six report meetings and four discharge meetings in the unit. Transcripts of interviews and observations were analysed using a method of systematic text condensation. The results show that collaboration inside the intermediate unit and between the healthcare institutions was primarily 'a nursing matter'. Collaboration among the nurses was generally good. Except for the physician, all the healthcare providers experienced the collaboration in the unit as unidisciplinary rather than interprofessional. Although they wanted to collaborate interprofessionally, they were unable to do so in practice. The unit's physiotherapists and occupational therapists found themselves to be excluded from the nurses' community of practice, while the physician experienced the collaboration as excellent. The findings indicate that healthcare providers have different understandings of interprofessional collaboration and that in certain situations, they consider interprofessional collaboration to be an inappropriate working method. Interprofessional collaboration can promote a learning environment among healthcare providers. To achieve better interprofessional collaboration, it is probably necessary to create mutual understandings of interprofessionality and to reach an agreement on the situations in which it is an appropriate way to work.
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126
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Ford CR, Foley KT, Ritchie CS, Sheppard K, Sawyer P, Swanson M, Harada CN, Brown CJ. Creation of an interprofessional clinical experience for healthcare professions trainees in a nursing home setting. MEDICAL TEACHER 2013; 35:544-548. [PMID: 23631410 DOI: 10.3109/0142159x.2013.787138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Successful interprofessional teams are essential when caring for older adults with multiple complex medical conditions that require ongoing management from a variety of disciplines across healthcare settings. To successfully integrate interprofessional education into the healthcare professions curriculum, the most effective learning experiences should utilize adult learning principles, reflect real-life practice, and allow for interaction among trainees representing a variety of health professions. Interprofessional clinical experiences are essential to prepare future healthcare professionals to provide quality patient care and understand the best methods for utilizing members of the healthcare team to provide that care. To meet this need, the University of Alabama at Birmingham Geriatric Education Center has developed an Interprofessional Clinical Experience (ICE) to expose future healthcare providers to an applied training experience with older adults in the nursing home setting. This paper outlines how this program was developed, methods used for program evaluation, and how the outcome data influenced program revisions.
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Affiliation(s)
- Channing R Ford
- University of Alabama at Birmingham, Birmingham, AL 35294-2041, USA.
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127
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Moore J, Nahigian E. Nursing Student Perceptions of Nurse-to-Nurse Collaboration in Dedicated Education Units and in Traditional Clinical Instruction Units. J Nurs Educ 2013; 52:346-50. [DOI: 10.3928/01484834-20130509-01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 01/02/2013] [Indexed: 11/20/2022]
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128
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Tang CJ, Chan SW, Zhou WT, Liaw SY. Collaboration between hospital physicians and nurses: an integrated literature review. Int Nurs Rev 2013; 60:291-302. [PMID: 23961790 DOI: 10.1111/inr.12034] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ineffective physician-nurse collaboration has been shown to cause work dissatisfaction among physicians and nurses and compromised the quality of patient care. AIM The review sought to explore: (1) attitudes of physicians and nurses toward physician-nurse collaboration; (2) factors affecting physician-nurse collaboration; and (3) strategies to improve physician-nurse collaboration. METHODS A literature search was conducted in the following databases: CINAHL, PubMed, Wiley Online Library and Scopus from year 2002 to 2012, to include papers that reported studies on physician-nurse collaboration in the hospital setting. FINDINGS Seventeen papers were included in this review. Three of the reviewed articles were qualitative studies and the other 14 were quantitative studies. Three key themes emerged from this review: (1) attitudes towards physician-nurse collaboration, where physicians viewed physician-nurse collaboration as less important than nurses but rated the quality of collaboration higher than nurses; (2) factors affecting physician-nurse collaboration, including communication, respect and trust, unequal power, understanding professional roles, and task prioritizing; and (3) improvement strategies for physician-nurse collaboration, involving inter-professional education and interdisciplinary ward rounds. CONCLUSION This review has highlighted important aspects of physician-nurse collaboration that could be addressed by future research studies. These include: developing a comprehensive instrument to assess collaboration in greater depth; conducting rigorous intervention studies to evaluate the effectiveness of improvement strategies for physician-nurse collaboration; and examining the role of senior physicians and nurses in facilitating collaboration among junior physicians and nurses. Other implications include inter-professional education to empower nurses in making clinical decisions and putting in place policies to resolve workplace issues.
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Affiliation(s)
- C J Tang
- Alice Lee Centre for Nursing Studies, National University of Singapore, National University Health System, Singapore, Singapore
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129
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Irwin RS, Flaherty HM, French CT, Cody S, Chandler MW, Connolly A, Lilly CM. Interdisciplinary collaboration: the slogan that must be achieved for models of delivering critical care to be successful. Chest 2013. [PMID: 23208334 DOI: 10.1378/chest.12-1844] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
There is wide acceptance of the concept that interdisciplinary collaboration is an essential building block for successful health-care teams. This belief is grounded in our understanding of how teams function to address complex care needs that change with acute illness or injury. This general agreement has been validated in studies that have reported favorable outcomes associated with successfully implementing interdisciplinary models of health-care delivery in non-critical care settings. The very short time frames over which the care needs of critically ill or injured adults change and the team approach taken by nearly all ICUs strongly suggest that interdisciplinary collaboration is also beneficial in this setting. In this commentary, we define interdisciplinary collaboration and share the story of how we successfully redesigned and transformed our system-wide, interdisciplinary collaborative model for delivering critical care in order to share the lessons we learned as the process evolved with those who are about to embark on a similar challenge. We anticipate that those health-care systems that successfully implement interdisciplinary collaboration will be ahead of the curve in providing high-quality care at as low a cost as possible. Such institutions will also potentially be better positioned for improving teaching and providing a better foundation for critical care research in their institutions.
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Affiliation(s)
- Richard S Irwin
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA.
| | - Helen M Flaherty
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
| | - Cynthia T French
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
| | - Shawn Cody
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
| | - M Willis Chandler
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
| | - Ann Connolly
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
| | - Craig M Lilly
- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
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- Critical Care Operations Team, UMass Memorial Medical Center, Worcester, MA
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130
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Fries KS, Bowers DM, Gross M, Frost L. Service learning in Guatemala: using qualitative content analysis to explore an interdisciplinary learning experience among students in health care professional programs. J Multidiscip Healthc 2013; 6:45-52. [PMID: 23430865 PMCID: PMC3573825 DOI: 10.2147/jmdh.s35867] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Interprofessional collaboration among health care professionals yields improved patient outcomes, yet many students in health care programs have limited exposure to interprofessional collaboration in the classroom and in clinical and service-learning experiences. This practice gap implies that students enter their professions without valuing interprofessional collaboration and the impact it has on promoting positive patient outcomes. Aim The aim of this study was to describe the interprofessional experiences of students in health care professional programs as they collaborated to provide health care to Guatemalan citizens over a 7-day period. Methods In light of the identified practice gap and a commitment by college administration to fund interprofessional initiatives, faculty educators from nursing, occupational therapy, and physical therapy conducted a qualitative study to explore a service-learning initiative focused on promoting interprofessional collaboration. Students collaborated in triads (one student from each of the three disciplines) to provide supervised health care to underserved Guatemalan men, women, children, and infants across a variety of community and health care settings. Eighteen students participated in a qualitative research project by describing their experience of interprofessional collaboration in a service-learning environment. Twice before arriving in Guatemala, and on three occasions during the trip, participants reflected on their experiences and provided narrative responses to open-ended questions. Qualitative content analysis methodology was used to describe their experiences of interprofessional collaboration. Results An interprofessional service-learning experience positively affected students’ learning, their growth in interprofessional collaboration, and their understanding and appreciation of health care professions besides their own. The experience also generated feelings of gratitude for the opportunity to be a member of an interprofessional team and to serve those in need by giving of themselves. Conclusion The findings support service learning as a platform to encourage interprofessional collaboration among students in health care professional programs. The research will inform future service-learning experiences in which interdisciplinary collaboration is an outcome of interest.
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131
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Myors KA, Schmied V, Johnson M, Cleary M. Collaboration and integrated services for perinatal mental health: an integrative review. Child Adolesc Ment Health 2013; 18:1-10. [PMID: 32847263 DOI: 10.1111/j.1475-3588.2011.00639.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND An integrative review was undertaken to synthesise the research related to professionals' perceptions and experiences of working in collaborative and integrated models of perinatal care for women with mental health problems. METHOD A search of the databases CINAHL, Medline, PubMed, Psychinfo and Scopus was conducted. Studies were limited to English language papers published from 2000 to 2010. Fourteen papers were included in the review. RESULTS The overarching theme identified in the review related to the process of 'making it happen'. Eight key elements were identified as central components of this process: funding and resources for collaboration; shared vision, aims and goals; pathways and guidelines; continuity of care; building relationships and trust; role clarity; training and education of staff and support to work in new ways. CONCLUSION Perinatal mental health is an emerging field that is particularly challenging as it requires professionals to work across disciplines and timeframes, where there is a risk of dichotomising care, compounding existing barriers to service uptake. Professionals need resources and to feel supported to change clinical practice and work in more collaborative ways. The voices of women and families are missing in the literature.
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Affiliation(s)
- Karen A Myors
- School of Nursing and Midwifery, The University of Western Sydney, Parramatta Campus, Locked Bag 1797, Penrith South DC, NSW 1797, Australia. E-mail:
| | - Virginia Schmied
- School of Nursing and Midwifery, The University of Western Sydney, Parramatta Campus, Locked Bag 1797, Penrith South DC, NSW 1797, Australia. E-mail:
| | - Maree Johnson
- School of Nursing and Midwifery, The University of Western Sydney, Parramatta Campus, Locked Bag 1797, Penrith South DC, NSW 1797, Australia. E-mail:
| | - Michelle Cleary
- School of Nursing and Midwifery, The University of Western Sydney, Parramatta Campus, Locked Bag 1797, Penrith South DC, NSW 1797, Australia. E-mail:
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132
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Chung VCH, Ma PHX, Hong LC, Griffiths SM. Organizational determinants of interprofessional collaboration in integrative health care: systematic review of qualitative studies. PLoS One 2012; 7:e50022. [PMID: 23209634 PMCID: PMC3510174 DOI: 10.1371/journal.pone.0050022] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 10/19/2012] [Indexed: 12/04/2022] Open
Abstract
Context Inteprofessional collaboration (IPC) between biomedically trained doctors (BMD) and traditional, complementary and alternative medicine practitioners (TCAMP) is an essential element in the development of successful integrative healthcare (IHC) services. This systematic review aims to identify organizational strategies that would facilitate this process. Methods We searched 4 international databases for qualitative studies on the theme of BMD-TCAMP IPC, supplemented with a purposive search of 31 health services and TCAM journals. Methodological quality of included studies was assessed using published checklist. Results of each included study were synthesized using a framework approach, with reference to the Structuration Model of Collaboration. Findings Thirty-seven studies of acceptable quality were included. The main driver for developing integrative healthcare was the demand for holistic care from patients. Integration can best be led by those trained in both paradigms. Bridge-building activities, positive promotion of partnership and co-location of practices are also beneficial for creating bonding between team members. In order to empower the participation of TCAMP, the perceived power differentials need to be reduced. Also, resources should be committed to supporting team building, collaborative initiatives and greater patient access. Leadership and funding from central authorities are needed to promote the use of condition-specific referral protocols and shared electronic health records. More mature IHC programs usually formalize their evaluation process around outcomes that are recognized both by BMD and TCAMP. Conclusions The major themes emerging from our review suggest that successful collaborative relationships between BMD and TCAMP are similar to those between other health professionals, and interventions which improve the effectiveness of joint working in other healthcare teams with may well be transferable to promote better partnership between the paradigms. However, striking a balance between the different practices and preserving the epistemological stance of TCAM will remain the greatest challenge in successful integration.
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Affiliation(s)
- Vincent C H Chung
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China.
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133
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Clancy A, Gressnes T, Svensson T. Public health nursing and interprofessional collaboration in Norwegian municipalities: a questionnaire study. Scand J Caring Sci 2012; 27:659-68. [DOI: 10.1111/j.1471-6712.2012.01079.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 07/17/2012] [Indexed: 11/25/2022]
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134
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Abstract
The focus of this column is the idea of collaborative research as part of sweeping changes that the Institute of Medicine has recommended for the future of nursing. An overview of the recommendations will be presented followed by a cursory review of the concept of collaboration, and a discussion of a theoretical model. Barriers to interdisciplinary collaboration will also be entertained. Finally, loosely coupled systems will be proposed as a way to protect the profession of nursing.
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135
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Thompson MC. Professional autonomy of occupational health nurses in the United States. Workplace Health Saf 2012; 60:159-65. [PMID: 22496469 DOI: 10.1177/216507991206000404] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Accepted: 02/22/2012] [Indexed: 11/17/2022]
Abstract
Autonomy, the freedom to practice independently and to exercise professional judgment in practice activities, is a central element for professional practice. Numerous articles and studies have reported on professional autonomy in general nursing practice; however, professional autonomy for occupational health nurses has not been explored in depth. This article advances the development of a body of knowledge relative to professional autonomy in the practice of occupational health nursing. This article also provides an overview of professional autonomy in nursing practice; discusses the nature and importance of professional autonomy in the occupational health practice setting; reports findings from a seminal study of occupational health nurse autonomy; and addresses professional autonomy in the context of collaborative practice.
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136
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Bender M, Connelly CD, Brown C. Interdisciplinary collaboration: the role of the clinical nurse leader. J Nurs Manag 2012; 21:165-74. [PMID: 23339506 DOI: 10.1111/j.1365-2834.2012.01385.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To explore the feasibility and acceptability of a clinical nurse leader (CNL) role to improve interdisciplinary collaboration (IC) within a fragmented acute-care microsystem. BACKGROUND Fragmented patient care is associated with preventable adverse healthcare outcomes. IC decreases fragmentation and improves patient care quality. The CNL role is theorized to provide the necessary leadership and competency skill base to impact IC at the optimal organizational level, the point of care where most healthcare decisions are made. METHODS This study used a descriptive non-experimental design. CNL daily workflow was developed to target empirical determinants of IC. Descriptive data were collected from multiple stakeholders using an investigator-developed survey. RESULTS Findings indicate the integration of the role is feasible and acceptable to the microsystem healthcare team. CONCLUSIONS Preliminary evidence suggests the CNL role may be an effective intervention to facilitate IC. More research is needed to support the CNL role's association with microsystem IC. IMPLICATIONS FOR NURSING MANAGEMENT The CNL role presents an innovative opportunity for clinical and administrative leadership to partner together to redesign a healthcare delivery system and improve patient care quality.
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Affiliation(s)
- Miriam Bender
- Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA 92110, USA.
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137
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Abstract
Autonomy, the freedom to practice independently and to exercise professional judgment in practice activities, is a central element for professional practice. Numerous articles and studies have reported on professional autonomy in general nursing practice; however, professional autonomy for occupational health nurses has not been explored in depth. This article advances the development of a body of knowledge relative to professional autonomy in the practice of occupational health nursing. This article also provides an overview of professional autonomy in nursing practice; discusses the nature and importance of professional autonomy in the occupational health practice setting; reports findings from a seminal study of occupational health nurse autonomy; and addresses professional autonomy in the context of collaborative practice.
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138
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Perreault K, Careau E. Interprofessional collaboration: One or multiple realities? J Interprof Care 2012; 26:256-8. [DOI: 10.3109/13561820.2011.652785] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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139
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Hiner J, Pyka J, Burks C, Pisegna L, Gador RA. Preventing infant abductions: an infant security program transitioned into an interdisciplinary model. J Perinat Neonatal Nurs 2012; 26:47-56. [PMID: 22293642 DOI: 10.1097/jpn.0b013e31824003a2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ensuring the safety of infants born in a hospital is a top priority and, therefore, requires a solid infant security plan. Using an interdisciplinary approach and a systematic change process, nursing leadership in collaboration with clinical nurses and security personnel analyzed the infant security program at this community hospital to identify vulnerabilities. By establishing an interdisciplinary approach to infant security, participants were able to unravel a complicated concept, systematically analyze the gaps, and agree to a plan of action. This resulted in improved communication and clarification of roles between the nursing and security divisions. Supply costs decreased by 17.4% after the first year of implementation. Most importantly, this project enhanced and strengthened the existing infant abduction prevention measures, hard wired the importance of infant security, and minimized vulnerabilities.
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Affiliation(s)
- Jacqueline Hiner
- Labor and Delivery, Sharp Grossmont Hospital, La Mesa, California
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140
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Dugan Day M. Interdisciplinary hospice team processes and multidimensional pain: a qualitative study. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2012; 8:53-76. [PMID: 22424384 DOI: 10.1080/15524256.2011.650673] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Hospice teams may address multidimensional pain through the synergistic interaction of team members from various professional disciplines during regularly scheduled team meetings. However, the occurrence of that critical exchange has not been adequately described or documented. The purpose of this qualitative study was to explore two processes in team pain palliation: communication and collaboration. Data were gathered through individual interviews and a 1-year observation of team members from two hospices (physicians, nurses, aides, chaplains, social workers). Utilizing constant comparison, 14 final thematic categories were discovered. Use of biopsychosocial/spiritual terms by all team members meant that the team had the common language needed to communicate about multidimensional pain. Interviews and observation revealed a gap in translating multidisciplinary communication in team meetings into collaborative acts for pain treatment. In addition, structural influences inhibited creativity in pain palliation. There was no mutual understanding of the purpose for team meetings, no recognition of the need to reflect on team process, or common definition of leadership. Social work roles in hospice should include leadership that moves teams toward interdisciplinary care for multidimensional pain.
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Affiliation(s)
- Michele Dugan Day
- School of Social Work, Missouri State University, Springfield, Missouri 65897, USA.
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141
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Careau E, Vincent C, Swaine BR. Consensus group session of experts to describe interprofessional collaboration processes in team meetings. J Interprof Care 2011; 25:299-301. [PMID: 21554062 DOI: 10.3109/13561820.2011.566649] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Emmanuelle Careau
- Faculty of Medicine, Department of Rehabilitation, Universite Laval, Quebec, Canada.
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