A culture of caring: the essence of healthcare interprofessional collaboration

Conceptualising the experiences of continuing professional development of young private sector audiologists as an attribute of andragogy

Background

Continuing professional development (CPD) is an ongoing learning process that builds on initial training and education to improve competency. Low compliance rates of audiologists adhering to CPD have been reported by the Health Professions Council of South Africa. However, there is an absence of research on the uptake of CPD from the perspective of young audiologists working in the private sector.

Aim

This study aimed to explore the experiences and views of young audiologists working in the private sector on continuing professional development.

Setting

The study was conducted in KwaZulu-Natal province, South Africa.

Methods

The descriptive, qualitative approach entailed conducting 11 online, semi-structured interviews with audiologists working in the private sector. Semi-structured interviews consisted of open-ended questions, and the qualitative data were thematically analysed. The adult learning theory, andragogy, was used as both the conceptual and analytical framework.

Results

Five andragogy concepts were used to analyse the data, with eight sub-themes emerging related to: self-concept, adult learning experiences, readiness to learn, orientation to learning and internal motivation.

Conclusion

The experiences of audiologists in the private sector on CPD aligned with the concepts of andragogy. Audiologists' experiences need to be taken into consideration during the planning and implementation of CPD for it to be relevant, effective and purposeful.

Contribution

This study highlighted the experiences of audiologists on CPD working in the private sector with continuing professional development.

Adjustments in Interprofessional Communication: A Focus Group Study in Psychiatric Outpatient Units

Communication in healthcare extends beyond patient care, impacting the work environment and job satisfaction. Interprofessional communication is essential for fostering collaboration, but challenges arise from differences in training, roles, and hierarchies. The study aimed to explore psychiatric outpatient clinicians' experiences of interprofessional communication and their perceptions of how the communication intersects the organizational and social work environment of healthcare. Qualitative research involved focus group interviews with clinicians from five psychiatric outpatient units in Central Sweden, representing diverse professions. The authors analyzed semi-structured interview data thematically to uncover clinicians' perspectives on interprofessional communication. An overarching theme, "Adjustment of communication," with subthemes "Synchronized communication" and "Dislocated communication," emerged. Clinicians adapted communication strategies based on situations and needs, with synchronized communication promoting collaboration and dislocated communication hindering it. Communicating with each other was highly valued, as it contributed to a positive work environment. The study underscores the importance of an open, supportive environment that fosters trust, and respect among healthcare clinicians. Consistent with prior research, collaboration gaps underscore the urgent need to improve interprofessional communication.

Exploring the Role of Sickness Absence Coordinators in Implementing Interventions to Reduce Sickness Absence in Public Sector Workplaces in Denmark

PURPOSE

In 2019, an initiative to reduce sickness absence in public sector workplaces in Denmark was introduced. The initiative involved appointing a sickness absence coordinator (SA coordinator) to oversee the implementation of workplace-based sickness absence interventions. Since the role of the SA coordinator is a novel concept introduced as part of the initiative, this study investigates the responsibilities of SA coordinators and the challenges they experienced in fulfilling this role during the implementation process.

METHODS

Semi-structured interviews with and observations of SA coordinators from four public sector workplaces were carried out. We collected the first four interviews and observations during the implementation process with follow-up interviews collected at the end of the process. The data were analyzed using thematic analysis.

RESULTS

The SA coordinators all experienced challenges in terms of lack of commitment among the line managers to participate in the intervention. They experienced being seen as a burden rather than a helping hand, and felt that the line managers might have difficulty recognizing the value of the SA coordinators. Potential ways to improve the collaboration between the SA coordinators and the line managers include considering hiring the SA coordinator in-house and incorporation of intervention components into existing activities to accommodate the busyness of the line managers.

CONCLUSIONS

To support the SA coordinators in carrying out their role and responsibilities, this study suggests that it is important to ensure commitment to the role, especially among the line managers in order to enhance good working relationships.

The effectiveness of a training program on perceptions of caring culture among Turkish nurses: A quasi-experimental trial

AIM

To assess the effectiveness of a training program on perceptions of caring culture among Turkish nurses and investigate the relationships among caring culture, job satisfaction, and intention to leave.

BACKGROUND

Every organisation has its on culture with its vairous components including values, symbols, practices and policies. Healthcare organizations need a favorable caring culture to support nurses and other professional working in the organisation.

METHODS

This was a quasi-experimental trial of an educational intervention conducted between October and December 2020 at a university hospital in Turkey. The sample of the study consisted of 86 nurses. A four-week training program based on caring culture was provided for the training group. The data were collected using a Personal Information Form, the Turkish version of the Caring Culture Survey, and the Job Satisfaction Scale. Intention to leave was measured with a single question.

FINDINGS

The mean total caring culture and personal caring scores of the training group were significantly higher after the training than before (p < 0.05). There were significant positive correlations between the mean caring culture total and subscale scores of the participants and their total job satisfaction scores. Besides, there were significant negative correlations between the caring culture total and subscale scores of the participants and their intentions to leave, but these relationships were weak or moderate (p < 0.05).

CONCLUSION

This training program based on caring culture can contribute to improving the caring culture perceptions of nurses. Caring culture is positively related to job satisfaction and negatively related to intentions to leave.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Healthcare organizations should prioritize creating a caring culture and designing initiatives that focus on caring culture. The perceptions of nurses about caring culture should be measured and identified regularly.

Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education

Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional's profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders' perspectives (without "blind spots" from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers' contributions.

Insights from defining nurses' career success: An integrative review

AIMS

To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success.

DESIGN

An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review.

METHODS

The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords "nurs*" and "career success" in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross-sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups.

RESULTS

Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person-organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment.

NO PATIENT OR PUBLIC CONTRIBUTION

Patients or members of the public were not involved in this review.

Interprofessional education in problem-based learning: A frontier form of PBL in medical education

BACKGROUND

Interprofessional education (IPE) aims to educate healthcare students to improve collaboration and the quality of care. The delivery of IPE through a problem-based learning (PBL) setting appears to hold good validity. However, there are few studies that show the value of combining these two teaching modes.

MATERIALS AND METHODS

The research was a longitudinal intervention study. A total of 360 students were randomly divided into three interprofessional PBL (IPBL) groups that mixed nursing, pharmacy, and clinical medical students and three uniprofessional PBL (UPBL) groups that consisted of a single profession. An improved Attitude and Learning Ability Questionnaire (ALAQ) was used to measure the improvement in attitudes toward interprofessional cooperation and learning outcomes. The tutorial session and final examination grades were compared between IPBL and UPBL by Chi-square tests and Cochran-Mantel-Haenszel tests. Cronbach's α analysis was calculated to assess the validity and reliability. Cronbach's alpha coefficient of the questionnaire was 0.887, demonstrating high levels of reliability (95% confidence interval [CI]: 0.842 0.916).

RESULTS

According to Chi-square tests and Cochran-Mantel-Haenszel tests, we observed the student's positive attitudes toward interprofessional collaboration and the student's role awareness in the IPBL students was increased compared with UPBL students. In addition, a great majority of IPBL students felt that they had improved their self-learning ability and maintained a high enthusiasm for learning during the course.

CONCLUSION

Our study found that the IPBL teaching model was more effective than the UPBL teaching model in healthcare student's positive attitudes toward interprofessional collaboration and learning outcomes.

Person-centered care for people with aphasia: tools for shared decision-making

Shared decision-making is a fundamental aspect of person-centered care, and can and should be part of many different aspects of the rehabilitation process. Communication disabilities like aphasia, which affects people's ability to use and understand spoken and written language, can make shared decision-making especially challenging to the resources and skills of rehabilitation practitioners. The purpose of this narrative review is to provide a comprehensive description of tools that can support successful shared decision-making with people with aphasia in the rehabilitation environment. These tools and strategies are appropriate for use by physicians, nurses, social workers, physical therapists (also referred to as physiotherapists), occupational therapists, and other service or care providers. The important role of speech-language pathologists as consultants is also described. Case scenarios throughout the paper illustrate the application of recommended tools and strategies along with best practices.

Adult patient and carer experiences of planning for hospital discharge after a major trauma event: a qualitative systematic review

PURPOSE

To identify, evaluate and synthesize qualitative literature on adult patients and carer experiences of planning for discharge from an acute setting after a major trauma event.

METHODS

The JBI approach to meta-aggregation was followed. Qualitative studies exploring patient and carer discharge planning experiences of major trauma were included in the systematic review. A comprehensive search was conducted in five databases, supplemented by grey literature. Eligible studies were appraised for methodological quality by two reviewers and data extracted using standardized JBI tools.

RESULTS

Four synthesized findings emerged using 69 findings from sixteen papers. (i) Patients and carers feel generally unprepared to manage at home after discharge, (ii) early identification of patients' post discharge needs allows for appropriate referrals and supports to be organised prior to discharge, (iii) patients and carers value participation in the discharge planning process to facilitate a considered, organized and timely discharge from hospital (iv) the timely presentation, delivery, language used, format and relevancy of information impacts how patients and carers manage their discharge.

CONCLUSION

This meta-synthesis demonstrates that patients and carers predominantly have poor experiences of discharge planning after major trauma. Adoption of patient centered principles may improve patient and carer experiences of the discharge planning process.

IMPLICATIONS FOR REHABILITATIONPatients and their carers benefit from a client-centred approach where their needs are recognised and their collaboration encouraged in important decisions, and if they are adequately prepared to reintegrate into their community.Patients can benefit from having a trauma pathway healthcare professional to provide support and advocacy services throughout their hospital admission and after discharge.Discharge planning that is organised, prepared and collaborative leads to a more positive patient experience.Discharge information should be individualised and presented in an easily accessible format for patients and carers.

Academic emotions and attitudes regarding interprofessional collaboration in health care activities: a prospective study among newly arrived physicians participating in a fourteen-week course

BACKGROUND

One way of facilitating entrance into the Swedish health care system, for newly arrived physicians from outside the European Union/European Economic Area, could be to set up and offer a course aimed to enhance understanding of it. This course was offered to increase insight about clinical practices, interprofessional teamwork and topics such as, Swedish health care laws, culture, and ethics. Acceptance of, and a flexible attitude towards, interprofessional teamwork are important for maintaining both the physician's professional identity and a high quality of patient care. The aim of this study was to investigate newly arrived physicians', academic emotions, experience of stress and flow during a fourteen-week course, as well as attitudes to interprofessional collaboration, both before and after.

METHOD

A prospective study was conducted, with participants asked to respond on one questionnaire every course day, by using the Contextual Activity Sampling System methodology. The participants were asked to complete a questionnaire comprising ten questions about ongoing activity and in what way they experience, e.g., collaboration, interprofessional teamwork, academic emotions, flow, and stress. Furthermore, the participants were asked to score their attitude towards interprofessional teamwork by using the interdisciplinary education perception scale both before and after the course.

RESULTS

The total sample comprised 27 qualified physicians, from outside the European Union/European Economic Area. In the interdisciplinary education perception scale category, "perception of actual cooperation¨, the participants had significantly higher scores after the course. Flow and academic emotions were felt mostly during own periods of study, seminars, and lectures. The academic emotions were apathy, anxiety, and boredom. The most frequently experienced academic emotion was apathy. Course participants rated stress highest in connection with the examination.

CONCLUSION

The results show that the course had a positive impact on the participants perception of actual cooperation. It appears that participating in this kind of course was a positive experience for the participants, since they mostly experienced high levels of flow. Collaborating with others was experienced as positive, with participants reporting a high degree of flow in activities during collaboration.

Locum doctors in English general practices: evidence from a national survey

BACKGROUND

Locum doctors give practices flexibility to deliver patient services but there are concerns about the impact of locum working on continuity of care, patient safety, team function, and cost.

AIM

To explore locum working in English general practices, and understand why and where locum doctors were needed and how they were engaged, supported, perceived, and managed.

DESIGN AND SETTING

An online survey was sent to 3745 practices.

METHOD

Quantitative responses were analysed using frequency tables, t-tests, and correlations. Free-text responses were analysed using thematic analysis.

RESULTS

In total, 605 (16.2%) responses were returned between June and December 2021. Practices made frequent use of locums, preferring regular locums familiar with processes and patients. Disadvantages of agency locums included cost, lack of patient familiarity, and impact on continuity of care. Care provided by locums was generally viewed as the same but sometimes worse compared with permanent GPs. Some practices reported that locums did not always perform the full range of duties, resulting in increased workload for other staff. Practices were largely unfamiliar with national guidance for organisations engaging locums, and, although processes such as verifying documentation were conducted, far fewer responders reported providing feedback, support for revalidation, or professional development.

CONCLUSION

Locum working is an essential part of English general practice, but this research raises some concerns about the robustness of arrangements for locum working and the impact on quality and safety of care. Further research is needed about the clinical practice and performance of locums, and to explore how locum working can be organised in ways that assure safe and high-quality care.

The Utility of Language Models in Cardiology: A Narrative Review of the Benefits and Concerns of ChatGPT-4

Artificial intelligence (AI) and language models such as ChatGPT-4 (Generative Pretrained Transformer) have made tremendous advances recently and are rapidly transforming the landscape of medicine. Cardiology is among many of the specialties that utilize AI with the intention of improving patient care. Generative AI, with the use of its advanced machine learning algorithms, has the potential to diagnose heart disease and recommend management options suitable for the patient. This may lead to improved patient outcomes not only by recommending the best treatment plan but also by increasing physician efficiency. Language models could assist physicians with administrative tasks, allowing them to spend more time on patient care. However, there are several concerns with the use of AI and language models in the field of medicine. These technologies may not be the most up-to-date with the latest research and could provide outdated information, which may lead to an adverse event. Secondly, AI tools can be expensive, leading to increased healthcare costs and reduced accessibility to the general population. There is also concern about the loss of the human touch and empathy as AI becomes more mainstream. Healthcare professionals would need to be adequately trained to utilize these tools. While AI and language models have many beneficial traits, all healthcare providers need to be involved and aware of generative AI so as to assure its optimal use and mitigate any potential risks and challenges associated with its implementation. In this review, we discuss the various uses of language models in the field of cardiology.

The Right to Refuse: Understanding Healthcare Providers' Perspectives on Patient Autonomy in Emergency Care

Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into the attitudes of these providers toward treatment refusal, unearthing the strategies they employ in navigating such challenging situations while actively working in prehospital emergency health services. Our findings showed that, as the participants' age and experience increased, so did their inclination to respect patient autonomy and avoid persuading them to change their decision about treatment. It was noted that doctors, paramedics, and emergency medical technicians demonstrated a deeper understanding of patients' rights than other medical specialists. However, even with this understanding, the prioritization of patients' rights tended to diminish in life-threatening situations, giving rise to ethical dilemmas. This underlines the complexity of balancing the healthcare professionals' responsibilities and the patients' autonomy, which can generate ethically challenging scenarios for those working in emergency healthcare. By investigating these attitudes and experiences, this study seeks to foster a more profound understanding of the ethical quandaries faced by emergency healthcare providers. Our ultimate aim is to contribute to the development of effective strategies that support both patients and professionals in managing these tough circumstances.

"It Is Not About Us and Them": Nursing Students' Perception of Interdisciplinary Collaboration in Mental Health Clinical Studies

Through interdisciplinary collaboration, a synthesis can be made together across subject boundaries that basically separate the subjects. This means that in addition to their own expertise, the professions can create a new understanding, new attitudes and new knowledge. In other words, a shared additional knowledge. The purpose of this study was to explore and describe nursing students' experiences of interdisciplinary collaboration in clinical studies in mental health services. A qualitative, explorative study was performed based on three focus group interviews. A qualitative content analysis was conducted. The analysis resulted in the categories: 'Community'-The students experienced the interaction and the communication in different ways. 'Learning'-The students could gain both knowledge and understanding. In conclusion when the interdisciplinary collaboration was optimal, the students experienced it as enriching both in terms of interaction, communication, learning and understanding. Interdisciplinary collaboration can give students knowledge of cultural forms of expression so that they can better meet patients' needs. The students also gain an increased understanding related to care. Students can get good learning opportunities when different professions are taught together.

Interprofessional primary palliative care: Do the AACN Essentials prepare nurses for collaborative practice?

BACKGROUND

Palliative care specialists alone cannot meet the rising needs for palliative care. Primary palliative care, delivered interprofessionally by generalist health professionals, is essential to ensure equitable access. Educational competencies and clinical practice guidelines prepare these clinicians to integrate palliative care principles into practice.

PURPOSE

The purpose of this project was to evaluate how the AACN Essentials prepares entry-level professional nursing students to function as members of the interdisciplinary primary palliative care team, as described in the National Consensus Project (NCP) for Quality Palliative Care Clinical Practice Guidelines.

METHOD

A team of nurse educators utilized a crosswalk mapping process with the Essentials domains, the Competencies and Recommendations for Educating Undergraduate Nursing Students (CARES) statements, and the NCP Guidelines.

RESULTS

All eight of the NCP domains align with the Essentials. There were clear areas of overlap between the documents and unique areas of emphasis.

CONCLUSION

This project identifies how educational competencies and clinical guidelines can guide competent palliative care practice. It also describes how nurses are prepared to collaborate in the delivery of palliative care.

Longitudinal faculty development to improve interprofessional collaboration and practice: a multisite qualitative study at five US academic health centres

OBJECTIVES

Interprofessional (IP) collaboration and effective teamwork remain variable in healthcare organisations. IP bias, assumptions and conflicts limit the capacity of healthcare teams to leverage the expertise of their members to meet growing complexities of patient needs and optimise healthcare outcomes. We aimed to understand how a longitudinal faculty development programme, designed to optimise IP learning, influenced its participants in their IP roles.

DESIGN

In this qualitative study, using a constructivist grounded theory approach, we analysed participants' anonymous narrative responses to open-ended questions about specific knowledge, insights and skills acquired during our IP longitudinal faculty development programme and applications of this learning to teaching and practice.

SETTING

Five university-based academic health centres across the USA.

PARTICIPANTS

IP faculty/clinician leaders from at least three different professions completed small group-based faculty development programmes over 9 months (18 sessions). Site leaders selected participants from applicants forecast as future leaders of IP collaboration and education.

INTERVENTIONS

Completion of a longitudinal IP faculty development programme designed to enhance leadership, teamwork, self-knowledge and communication.

RESULTS

A total of 26 programme participants provided 52 narratives for analysis. Relationships and relational learning were the overarching themes. From the underlying themes, we developed a summary of relational competencies identified at each of three learning levels: (1) Intrapersonal (within oneself): reflective capacity/self-awareness, becoming aware of biases, empathy for self and mindfulness. (2) Interpersonal (interacting with others): listening, understanding others' perspectives, appreciation and respect for colleagues and empathy for others. (3) Systems level (interacting within organisation): resilience, conflict engagement, team dynamics and utilisation of colleagues as resources.

CONCLUSIONS

Our faculty development programme for IP faculty leaders at five US academic health centres achieved relational learning with attitudinal changes that can enhance collaboration with others. We observed meaningful changes in participants with decreased biases, increased self-reflection, empathy and understanding of others' perspectives and enhanced IP teamwork.

Implementation of interprofessional learning in hospital practice

AIM

Some universities of applied science struggle with implementing interprofessional learning due to a lack of diversity in professions. The aim of this study was to investigate whether an interprofessional learning model with an informational letter describing interprofessional learning opportunities can provide nursing students in rural areas with sufficient interprofessional learning during internships.

DESIGN

This qualitative study utilized a hermeneutical approach.

METHODS

A total of 17 individuals participated in focus groups, group interviews and written responses. The data collection: January 2019.

RESULTS

Four categories were observed: (a) assumptions about interprofessional learning, (b) available interprofessional learning opportunities, (c) hindrances to interprofessional learning and (d) stimulation of interprofessional learning. The conclusion was that interprofessional learning can be implemented to some extent in areas where different professions work, even when only one student is present. A focus on interprofessional collaboration, patient safety and patient flow are valuable interprofessional learning objectives. An informational letter with suggestions for interprofessional learning, such as shadowing, was considered valuable by the participants.

Effective handovers on escalation of care for the deteriorating patient

Evidence suggests that improvements in clinical practice are required to ensure that deteriorating patients are rapidly identified and assessed in a systematic manner. The important step of escalating care involves a detailed handover to the most appropriate colleague so that interventions can be put in place to reverse or optimise the patient's condition. However, multiple issues can hinder this handover process, including a lack of confidence among nurses and suboptimal team dynamics or cultures. Using structured communication tools such as situation, background, assessment, recommendation (SBAR) can assist nurses in delivering a handover that results in the desired outcome. This article explains the steps involved in identifying, assessing and escalating the care of deteriorating patients, and describes the components of an effective handover.

Medication safety education in nursing research: Text network analysis and topic modeling

OBJECTIVES

This study aimed to identify the knowledge structure of medication safety nursing education literature by developing schematic diagrams of the relationship between keywords from a macro perspective. This study also identifies the research topics and trends over time.

DESIGN

This quantitative content study used text network analysis to explore keywords and research topics using topic modeling within the medication safety nursing education literature.

DATA SOURCES

PubMed, EMBASE, and Cochrane databases were used to search for the medication safety nursing education literature published until December 2021.

METHODS

Keywords from 2085 articles were examined using text network analysis and topic modeling with NetMiner 4.4.3.

RESULTS

The keywords with the most frequency and the highest networking degree in centrality were "patient," "medication," "program," "nurse," and "care." The emerging keywords assessed by time periods were identified; the first phase ("heart failure," "insulin," "chemotherapy," and "infusion"), the second phase ("medication errors," "staff," and "information"), the third phase ("program," "management," and "data"). The results of topic modeling were as follows: safe medication administration, safe medication reconciliation process, medication education for patients, medication errors in nursing practice, and multidisciplinary teamwork for medication safety.

CONCLUSION

These findings will help nursing researchers and educators to understand the trends and insights for medication safety education and educate future nurses to provide safer nursing care.

The integration of accompanying patients into clinical teams in oncology: Perceptions of accompanying patients and nurses

OBJECTIVES

In Canada, two out of five people will be diagnosed with cancer which will affect their lives on a physical, psychological, and social levels. To help people affected by cancer (PAC) cope with the disease, support is provided by oncology nurses (ONs), including oncology pivot nurses (OPNs), as well as by accompanying patients (APs), i.e. people who have already had to deal with a cancer problem. APs are still a recent addition to the services offered in oncology, and as of yet no study has explored how the support provided by APs is being integrated into usual care, especially ONs care. This study explores the perceptions of APs and ONs on APs' integration into clinical teams.

METHOD

An exploratory qualitative study was carried out with six ONs and six APs through semi-structured interviews conducted from 2020 to 2021. Data were analyzed using a qualitative content analysis.

RESULTS

Participants perceived the AP's integration into the teams and during care as variable and in flux. They also identified factors that influence APs' integration into clinical teams (e.g.:the clinical teams' dynamics, the understanding of the AP's role, APs and patients' characteristics). Lastly, participants made recommendations to improve APs integration into clinical teams.

CONCLUSION

This study highlights how integrating APs into clinical teams has not yet become part of ONs' routines. ONs can play a key role in their integration through their collaborative and teamwork skills. Furthermore, there is a recognition that these two approaches can play complementary roles in supporting PACs.

The effect of COVID-19 patient care and emergency response interprofessional training on COVID-19 knowledge, perception, behavior and readiness for care

BACKGROUND

During the COVID-19 pandemic, the need for Interprofessional Education (IPE) and collaborative practices have gained even more importance.

OBJECTIVE

The aim of this study is to evaluate the impact of IPE on COVID-19 on students' knowledge, perceptions, behaviors and readiness for care regarding COVID-19.

METHOD

The study followed a single-group pre-/post-test semi-experimental research design. The sample consisted of 435 students studying Elderly Care/Home Patient Care/First and Emergency Aid programs. The students' perception of interdisciplinary education was evaluated at the beginning of the study.

RESULTS

The students were given an online COVID-19 Patient Care and Emergency Response IPE that lasted five hours and was split into two parts. The perception of interdisciplinary education was significantly higher among female students and first and emergency students before receiving IPE. Before and after IPE, the knowledge level scores of the students who did not receive IPE were found to be higher than those who did. After the training, the students' knowledge levels, readiness for care and their perceptions of control towards the COVID-19 pandemic increased statistically significantly (p < 0.001).

CONCLUSION

The students' knowledge levels and perceptions of control surrounding the pandemic may grow as a result of the IPE given about COVID-19 during the pandemic, when IPE became more important, and students may feel more prepared to care.

Mental Healthcare Providers Understanding and Experiences of Palliative Care: A Qualitative Analysis

Objective: To understand the experiences and perceptions of mental health providers about palliative care. Background: Little attention is paid to the experience of people with chronic persistent mental illness (CPMI) and life-threatening diseases and how their dying experience might differ from those without a CPMI. Methods: Interpretive description informed the project. Sixteen mental health care providers were interviewed using a semi-structured interview template. The interviews were recorded, transcribed, and analyzed using a reflexive, inductive-deductive thematic approach, guided by Braun & Clarke's framework for thematic analysis. Results: Four themes were identified from the data: intersectionality, limited collaboration, misconceptions about palliative care, and relationships. Mental health providers identified gaps in their knowledge of palliative care practices along with their knowledge of death and dying.

Prática colaborativa na Estratégia Saúde da Família

Objetivo: compreender a configuração da Prática Colaborativa no contexto da Estratégia Saúde da Família. Método: trata-se de um estudo de caso único, de natureza qualitativa, realizado com trinta e cinco profissionais das equipes de saúde da família. A coleta de dados ocorreu por meio de entrevistas, guiadas por roteiro semiestruturado e observação não participante. Os dados foram analisados por meio de Análise de Conteúdo Temática. Resultados: os resultados evidenciaram potencialidades da prática colaborativa para a qualificação das práticas profissionais e dos resultados de saúde, no contexto da ESF. Entretanto observou-se insuficiência de dispositivos organizacionais para apoiar o trabalho compartilhado na ESF, desafio a ser superado, inclusive no que tange às políticas públicas, revelando o chamamento para a educação interprofissional no contexto dos serviços de saúde para estimular a colaboração. Conclusão: a configuração da Prática Colaborativa interprofissional no contexto da Estratégica Saúde da Família é desafiadora e requer processos interacionais e da organização do trabalho.

Collaboration in interprofessional teams: A needs assessment of factors that impact new resident physicians

Many resident physicians struggle with effective interprofessional collaboration (IPC), but characterization of their challenges is not well known. This study examines gaps in IPC skills for graduating medical students entering residency. A needs assessment was completed to evaluate factors that impact resident physicians' ability to effectively collaborate with other healthcare professionals. This study included online surveys of 123 recent medical school graduates, 21 semi-structured interviews of residency program directors, and 3 focus groups of healthcare professionals who interacted with residents. Survey results were analyzed for means and narratives from surveys, interviews, and focus groups were analyzed for themes. We found that graduates felt they did not have a strong understanding of other providers' roles and did not feel well prepared to handle conflict with other providers or navigate interprofessional team dynamics. Themes emerging from narrative data generally aligned with the Interprofessional Education Collaborative core competencies including understanding team roles, communicating effectively, and working effectively in a team, but these interviews also elucidated an additional theme, overcoming system barriers. Data from this work can inform curricula in preparation for the transition to residency. The authors also offer an educational framework for learning effective IPC as a new team member.

İşe Yeni Başlayan Genç Hemşirelerin Kıdemli Meslektaşları ile İlişkileri: Fenomenolojik Bir Çalışma

Giriş: İşe yeni başlayan genç hemşirelerin uyum süreçleri, arkadaşça olmayan davranışlara maruz aldıkları çalışma ortamlarından olumsuz etkilenmektedir. Bu nedenle, işe yeni başlayan genç hemşirelerin deneyimledikleri meslektaş ilişkilerinin bilinmesi uyum süreçlerinin iyileştirilmesi açısından önemlidir. Amaç: İşe yeni başlayan genç hemşirelerin, çalışma yaşamlarının ilk altı ayında kıdemli meslektaş ilişkileri ile ilgili deneyimlerinin, düşüncelerinin ve duygularının özünü anlamaktır. Yöntem: Araştırma, tanımlayıcı fenomenolojik nitel tasarımda, Nisan-Ağustos 2021 tarihleri arasında İzmir’deki bir üniversite hastanesinde amaçlı örneklem yöntemiyle seçilen 14 işe yeni başlayan genç hemşire ile gerçekleştirilmiştir. Derinlemesine görüşmeler video konferans yöntemi ile yapılmıştır. Görüşme dökümleri Colaizzi’nin tekniğine göre analiz edilmiş ve çalışmanın ana temalarının oluşturulması aşamasında deneyimlerin özüne ulaşmak için “Watson İnsan Bakım Kuramı” kullanılmıştır. Bulgular: İşe yeni başlayan genç hemşirelerin, kıdemli meslektaşlarıyla olan ilişkileri üç ana tema ve iki alt temadan oluşmaktadır: ana temalar; “sevecen/olumlu yaklaşımlar”, “nezaketsiz davranış”, “yetersiz destek”; alt temalar;“destekleyici ve geliştirici yaklaşım”, “kabul görme ve önemsenme” olarak belirlenmiştir. Sonuç: Çalışmanın sonuçları, işe yeni başlayan genç hemşirelerin, geçiş sürecinde özellikle rehber hemşire yaklaşımlarını sevecen ve geliştirici bulması ve olumlu deneyimler yaşamasının destekleyici ilişkinin varlığını; öte yandan yönetici ve kıdemli meslektaşlarının nezaketsiz davranışlarına maruz kalmasının ve yardım görmemesinin olumsuz ilişkilerin varlığını ortaya koymuştur. İşe yeni başlayan genç hemşirelerin, geçiş sürecinde olumsuz meslektaş ilişkilerine maruz kalmasının önlenmesi için kurumsal ve ulusal düzeyde Watson’ın İnsan Bakım Kuramı’na temelli stratejiler geliştirilebilir.

Exploring the Nursing Care Process for Patients with COVID-19: A Grounded Theory Study

Introduction:

A specific model and process of nursing care for patients with COVID-19 has yet to be developed. However, nurses are navigating how to care for patients and themselves in a novel and stressful work environment. A care process is needed that promotes effective nursing for patients’ health and well-being.

Objective:

This study aimed to explore the current nursing care process for patients with COVID-19.

Methods:

The present qualitative study used a grounded theory approach. Participants included 23 nurses working in a hospital COVID-19 ward who were selected through purposive sampling. Semi-structured interviews were conducted with nurses, and data were simultaneously analyzed using MAXQDA software to code the data. Grounded theory with a storyline approach was used to categorize codes to elucidate themes from interviews and check for data saturation. This consists of several steps, including open coding, developing concepts in terms of their properties and dimensions, analyzing data for context, bringing the process into the analysis, and integrating categories.

Results:

Data analysis revealed seven main categories to describe nurses’ conceptions of the care process for COVID-19 patients: ‘patients’ complicated condition’, ‘severe nursing staff shortage’, ‘nursing professionalism’, ‘treatment team collaboration’, ‘work and environmental pressure’, ‘efficacy of care’ and ‘care deficit’. The category of ‘nursing professionalism’ was determined to be the core concept that nurses used to describe their care process.

Conclusion:

Though nurses think highly of their efficacy of care for patients with COVID-19, they face many challenges in their care process that lessen the care they are able to provide for patients and themselves. These include the complex health status of patients, shortage of staff, environmental stresses such as becoming infected, and lack of resources in the hospital. The results of the present study can be used for planning in various fields of nursing, including management, education and clinical training.

Developing an interprofessional learning and working culture to improve person-centred care in nursing homes: a realist action research protocol

INTRODUCTION

Healthcare is changing due to the ageing of the general population, complex care demands and growing attention to person-centred care. To deal with these changes and provide the best possible person-centred care, the different professionals in nursing homes should all collaborate intensively. However, most professionals work within the field of their own expertise and share very little knowledge, experiences and insights. A lack of an interprofessional learning and working culture also prevents professionals with different expertise from working and learning intensively together to achieve high-quality person-centred care. There is a gap of knowledge about how to develop such a culture. Our aim is to provide insights into what actions, in what context and to what extent can contribute to an impactful development of an interprofessional learning and working culture.

METHODS AND ANALYSIS

The realist action research design will be applied. It consists of three iterative steps: plan, act and observe, and reflect. First, we will formulate the theory about interprofessional learning and working culture and measure this culture by means of interviews, focus groups and questionnaires. Second, we will apply the nine principles of Practice Development to coach professionals from six Dutch nursing homes to improve their interprofessional learning and working culture. Finally, we will evaluate the impact of the changed attitudes and skills on healthcare practice.

ETHICS AND DISSEMINATION

Approval for the project was given by the Hogeschool van Arnhem en Nijmegen (HAN) Research Ethics Committee, the Netherlands, registration number EACO 164.12/19. All organisations, professionals and residents/family members will be informed verbally and by letter about the study and asked for informed consent. The results will be presented in peer-reviewed scientific journals, professional journals and at symposia and conferences. The findings will be transferred to an online toolbox and e-learning modules for graduated professionals and students.

Emerging Frontline Leaders' Voices in Response to COVID-19 Crisis

BACKGROUND

The COVID-19 pandemic has significantly affected healthcare institutions, introducing new challenges for nurse leaders and their colleagues. However, little is known about how the pandemic has specifically affected the lives of these leaders and what methods and strategies they are using to overcome pandemic-related challenges.

OBJECTIVES

The aim of this study was to examine the effect of the 2019 pandemic on emerging healthcare leaders and highlight methods and strategies they used to overcome pandemic-related challenges.

METHODS

The participants in this study represent a diverse group of interprofessional healthcare faculty enrolled in a transformational leadership course (Paths to Leadership) when the pandemic first appeared. Three months into the pandemic, the leadership cohort was invited to participate in this qualitative study, exploring four questions: Q1: How have you transformed your working styles in response to the pandemic? Q2: How have you adjusted your personal life in response to the pandemic? Q3: How have you used leadership skills learned from Paths to Leadership during the pandemic? Q4: What lessons have you learned from the pandemic? Participant narratives were analyzed by a team of nurse researchers using conventional qualitative content analysis.

RESULTS

Themes for Q1 (working styles) included shifted from face-to-face to telework, faced novel disease and decisions, worked more from home, and challenged to maintain contact with professional peers and team. Themes for Q2 (personal life) included accommodate adults working and children learning from home, looked for and found the positive, and continue to struggle. Themes for Q3 (leadership skills) included reflective practice, listening, holding, and reframing. Finally, themes for Q4 (pandemic lessons) included leadership, human connection, be prepared, taking care of ourselves, and connecting with nature.

DISCUSSION

The 2019 pandemic brought hardships and opportunities to faculty members enrolled in an interprofessional transformational leadership course. In conjunction with this course, the pandemic provided a unique opportunity for participants to apply newly acquired relationship building, positive organizational psychology, and reframing skills during a time of crisis. Nursing leaders, whose educational offerings may be immediately "put to the test," may find our lessons learned helpful as they develop strategies to cope with unanticipated future challenges.

The development of an evidence-informed Convergent Care Theory: Working together to achieve optimal health outcomes

BACKGROUND

Healthcare is a complex and divergent system with uncertainty, unpredictability, and multi-layered stakeholders. The relationships among the stakeholders are multifaceted and dynamic, requiring continual interpersonal connections, networks, and co-evolution. It is pivotal to have an evidence-informed theory to explain the phenomenon, uniting the multifaceted stakeholders' efforts.

PURPOSE

To describe the development of an evidence-informed theory, the Convergent Care Theory, assembling healthcare stakeholders to work together and achieve optimal health outcomes.

METHODS

The Convergent Care Theory was developed using a theory synthesis approach based on empirical research and literature reviews published by the theory-proposing author. The empirical evidence was categorized into: patients and families, healthcare providers, healthcare organizations, and patients' and healthcare providers' self-care.

RESULTS

The Convergent Care Theory includes four concepts: all-inclusive organizational care , healthcare professional collaborative care, person-centered precision care, and patients ' and healthcare providers' self-care. Achieving convergent care is a process requiring all stakeholders to work together. Six major facilitators emerged from the research evidence: competence, compassion, accountability, trusting, sharing, and engaging.

CONCLUSION

This article introduced the development process of the evidence-informed Convergent Care Theory. Healthcare systems are complex, with multiple stakeholders' needs to meet. The Convergent Care Theory strives to unite healthcare stakeholders, bond resources, and join forces to achieve optimal healthcare outcomes. The underpinning of the theory is a caring culture, which is an underlying code for organizational and team behaviors and the foundation of optimal health outcomes.

A Qualitative Exploration of the Psychological Experience of Patients Hospitalized With COVID-19

This qualitative study describes the psychological experience of patients hospitalized with COVID-19. These patients went through 3 psychological stages: extremely uncertainties during the initial diagnostic stage, complicated feelings of negativity during the treatment stage, and positive growth in the recovery stage. It is important for nurses to provide holistic care.

Interprofessional practice: the path toward openness

This article seeks to shed light on the meanings healthcare practitioners attach to practicing interprofessionally and how interprofessional relationships play out in "everyday" practice. It draws on findings from a hermeneutic phenomenological study of health professionals' lived experience of practice, interpreted in relation to Martin Heidegger's concept of a path through the dense forest which leads to an open space where there is no predefined path to follow. Analysis of data from in-depth, semi-structured interviews with 12 health professionals from medicine, midwifery, nursing, occupational therapy, physiotherapy, speech and language therapy, and social work suggests that health practitioners come upon the clearing having walked their own track toward practicing interprofessionally. Our argument is that when: getting to know others; genuine dialogue; trust; and respect are in play, a spirit of interprofessional practice flourishes. The ontological view presented, sheds light on the nature of the relationships and the personal qualities that foster a spirit of interprofessional practice in these human-to-human interactions. It highlights how health practitioners need to be free to enact their humanity; to move beyond the "professional" pathway, which encourages them to leave "who they are" at home.

The 'PRICE' of Physical Activity Referral Schemes (PARS): Stakeholders' Recommendations for Delivering Quality Care to Patients

Evidence-based strategies are needed to curb the growing cases of physical inactivity related morbidities. Delivering holistic care through collaborative shared decision making could boost the effectiveness of physical activity referral schemes (PARS) and foster the quality of care for patients with multimorbidity. A qualitative study involving semi-structured telephone interviews was utilised to gain insights from Australian PARS stakeholders (general practitioners, exercise physiologists, and patients). A pluralistic evaluation approach was employed to explore and integrate participants' opinions and experiences of PARS and their recommendations were used to develop a model for quality care delivery in PARS initiatives. Five overarching themes: promote, relate, incentivise, communicate, and educate were identified as the 'PRICE' for developing effective and functional PARS programmes that foster quality patient care. It was evident that PARS programmes or policies aimed at optimising publicity, encouraging incentives, improving interdisciplinary information sharing and professional relationships between patients and healthcare professionals can transform healthcare delivery and provide top quality PARS care services to patients. Therefore, governments, healthcare systems, and PARS administrators can translate and leverage the insights from this study to optimise the delivery of high quality care to PARS patients.

The lived experience of workplace reciprocity of emergency nurses in the mid-Atlantic region of the U.S.: A descriptive phenomenological study

INTRODUCTION

Emergency nurses work under sometimes uncertain conditions to provide care to patients with all kinds of illnesses and afflictions from all segments of the population. Despite implications that they must work together to provide efficient and effective patient care, few studies explore reciprocal workplace relationships of emergency nurses.

AIM

This research sought to illuminate the lived experience of workplace reciprocity of emergency nurses.

METHODS

Using a phenomenological approach with snowball sampling technique, unstructured, open-ended interviews were conducted with emergency nurses in the mid-Atlantic region of the United States. The original study was conducted in 2013 (n = 9) and a replication study in 2018 (n = 7). Data were collected and analyzed using Giorgi's Phenomenological Method. Results from each study were evaluated for thematic congruence.

RESULTS

Six themes of workplace reciprocity of emergency nurses were identified for both studies: emergency department (ED) culture, balancing, technology, caring, bridging, and connection. An additional theme, bonding, was identified with the replication study.

CONCLUSIONS

Exploring workplace reciprocity of emergency nurses provided insight the influences on workplace relationships. Establishing and nurturing workplace reciprocity may create a culture of safety, connection, enhance work engagement, and influence nurse recruitment and retention.

Designing a Short-Term Healthcare Service-Learning Mission Trip for Impact and Sustainability

ABSTRACT

Educators creating healthcare service-learning mission trips for students recognize that success is measured in benefit to students, the community served, and in sustainability. Partnering in Guatemala with a nonprofit ministry, Belmont University faculty describe their experience with service-learning trips and how impact was measured, particularly on students' faith and service. Useful steps for overcoming barriers to sustainability for the university and local community served are provided.

An Overview of Reviews on Interprofessional Collaboration in Primary Care: Barriers and Facilitators

Introduction:

Interprofessional collaboration (IPC) is becoming more widespread in primary care due to the increasing complex needs of patients. However, its implementation can be challenging. We aimed to identify barriers and facilitators of IPC in primary care settings.

Methods:

An overview of reviews was carried out. Nine databases were searched, and two independent reviewers took part in review selection, data extraction and quality assessment. A thematic synthesis was carried out to highlight the main barriers and facilitators, according to the type of IPC and their level of intervention (system, organizational, inter-individual and individual).

Results:

Twenty-nine reviews were included, classified according to six types of IPC: IPC in primary care (large scope) (n = 11), primary care physician (PCP)-nurse in primary care (n = 2), PCP-specialty care provider (n = 3), PCP-pharmacist (n = 2), PCP-mental health care provider (n = 6), and intersectoral collaboration (n = 5). Most barriers and facilitators were reported at the organizational and inter-individual levels. Main barriers referred to lack of time and training, lack of clear roles, fears relating to professional identity and poor communication. Principal facilitators included tools to improve communication, co-location and recognition of other professionals’ skills and contribution.

Conclusions:

The range of barriers and facilitators highlighted in this overview goes beyond specific local contexts and can prove useful for the development of tools or guidelines for successful implementation of IPC in primary care.

Road to Sustainability: University–Start-Up Collaboration

Considerations on sustainability have growing attention not only for scholars and businesses, but also for almost everyone. However, accomplishing sustainable progress is complicated and cannot be completely reached by single individuals or organizations. Consequently, entrepreneurs striving for sustainable change might search for collaborations with universities to overcome their resource and technology constraints. A quantitative research method was employed to explore the value of such collaborations. Data were gathered via questionnaires, between February and March 2020, from entrepreneurs/start-ups that are spin-offs of the ten leading higher education institutions in Berlin and Brandenburg (Germany). Correlation and logistic regression disclosed that start-ups with different sustainability goals employed dissimilar formats of collaboration with universities. Ecological-oriented entrepreneurs tend to utilize all three forms of university–start-up collaboration. On the contrary, social-driven start-ups are not likely to adopt any kind of collaboration with universities. While ventures with economical SDGs are prone to employ product and prototype development along with support from professors. The study extends the knowledge about the search for collaborations of start-ups when pursuing different SDGs. In the practical domain, this research can encourage entrepreneurs to cooperate with universities in order to achieve their sustainable goals beyond incubation and acceleration. Additionally, it can also trigger universities to supply resources for supporting start-ups, especially social-driven ventures, to facilitate them to accomplish sustainability as well as to reach the third mission of universities in terms of supporting society.

Interprofessional collaboration in connection with a medical ship: nurses' experiences

AIMS AND OBJECTIVES

To describe nurses´ experiences of interprofessional collaboration (IPC) in connection with a medical ship offering primary health care in Papua New Guinea.

BACKGROUND

More than a third of the population in Papua New Guinea are living in severe poverty, resulting in serious and fatal diseases. Due to rough terrain and lack of infrastructure, most of them cannot benefit from health care in the cities. Thus, a medical ship is used since the sea route is one of the few possible ways to reach the people.

DESIGN

A qualitative study with an inductive and descriptive approach was performed, and content analysis of the data was used.

METHODS

In January 2018, eleven nurses from seven countries were interviewed onboard the medical ship assessing their experiences when performing IPC. The COREQ checklist for qualitative studies was applied in the conduct and reporting of this study.

RESULTS

Three generic categories emerged: Nurses' motivation to achieve the common goal of doing good using IPC; Nurses' view of performing IPC within special conditions; and Nurses' perception of their role in IPC. Overall, the IPC was perceived by the nurses as well functioning. Having a common goal, positive mindset and effective communication improved the team's collaboration. When these aspects were accomplished, the chances of overcoming the challenge of working in new circumstances and limited space with a newly formed team were increased.

CONCLUSION

Good collaboration within an interprofessional team required repeated sharing of information. This demonstrates the importance of communication and engagement to overcome existing challenges when working interprofessionally.

RELEVANCE TO CLINICAL PRACTICE

This study recommends the establishment of IPC for similar contexts such as onboard Youth With a Mission and ashore, as well as in disaster situations or home care where the healthcare professional must collaborate and adapt to new circumstances and prevailing situations.

Communication Styles Inventory-Brief: Adaptation and validation for Spanish nursing

Healthcare attention is sometimes considered purely technical, but communication has proven to be closely related to clinical results and patient satisfaction. Therefore, evaluation of communication in the scope of healthcare is a priority. The purpose of this study was to validate and adapt the Spanish version of the Communication Styles Inventory in a sample of nursing professionals. The sample was made up of 2313 nursing professionals selected at random from various medical centres in Spain, and is therefore a sample actively employed at the time data were acquired. We started out from the Communication Style Inventory, a questionnaire for evaluating the predominance of certain individual communication behaviours on six scales (expressiveness, preciseness, verbal aggressiveness, questioningness, emotionality and impression manipulativeness). Confirmatory Factor Analysis of the model proposed showed god fit indices. The reliability of the model shown by the Cronbach's alpha of α = 0.81 was adequate, and so was single-level and aggregate consistency. Finally, in the analysis of variance by type of contract, configural, metric and scalar invariance was acceptable, but not strict invariance. This instrument progresses in measuring non-technical attributes, such as communication styles, in nursing personnel.

Knowledge and readiness for inter professional education and collaborative practice among undergraduate nursing students in a Middle Eastern country - A pilot study

BACKGROUND

Inter Professional Education and Collaboration (IPEC) is grounded on mutual respect, enhances collaborative practice, and increases satisfaction among health care professionals.

PURPOSE

The study was conducted to assess the level of knowledge and readiness for IPEC among nursing students.

METHODS

The student's level of knowledge was assessed using a 20 item questionnaire while their readiness for IPEC was measured using the Readiness for Interprofessional Learning Scale (RIPLS) comprising 19 items. A total of 125 nursing students participated in the study and data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25 DISCUSSION: The mean level of knowledge was 44.41 with SD of 4.72. The mean readiness score was 79.09 with the SD of 11.77. There is no significant association between the knowledge and readiness of nursing students regarding IPEC and their demographic variables at 0.05 confidence level.

CONCLUSIONS

Majority of the students had moderately adequate knowledge about IPEC and high level of readiness towards IPEC. This implies that when appropriately implemented, the students will reap the benefits of IPEC, which has the potential to improve their ability to provide holistic nursing care to their patients.

A work motivational grounded theory study of workers in caring roles

The aim of this study was to examine and construct a theoretical model of key elements that care workers perceive to have an impact on their autonomy, cohesion, and work motivation. Grounded theory was used for data collection and analysis. There were 20 participants from social welfare service, geriatric care, and women's aid settings (women = 18, men = 2, mean age = 37.6). The analysis resulted in the following categories: (a) Being-a-Cohesive-Team; (b) Agency-Making; (c) Living-Up-to-Expectations; and (d) Developing-Support-and-Feedback. The results identified potential interactions between these factors and suggested how they influenced each other, showing how cohesion, autonomy, and motivation are interdependent and amplified.

A unitary caring science resilience-building model: Unifying the human caring theory and research-informed psychology and neuroscience evidence

Resilience is the psychological capability to recover from difficulties quickly. Healthcare professionals are especially vulnerable to job-related stress and burnout. Unitary Caring Science is the framework for Watson's Human Caring Theory, providing a philosophy of practice in healthcare. With the high rates of clinician burnout and psychological issues, it will be significant to unify the human caring theory with research-informed psychological and neuroscience evidence to develop clinicians' resilience-building strategies. The purpose of this article is to introduce a Unitary Caring Science Resilience Model and explain the science behind the core strategies based on Unitary Caring Science philosophy and the psychological and neuroscience research. This model includes six strategies: Embracing loving-kindness for self and others; Nurturing interpersonal and intersubjective connections/relations; Deepening a creative use of self and sense of belonging; Balancing self-learning, self-awareness, and an evolved self-consciousness; Valuing forgiveness and releasing negativity; Inspiring and maintaining faith-hope. The caring-theory guided resilience-building strategies are proven to alleviate the depletion of clinicians' energy and emotions. Healthcare practices are challenging but rewarding. Clinicians can be emotionally, psychologically, and physically exhausted if they always consider themselves 'giving' and 'doing' institutional tasks without a sense of purpose or fulfillment. The practice can be rewarding if it becomes more aligned with clinicians' value to serve humanity. Through the unitary caring science resilience strategies, clinicians can build resilience as an antidote to clinician burnout and depletion.

An Approach to Improving Clinical Morale: Targeting a Positive Culture

Establishing a positive work environment is critical for successful outcomes and optimized performance. In a high-stakes arena such as healthcare, having all individuals engaged and ready to be part of the team is crucial. In this paper, we highlight a novel strategy for establishing effective communication and breaking down barriers. Through the implementation of a positive culture committee the neurosurgical department will improve relationships and performance. Goals and different strategies are addressed in the discussion. As implementation is underway, we plan to measure improved performance metrics in the coming years.

Nursing education on palliative care across Europe: Results and recommendations from the EAPC Taskforce on preparation for practice in palliative care nursing across the EU based on an online-survey and country reports

BACKGROUND

Nurses are the largest regulated group of healthcare professionals involved in palliative care. In 2004, a taskforce of the European Association for Palliative Care (EAPC) launched the 'Guide for development of palliative nurse education in Europe' (hereinafter, the EAPC 2004 Guide). No systematic evaluation of its impact in the development of palliative care education was undertaken.

AIMS

To describe current undergraduate and postgraduate nursing education across Europe; to identify the roles that nurses with different palliative care educational levels have in palliative care; and to assess the uptake of the EAPC 2004 Guide in the development of palliative care nursing in Europe.

DESIGN

Descriptive research involving an online survey among nursing experts, and the consultation of national representatives.

SETTING/PARTICIPANTS

A total of 135 nurses (52% response rate) from 25 countries completed the online survey; representatives from 16 countries were consulted.

RESULTS

In 14 (56%) countries, palliative care was not identified as a mandatory subject within undergraduate nursing education. The EAPC 2004 Guide is widely known and was/is being used in many countries to promote palliative care nursing education. Large variations were found across and within country responses.

CONCLUSIONS

Palliative care nursing education varies largely in Europe. The wide awareness and use of the EAPC 2004 Guide show how policy measures can influence the development of palliative care education. Recommendations are built and focus on both fostering the use of this guide and implementing policy measures to ensure that palliative care nursing is recognised and certified as a specialty in all European countries.

A Systematic Review of the Outcome Measures Used to Evaluate Interprofessional Learning by Health Care Professional Students During Clinical Experiences

Interprofessional education (IPE) occurs when members of more than one health or social care profession learn interactively together to improve interprofessional collaboration and health care delivery. Interprofessional experiences provide students with the skills and knowledge needed to work in a collaborative manner; however, there is no review on the outcome measures used to assess the effectiveness of IPE learning. The current systematic review examined the outcome measures used to assess interprofessional learning during student clinical experiences. An electronic search of databases retrieved trials of health professional students who completed an IPE intervention during a student clinical experience. Methodological quality of twenty-five studies meeting the inclusion criteria published between 1997 and 2018 was scored independently by two raters using the Physiotherapy Evidence Database and the Confidence in the Evidence from Reviews of Qualitative Research tool. The Interdisciplinary Education Perception Scale was used most frequently to assess interprofessional learning during a student clinical experience. This review provides a summary of outcome measures for educators to consider for evaluation of interprofessional activities during student clinical placements and serves to inform future conversations regarding the use and development of outcome measures to provide evidence for student achievement of IPE objectives and competencies.

Health and social care professionals' experiences of collaborative planning-Applying the person-centred practice framework

Aim

To explore how person‐centred practice framework can be applied to professionals participating in collaborative planning.

Design

An explorative, deductive approach.

Method

Eleven professionals from health care and social care participated in the study. A deductive content analysis was performed using a framework for person‐centred practice for the analysis.

Results

Practicing person‐centred care and collaborative planning is a complex process that needs to take into account system factors on both the macro‐ and the microlevel. Everyone working within the system needs to apply the same approach. Using a framework analysis offered new insights into how person‐centred care is expressed in practice during collaborative planning between the patient, and healthcare and social care professionals.