The nurse-nurse collaboration scale

The relationship between attitudes towards professional autonomy and nurse-nurse collaboration: A cross-sectional study

AIM

This study aimed to determine the relationship between attitudes towards professional autonomy and nurse-nurse collaboration among nurses.

BACKGROUND

Professional autonomy is crucial for nurses in today's complex and ever-changing healthcare environment. Therefore, attitudes towards professional autonomy may result in effective collaboration among nurses, one of the nursing roles and responsibilities.

METHODS

This descriptive, cross-sectional study was conducted with 685 nurses in four private hospitals affiliated with a university. Descriptive tests, correlation analysis and hierarchical regression analysis were used. An ethics committee approved this study, and the STROBE Statement guidelines for cross-sectional studies were followed.

RESULTS

Significant predictors for nurse-nurse collaboration were identified as job-related independence, autonomous clinical judgement and working unit from control variables.

CONCLUSION

This study's results provided valuable insights for nurse managers to enhance nurses' attitudes towards professional autonomy and foster collaborative work environments.

IMPLICATIONS FOR NURSING

Nurse managers can increase nurses' participation in decision-making processes and allow them to recognize their autonomy and that of their colleagues.

The development of a research-based interprofessional communication behaviors repository in healthcare education: A systematic review

Interprofessional communication is crucial for patient care, yet there is a dearth of comprehensive assessment tools essential to train and assess healthcare students. While the Interprofessional Educational Collaborative framework (IPEC) outlines eight sub-competencies, it lacks detailed behavioral indicators. This study aimed to create a repository of interprofessional communication behaviors to complement the IPEC sub-competencies. From 12,448 articles, 55 were selected and thematically analyzed with NVivo18®. We identified 230 interprofessional communication behaviors, organized into 10 themes and 61 sub-themes, aligning with the IPEC sub-competencies. This comprehensive repository could be foundational for developing interprofessional communication assessment tools in healthcare education and aiding healthcare institutions in improving interprofessional communication practices.

How can strategies based on performance measurement and feedback support changes in nursing practice? A theoretical reflection drawing on Habermas' social perspective

Strategies based on performance measurement and feedback are commonly used to support quality improvement among nurses. These strategies require practice change, which, for nurses, rely to a large extent on their capacity to coordinate with each other effectively. However, the levers for coordinated action are difficult to mobilize. This discussion paper offers a theoretical reflection on the challenges related to coordinating nurses' actions in the context of practice changes initiated by performance measurement and feedback strategies. We explore how Jürgen Habermas' theory of Communicative Action may shed light on the issues underlying nurses' collective actions and self-determination in practice change and the implications for the design of strategies based on performance measurement and feedback. Based on this theory, we propose differences between communicative and functional coordination according to the nature of the actions and the purposes involved. The domains of action underlying these coordination processes, which Habermas referred to as the lifeworld and the system, are then used to draw a parallel with aspects of nursing practice. Further exploration of these concepts allows us to consider the tensions between the demands of the system and the self-determination of nurses within their practice.

Nurse-to-Nurse Collaboration: A Scoping Review

OBJECTIVE

To map predictors and outcome of collaboration between nurses, outcomes of a good collaboration, and the tools developed to evaluate nurse-nurse collaboration.

BACKGROUND

Collaboration between nurses is an intraprofessional relationship between coworkers that is expressed through shared objectives, authority, and a decisional process. Studies on collaboration between nurses are very limited.

METHODS

A scoping review was conducted through 4 databases.

RESULTS

Eighteen studies were included. Nurses with higher levels of collaboration are more satisfied with their work and report less of an intention to leave their job. Greater collaboration among nurses resulted in a decrease of patient falling, hospital-acquired pressure ulcers, and a better care. Three tools have been developed to evaluate nurse-nurse collaboration: the Nurse-Nurse Collaboration Scale, the Nurse-Nurse Collaboration Behavior Scale, and the Nurse-Nurse Collaboration Between Sector.

CONCLUSIONS

Further studies should be conducted to fully understand the issue of collaboration between nurses and the factors connected to it.

Mediating effects of workgroup processes on the relationship between nurse turnover and nurse outcomes in hospitals

Background

Nurse turnover is often considered to be an outcome, and few studies have investigated its consequences in nursing care. The underlying mechanism of the nurse turnover-nurse outcome relationship has not been empirically investigated. Therefore, this study examines workgroup processes and nurse outcomes as the consequences of nurse turnover and the mediating effect of workgroup processes on the nurse turnover-nurse outcomes relationship.

Methods

A cross-sectional design was adopted to investigate the data collected from 264 staff nurses. Furthermore, six-month turnover rates, workgroup processes (nurse-nurse collaboration, team cohesion), and nurse outcomes (job satisfaction, intent to leave) were utilized in the multivariate regression models.

Results

Overall, 53 (24.4%) nurses had worked in nursing units with a zero six-month turnover rate. The average mean six-month turnover rate was 15.5%. Nurse turnover adversely affected nurses' job satisfaction and several subscales of team cohesion including task cohesion and social cohesion. Team cohesion partially mediated the relationship between nurse turnover and job satisfaction.

Conclusion

Nurse turnover decreased job satisfaction and team cohesion, and team cohesion partially mediated the nurse turnover-nurse outcomes relationship. These findings provide evidence supporting the significant adverse effects of nurse turnover and suggest the potential role of workgroup processes in explaining the underlying mechanism of the relationship between nurse turnover and nurse outcomes.

Implications for nursing and health policy

Healthcare organizations must create a positive work environment to reduce nurse turnover. Further, states and countries should try to develop and establish nursing and health policies to prevent turnover.

Improving Communication to Neonatal Resuscitation Team Members During High-Risk Births

OBJECTIVE

To determine whether implementation of a written communication tool in labor and delivery during high-risk births improves communication, preparation, and satisfaction of responding neonatal resuscitation team members.

DESIGN

Quality improvement project with a pretest and posttest design.

SETTING/LOCAL PROBLEM

Two labor and delivery units and a third labor-delivery-recovery-postpartum unit within a health care system in the southeastern United States.

PARTICIPANTS

Nurses, nurse practitioners, respiratory therapists, and physicians who are part of the neonatal resuscitation team.

INTERVENTIONS/MEASUREMENTS

A researcher-designed, written communication tool titled the High-Risk Delivery Communication Tool was implemented in the settings. A researcher-designed measurement tool titled the Neonatal High-Risk Delivery Communication Scale was used as a before-and-after survey to measure communication to the neonatal resuscitation team, preparation for high-risk births, and satisfaction with communication from labor and delivery nurses.

RESULTS

Findings from all portions of the Neonatal High-Risk Delivery Communication Scale indicated statistically significant improvements in communication, preparation, and neonatal resuscitation team member neonatal resuscitation team satisfaction while attending high-risk births. Scores improved on every item regarding hand-off, risk factor communication, preparation, and satisfaction.

CONCLUSION

Implementing a communication tool for use in high-risk births may improve communication to neonatal resuscitation team members, enhance preparation for neonatal care, and increase team members' satisfaction with interprofessional communication.

Scoping Review to Inform the Future Development of a Measure for Team-Based Care in Oncology

PURPOSE

Team-based care is the delivery of health services to an individual by at least two health care providers working collaboratively to achieve optimal care. Participants on the National Cancer Institute and the ASCO Teams in the Cancer Care Delivery Project have defined 13 key principles to serve as the foundation for a successful team; however, it is unclear whether there exist measures of these key principles.

METHODS

A scoping literature search was conducted for each key principle on PubMed and Embase to identify existing measures for key principles. Articles of interest were exported to a citation manager, Sciwheel, cataloged by the key principle. Existing measures were extracted via a two-stage screening process, with an abstract review followed by a full-text review.

RESULTS

Fifteen unique measures were identified, with items extrapolated for 12 of the 13 key principles. Measures were not exclusive and could represent more than one key principle. The number of measures varied per principle from zero to five, with Team Composition and Diversity yielding no existing measure.

CONCLUSION

The long-term goal is to compile and edit these measures, to create a comprehensive measure to be used in various team-based oncology care settings, and to address areas for improvement, ultimately optimizing patient care.

Physician-Nurse and Nurse-Nurse Collaboration From the Perspective of Nurses: A Cross-Sectional Study

The study aims to determine the physician-nurse and nurse-nurse collaboration levels of nurses and effective factors. A cross-sectional study was conducted with a sample of 477 nurses from five hospitals using a questionnaire. It was determined that the characteristics of working life explained 10% of the Nurse-Nurse Collaboration Scale and the regression model between variables and the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was not statistically significant. Physician-nurse and nurse-nurse collaboration are affected by a variety of factors.

The Effect of Nurses' Professionalism Attitudes on Nurse-Nurse Collaboration in a City Hospital in Turkey: A Cross-Sectional Study

Background: Professionalism in nursing plays a key role in establishing collaboration between nurses. Collaboration between nurses increases the quality of patient care and reduces medical errors. Aim: This study aimed to determine the effect of nurses' professionalism attitudes on nurse-nurse collaboration. Methods: This study adopted a descriptive and cross-sectional design. The sample consisted of 409 nurses in public hospitals in Kayseri, Turkey. Data were collected using a socio-demographic characteristics questionnaire, the Occupational Professional Attitude Inventory, and the Nurse-Nurse Collaboration Scale. Results: Nurses had high professionalism but low nurse-nurse collaboration. There was a weak positive correlation between professionalism and nurse-nurse collaboration. It was determined that professionalism affects nurse-nurse collaboration at low level. Conclusion: Nurses had high levels of professionalism but low levels of collaboration. However, professionalism was weakly associated with collaboration, and nurses' attitudes toward professionalism had little effect on nurse-nurse collaboration. Executive nurses should organize training to help nurses develop professionalism and collaboration skills. In addition, for collaboration, all nurses must have at least a bachelor's degree education.

Nursing Care Delivery Models and Intraprofessional Collaborative Care: Canadian Nurse Leaders' Perspectives

Introduction

There are many different types of nursing care delivery models used to organize and provide care in hospitals. These models are comprised of different organizational structures and staffing skill mixes.

Objective

The aim of this study was to explore how nursing care delivery models promote intraprofessional collaborative care in acute care hospitals from the perspectives of nurse leaders.

Methods

A qualitative descriptive approach was used for this study. Telephone interviews were conducted between January 2021 and August 2021 using an interview guide comprised of semi-structured and structured questions. Using a purposeful sampling technique, ten leaders from nine hospital systems, representing both urban and rural hospitals in the province of Ontario, Canada, participated in the study. Content analysis was conducted resulting in two overarching themes.

Results

The first theme, Fluidity of the Model addresses the flexibility of the models and the impact of contextual factors such as changes in nurses' scope of practice, government funding changes, staffing mix, and organizational policies and rules. The second theme, Tools of the Trade describes the resources that hospitals implement to promote intraprofessional collaboration that indirectly impacts on patient safety.

Conclusion

Nursing care delivery models need to be flexible and adaptable. All nursing care delivery models in this study used various tools to promote intraprofessional collaborative care.

The relationship between nurse-nurse collaboration and work readiness among new graduate nurses

BACKGROUND

Communication and collaboration with colleagues are crucial for new graduate nurses (NGNs) because of the adaptation to both the healthcare system and professional role. Therefore, working units with effective collaboration among nurses may increase new graduates' work readiness.

AIM

This study aimed to determine the relationship between the perceptions of nurse-nurse collaboration and the work readiness level among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 198 NGNs in four private hospitals affiliated with a university. A self-administered questionnaire, including a personal information form, the Nurse-Nurse Collaboration Scale, and Work Readiness Scale, was used to collect data. Data analysis was performed using descriptive tests, and Spearman's rank correlation coefficients.

RESULTS

NGNs had moderate perceptions of nurse-nurse collaboration, with a median score of 2.46 (2.23-2.88) out of 4. Work readiness among NGNs was moderate, with a median score of 304 (270-332) out of 460. There was a statistically significant correlation between nurse-nurse collaboration and work readiness (r_s  = 0.26; p < .001).

CONCLUSION

The results of this study demonstrated that improving nurse-nurse collaboration is an effective way to increase work readiness among NGNs.

Development of blended learning model integrated nursing leadership training using web-based in Indonesia

BACKGROUND

Nurse managers are the frontline leaders in the ward that directly impact the quality of care services. Many nurse managers in Indonesia were inadequately prepared to fulfill this role, especially during this crisis. The objective was to develop blended learning an Integrated Nursing Leadership Training (INLeT) using web based and test the effectiveness.

MATERIALS AND METHODS

This research is a research development using modified Borg and Gall by researcher, namely, Planning, Redesign, Intervention, Modify, and Evaluation. The INLET model was validated by nine experts in health and media technology design. Data were tested using quasi-experiment research in Sanglah General Hospital and Wangaya Public Hospital in Bali.

RESULTS

The results of analysis of the content validity of all items valued V index 0.96 (high category) from design experts and V Index 0.92 (high category from health experts. The experiment group obtained N Gain scored 0.5603 at medium level, and the control group result of N Gain Score was 0.2845 in the low-level category. Using t-test, both the experiment and control group showed significant improvement of score test with P = 0.000 (P < 0.005). Bivariate analysis using independent t-test result P = 0.000 (P < 0.005) means significant difference score test compared between experiment and control group.

CONCLUSIONS

Using the web, this blended learning INLeT Model is effectively applied for nurse manager professional development; therefore, this study can prepare nurse managers into a leadership role by integrating moodle web-based into nursing training.

Nurse-nurse collaboration and performance among nurses in intensive care units

BACKGROUND

An essential element for offering high-quality care in the intensive care units (ICUs) is the intraprofessional collaboration among nurses, which facilitates the exchange of knowledge and information and hence improves performance. More research is needed to understand the relationship between the nurse-nurse collaboration and job performance in the ICUs due to the multidimensionality of both concepts, the complexity of the ICU environment, and the lack of studies.

AIM

To examine the relationship between nurse-nurse collaboration and self-perceived nurse performance among Jordanian nurses in ICUs.

DESIGN

Descriptive, correlational cross-sectional design was used.

METHODS

Data were collected through an online survey including the demographic questionnaire, the nurse-nurse collaboration scale, and six-dimensions scale for nursing performance.

RESULTS

In total, 155 critical care nurses participated (response rate = 46.97%). Self-perceived job performance was significantly associated with gender (t = -3.189, P = .002), age (r = -0.301, P < .01), workplace (F = 28.20, P = .001), the type of ICU (F = 17.70, P = .001), and the number of assigned patients (r = 0.407, P < .01). Among all nurse-nurse collaboration subscales, only the conflict management subscale was an independent significant predictor of self-perceived nursing performance (t = 3.06, B = 3.066, P = .003).

CONCLUSIONS

Effective conflict management is associated with better nurse performance, which could ultimately improve patient care in ICUs.

RELEVANCE TO CLINICAL PRACTICE

Conflict resolution is an important dimension of optimal nurse-nurse collaboration and has an important effect on nursing performance. Nurses and nurse managers in ICUs need to attend workshops and training programs in conflict management.

The HDR CARE Scale, Inpatient Version: A validated survey instrument to measure environmental affordance for nursing tasks in inpatient healthcare settings

Rigorous healthcare design research is critical to inform design decisions that improve human experience. Current limitations in the field include a lack of consistent and valid measures that provide feedback about the role of the built environment in producing desirable outcomes. Research findings about nurses’ efficiency, quality of care, and satisfaction related to inpatient unit designs have been mixed, and there was previously no validated instrument available to quantitatively measure nurses’ ability to work efficiently and effectively in their environment. The objective of this study was to develop, refine, and validate a survey instrument to measure affordance of the care environment to nurse practice, based on various aspects of their work in inpatient units. The HDR Clinical Activities Related to the Environment (CARE) Scale Inpatient Version was developed using item design, refinement, and reliability and validity testing. Psychometric methods from classical test theory and item response theory, along with statistical analyses involving correlations and factor analysis, and thematic summaries of qualitative data were conducted. The four-phase process included (1) an initial pilot study, (2) a content validation survey, (3) cognitive interviews, and (4) a final pilot study. Results from the first three phases of analysis were combined to inform survey scale revisions before the second pilot survey, such as a reduction in the number and rewording of response options, and refinement of scale items. The updated 9-item scale showed excellent internal consistency and improved response distribution and discrimination. The factor analysis revealed a unidimensional measure of nurse practice, as well as potential subscales related to integration, efficiency, and patient care. Within the healthcare design industry, this scale is much needed to generate quantitative and standardized data and will facilitate greater understanding about the aspects of an inpatient healthcare facility that best support nurses’ ability to provide quality patient care.

The work of nurses to provide good and safe services to children receiving hospital-at-home: A qualitative interview study from the perspectives of hospital nurses and physicians

AIM

To explore and describe the work performed by the nurses providing hospital-at-home care to children and their families from the perspectives of hospital nurses and physicians.

BACKGROUND

To reduce capacity pressure on hospitals, various ambulatory services combining hospital and home treatment have emerged. Studies have shown that children and their families are satisfied with hospital-at-home when the parents experienced the professionals possessed the necessary competences. Knowledge is limited about nurses and physicians' perspectives on the work performed and competence needed when children receive hospital treatment in the family's home.

DESIGN

A qualitative descriptive design with semi-structured interviews was used. Sixteen nurses and physicians from two hospitals in Norway working in hospital-at-home for children were recruited to interview. Data were analysed using systematic text condensation. In preparing the manuscript, we applied the COREQ guidelines. The theory on 'expert nursing' supported the discussion of results.

RESULTS

We identified three categories through analysis; building a trustful relationship with the family and the sick child; performing essential skills in paediatric nursing care in hospital-at-home; and nurses serving as the 'hub' between the different parties.

CONCLUSION

The results demonstrate the complexity of the work performed by hospital nurses when children received hospital-at-home. Building a trustful relationship and alliance with the child and the family formed the cornerstone of accomplishing good and safe paediatric care. The nurses became a coordinating and collaborating 'hub' for actors involved, taking care of patient safety on a daily basis.

RELEVANCE TO CLINICAL PRACTICE

The way the nurses approached the children and their families, was the core element of the paediatric nursing expertise and important for the service quality and patient safety. The importance of building a trustful relationship needs to be more acknowledged, and the services would benefit to organise this through continuity of care.

The Relationship Between Emotional Intelligence and Nurse-Nurse Collaboration

PURPOSE

The purpose of this study was to examine the relationship between emotional intelligence and nurse-nurse collaboration among registered nurses in Jordan.

DESIGN

This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan.

METHODS

We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse-nurse communication.

FINDINGS

A total of 311 questionnaires were returned (91% response rate). Nurses' emotional intelligence was positively and significantly correlated with the nurse-nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit.

CONCLUSIONS

The present study demonstrated that nurse-nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse-nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system.

CLINICAL RELEVANCE

Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.

Collaboration among nurses when transitioning older adults between hospital and community settings: a scoping review

BACKGROUND

The transitioning of older patients between healthcare sectors requires the provision of high-quality nursing care. Collaboration among nurses is identified as an essential element of transitional care, yet nurse-nurse collaboration has received little attention.

AIM

The aim of this study was to examine the extent, range and nature of nurse-nurse collaboration when transitioning older patients between hospital and community settings, and to identify gaps in the literature.

METHODS

Arksey and O'Malley's (International Journal of Social Research Methodology, 8, 2005 and 19) framework was used to undertake a scoping review to answer the research questions: how do nurses collaborate together when transitioning older patients from hospital to community settings and what are the facilitators, barriers and outcomes of nurse-nurse collaboration when transitioning older patients between sectors? The Nurse-Nurse Collaboration Scale (NNCS) subdomains informed the identification of selected studies.

RESULTS

Twelve papers were included with most coming from Scandinavian countries and the majority using qualitative methodologies. Communication, coordination and professionalism were found to be both facilitators and barriers of nurse-nurse collaboration. Gaps in the literature included conflict management, and the outcomes of collaboration which was only reported in one study.

CONCLUSIONS

The findings indicate there is limited study of collaboration among nurses when transitioning older patients between hospital and community settings. Future research should address the impact of conflict on nurses working in collaborative practice as well as conducting intervention studies to examine the outcomes of nurse-nurse collaboration.

Relationship between emotional intelligence and job well-being in Chinese Registered Nurses: Mediating effect of communication satisfaction

AIM

To explore the relationship between emotional intelligence and job well-being among Chinese Registered Nurses, and the mediating role of communication satisfaction in the relationship.

DESIGN

A descriptive cross-sectional study design was employed.

METHODS

Random sampling was adopted. The study was conducted from September to December 2019, and 1,475 Registered Nurses from a Chinese hospital provided responses to Wong and Law's emotional intelligence scale, communication satisfaction scale, job well-being scale and general information questionnaire. SPSS25.0 software was used to calculate means, standard deviations and correlations, and AMOS 21.0 software was used to establish the structural equation model.

RESULTS

The emotional intelligence, communication satisfaction and job well-being of Registered Nurses in China were related to positional rank, work department, monthly income, years of service, night shift work distribution and intensity of work. There were positive correlations among emotional intelligence, communication satisfaction and job well-being. Communication satisfaction partly mediated the relationship between emotional intelligence and job well-being. Improving the level of emotional intelligence and communication satisfaction should be an important strategy to improve nurses' job well-being. Therefore, nursing managers could carry out targeted training on emotional intelligence management and communication between nurses and patients and pay attention to the spiritual needs of nurses and provide psychological guidance on a regular basis.

Nurse-to-nurse collaboration between nurses caring for older people in hospital and primary health care: A cross-sectional study

AIMS AND OBJECTIVES

To assess the level of nurse-to-nurse collaboration during the transfer of older people between hospital and primary health care and to evaluate the psychometric properties of the newly developed Nurse-to-Nurse Collaboration Between Sectors Instrument.

BACKGROUND

Nurse-to-nurse collaboration is required when older people transfer between hospital and primary health care to enhance the safety and continuity of care to patients. There is a lack of evidence about the nature and level of this collaboration.

DESIGN

A cross-sectional survey design was used. This study adhered to the STROBE checklist.

METHODS

A sample of 443 nurses (university hospital n = 240, primary health care n = 203) participated in the study from October 2017 to June 2018. Nurses completed the Nurse-to-Nurse Collaboration Between Sectors Instrument (86 items, 7-point Likert-type scale), the Nurse-Nurse Collaboration Scale and the Patient-Centred Competency Scale.

RESULTS

Nurses rated the overall level of nurse-to-nurse collaboration moderately high (mean=4.49, standard deviation=0.83, maximum 7.00). Nurses considered collaboration an important and confidential process, gaining older people's trust in their care. Lower scores were given to the agreement of mutual objectives, policies and guidelines in collaboration, opportunities for job rotation and interacting and networking during the collaboration process. The internal consistency reliability of the newly developed instrument was acceptable.

CONCLUSIONS

Nurses collaborate with competence and confidentiality during the transfer of older people between care settings. However, there is a need for more opportunities to collaborate, to obtain mutual agreement about objectives, policies and practices, and better understand other nurse's roles and responsibilities in collaboration. The reliability and validity of the Nurse-to-Nurse Collaboration Between Sectors Instrument were acceptable though the number and wording of items will be reviewed and further tested.

RELEVANCE TO CLINICAL PRACTICE

Nurses need opportunities to collaborate, and there is a need to develop agreed objectives, practices, roles and responsibilities in this collaboration.

Effects of horizontal violence among nurses on patient safety: Mediation of organisational communication satisfaction and moderated mediation of organisational silence

AIMS

This study aimed to investigate the effect of nurses' horizontal violence on patient safety as mediated by organisational communication satisfaction and to examine the moderated mediation effect of organisational silence.

BACKGROUND

Patient safety is a worldwide concern in health care, but patients still experience adverse events. Among factors affecting patient safety, organisational silence must be examined in relation to organisational communication satisfaction and horizontal violence.

METHOD

A total of 301 nurses working at four general hospitals with over 500 beds in Gyeonggi-do were recruited from October to November 2018. Data were collected through questionnaires and analysed using SPSS 25.0 and SPSS PROCESS macro.

RESULTS

Horizontal violence directly affected patient safety and indirectly affected patient safety via mediation by organisational communication satisfaction. Organisational communication satisfaction had a partial mediation effect, and organisational silence had a significant moderated mediation effect in the path from horizontal violence to organisational communication.

CONCLUSION

To enhance patient safety, educational programmes and strategies that improve organisational silence and organisational communication satisfaction should be developed at an organisational level.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital administrators should be aware of the pivotal impact of organisational silence among nurses on patient safety.

Collaboration among Registered Nurses and Licensed Practical Nurses: A Scoping Review of Practice Guidelines

Professional associations, nurse scholars, and practicing nurses suggest that intraprofessional collaboration between nurses is essential for the provision of quality patient care. However, there is a paucity of evidence describing collaboration among nurses, including the outcomes of collaboration to support these claims. The aim of this scoping review was to examine nursing practice guidelines that inform the registered nurse (RN) and registered/licensed practical nurse (R/LPN) collaborative practice in acute care, summarize and disseminate the findings, and identify gaps in the literature. Ten practice guidelines, all published in Canada, were included in the final scoping review. The findings indicate that many of the guidelines were not evidence informed, which was a major gap. Although the guidelines discussed the structures needed to support intraprofessional collaboration, and most of the guidelines mention that quality patient care is the desired outcome of intraprofessional collaboration, outcome indicators for measuring successful collaborative practice were missing in many of the guidelines. Conflict resolution is an important process component of collaborative practice; yet, it was only mentioned in a few of the guidelines. Future guidelines should be evidence informed and provide outcome indicators in order to measure if the collaborative practice is occurring in the practice setting.

Interpersonal Communication among Critical Care Nurses: an Ethnographic Study

Introduction: Interpersonal communication in critical care units is one of the most important factors due to complicated and critical conditions of patients. Nurses’ confrontation with ethical distresses and conflict resolution techniques are often influenced by the culture governing these units. This study aimed to explore interpersonal communication culture among critical care nurses.

Methods: A focused ethnographic approach was used to conduct study in Iran. The research method was based on the research evolutionary cycle model recommended by Spradley (1980). Data were collected over six months through purposeful sampling and semi structured interviews (n=18) and participation observation (n=43). The data were obtained over six months of observation and interview with participants. Data analysis was done by Spradley method and was interpreted to discover the meaning units from the obtained themes. MAXQDA10 was used to manage data.

Results: Five major domains of observations and high-level consensus were extracted in this study, including grouping, work-life interaction, professionalism, organizational atmosphere and experience.

Conclusion: Development of interpersonal communication culture is influenced by various factors. Besides, the working models and nurses’ use of workspace are indispensable components of effective communication at workplace. The findings of this study can be helpful in determining appropriate strategies and practices to resolve communication problems among nurses by specifying challenges, thereby leading to proper communication among nurses, promoting this communication and finally providing high quality and more effective care.

A multi-objective model for a nurse scheduling problem by emphasizing human factors

Assigning nurses to appropriate departments and work shifts based on human factors can strengthen teamwork and boost the efficiency of healthcare systems. The human factors considered in this study include skill, preference, and compatibility of nurses. In this regard, a unique multi-objective mathematical model for nurse scheduling is proposed in this article, in which nurses' decision-making styles are taken into account. Three objectives, including minimization of the total cost of staffing, minimization of the sum of incompatibility among nurses' decision-making styles assigned to the same shift days, and maximization of the overall satisfaction of nurses for their assigned shifts, are addressed in this model. Three meta-heuristics, namely, multi-objective Keshtel algorithm, non-dominated sorting genetic algorithm II, and multi-objective tabu search, are developed to solve the problem. Moreover, a data envelopment analysis method is employed to rank the obtained Pareto solutions. Afterwards, a real-life case at a large hospital in Tehran, Iran, is investigated. Eventually, the applicability and effectiveness of the proposed model are assessed based on the experimental results.

Good nurse-nurse collaboration implies high job satisfaction: A structural equation modelling approach

AIMS

To explore the relationship between nurse-nurse collaboration and job satisfaction among hospital nurses and to test and refine a model explaining this relationship.

DESIGN

A secondary analysis of a cross-sectional survey.

METHODS

Registered nurses (N = 406, female 88%) in one university hospital in Finland and one in Norway completed a self-administered questionnaire in 2015. Structural equation modelling analysis was used to analyse the relationships between collaboration and job satisfaction subscales.

RESULTS

The constructed SEM model fit the data well (RMSEA = 0.05, CFI = 0.985, χ2 p-value > 0.1). The model strongly supported the hypothesized covariance between nurse-nurse collaboration and job satisfaction, while significant and positive relationships were observed between most of the subscales. The results suggest that there is a strong association between nurse-nurse collaboration and job satisfaction such that nurses are more satisfied when there is good collaboration and vice versa.

Perceptions on nurse-nurse collaboration among registered nurses in Finland and Norway

BACKGROUND

Intraprofessional collaboration necessitates understanding and knowledge on how nurses perceive each other and what factors promote good collaboration. The relationship between nurse-nurse collaboration has been explored relatively little, though intraprofessional collaboration is an essential factor for a healthy work environment.

AIM

This study explores the Finnish and the Norwegian nurses' perceptions of nurse-nurse collaboration in nursing care and factors associated with those perceptions.

DESIGN

A cross-sectional quantitative study design.

METHODS

In 2015, data were collected from 406 Finnish and Norwegian RNs in two acute-care hospitals, by employing the Dougherty and Larson's Nurse-Nurse Collaboration Scale (NNCS). Descriptive statistics, cross-tabulations, Pearson's chi-Square tests and multivariate anova were used for analysis. Ethical approval for this study was obtained from ethics committees in both countries.

RESULTS

Findings indicated that the perception of nurse-nurse collaboration was good in both countries. However, significant inter-country differences were found in the collaboration subscales. Compared with their Finnish counterparts, Norwegian nurses awarded higher scores to conflict management, communication, shared process, coordination and professionalism. The results suggest that nurse characteristics, such as main working time and total work experience, were related to the perception of collaboration.

CONCLUSION

The subscales with the highest scores in both countries were professionalism, shared process and communication. Factors such as conflict management and coordination are areas which should be emphasised to achieve good collaboration between nurses. Here, nurse leaders play an important part in assessing and improving RN-RN collaboration.

Collaboration among registered nurses and practical nurses in acute care hospitals: A scoping review

AIM

This study examined the extent, range, and nature of registered nurse (RN) and practical nurse (PN) collaboration in acute care hospitals and identified research gaps in the existing literature.

BACKGROUND

Optimal patient care requires collaboration between RNs and PNs. A lack of unity and unresolved tension among different types of nurses influences collaboration and has significant implications on practice and the organizations where nurses work.

METHODS

Using Arksey and O'Malley's (2005) framework, a scoping review was undertaken to answer the research question: what is known from the existing literature about the structures, processes, and outcomes of RN-PN collaboration in hospitals?

RESULTS

Twenty-nine studies were included with the majority coming from North America. Donabedian's model assisted with the identification of three themes: scope of practice, interpersonal skills, and nurse and patient-related outcomes.

CONCLUSION

The findings demonstrate there is a paucity of research specific to RN-PN collaboration. Nurse administrators/managers play an important role in addressing the interpersonal skills of nurses and providing an ongoing education on collaboration in the practice setting. Additional studies should focus on the development of nursing collaborative practice models of patient care, the examination of interventions to improve RN-PN collaborative practice, and the assessment of outcomes relating to collaboration among nurses.

An integrative review on conflict management styles among nursing professionals: implications for nursing management

AIM

To critically appraise and synthesize empirical studies that examined conflict-management styles used by nursing professionals when dealing with conflict.

BACKGROUND

Conflict is an organisational issue not new to the nursing profession. Despite the increasing research interest on this topic, no studies had been conducted to appraise and summarize evidence that examined conflict-management styles in nursing professionals.

METHOD

An integrative review method was used to analyse the findings. The primary databases used to access articles published from 2000 onwards were CINAHL, Medline, Psych Info, ERIC, Embase and SCOPUS. The search words and MeSH terms included: conflict, management, nursing, nurse manager, nurse, style, and strategy.

RESULTS

Twenty-five studies met the inclusion criteria. Integration was the most frequent style employed by nursing professionals when dealing and managing conflict, followed by accommodation. Avoiding and competing were found to be the least frequently used styles. Mixed and conflicting results were obtained when nurses' demographic variables were considered. Studies are needed to examine how organisational and interpersonal factors influence nurses' choice of style for handling conflicts.

CONCLUSION

Findings demonstrated that nursing professionals used constructive/positive conflict management approaches rather than destructive/negative conflict management approaches.

IMPLICATIONS FOR NURSING MANAGEMENT

This integrative review provided up-to-date evidence that is useful when formulating interventions to equip nurses with positive conflict-management styles necessary to mitigate and manage conflict. Such interventions may include: structured training on conflict management, team building, and conflict coaching activities, continuing professional development, reflective exercises, simulation, and role playing.

Incivility and Professional Comportment in Critical Care Nurses

BACKGROUND

Civility among critical care nurses is important for achieving positive patient outcomes. Professional comportment refers to nurse behaviors that are respectful, knowledgeable, deliberate, and compassionate.

OBJECTIVE

To examine the relationship between perceptions of nurse-to-nurse incivility and professional comportment among critical care nurses, and the extent to which nurse characteristics influence their perceptions.

METHODS

Data were collected from nurses in 14 critical care units. Correlational analysis examined the relationship between nurses' perceptions of nurse-to-nurse incivility and professional comportment. Regression analysis was used to identify predictors of nurse-to-nurse incivility.

RESULTS

Decreased perceptions of nurse-to-nurse incivility were associated with increased perceptions of professional comportment. Nurses' reports of receiving education about professional comportment was a significant predictor of increased nurse perceptions of professional comportment.

CONCLUSION

Professional comportment education for critical care nurses is important and may provide an option to decrease incivility and promote healthy work environments for nurses.

The measurement of collaboration within healthcare settings: a systematic review of measurement properties of instruments

BACKGROUND

There is a growing call by consumers and governments for healthcare to adopt systems and approaches to care to improve patient safety. Collaboration within healthcare settings is an important factor for improving systems of care. By using validated measurement instruments a standardized approach to assessing collaboration is possible, otherwise it is only an assumption that collaboration is occurring in any healthcare setting.

OBJECTIVES

The objective of this review was to evaluate and compare measurement properties of instruments that measure collaboration within healthcare settings, specifically those which have been psychometrically tested and validated.

INCLUSION CRITERIA, TYPES OF PARTICIPANTS

Participants could be healthcare professionals, the patient or any non-professional who contributes to a patient's care, for example, family members, chaplains or orderlies. The term participant type means the designation of any one participant; for example 'nurse', 'social worker' or 'administrator'. More than two participant types was mandatory.

TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST

The focus of this review was the validity of tools used to measure collaboration within healthcare settings.

TYPES OF STUDIES

The types of studies considered for inclusion were validation studies, but quantitative study designs such as randomized controlled trials, controlled trials and case studies were also eligible for inclusion. Studies that focused on Interprofessional Education, were published as an abstract only, contained patient self-reporting only or were not about care delivery were excluded.

OUTCOMES

The outcome of interest was validation and interpretability of the instrument being assessed and included content validity, construct validity and reliability. Interpretability is characterized by statistics such as mean and standard deviation which can be translated to a qualitative meaning.

SEARCH STRATEGY

The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in this review. The databases searched included PubMed, CINAHL, Embase, Cochrane Central Register of Controlled Trials, Emerald Fulltext, MD Consult Australia, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Informit Health Databases, Scopus, UpToDate and Web of Science. The search for unpublished studies included EThOS (Electronic Thesis Online Service), Index to Theses and ProQuest- Dissertations and Theses.

METHODOLOGICAL QUALITY

The assessment of methodological quality of the included studies was undertaken using the COSMIN checklist which is a validated tool that assesses the process of design and validation of healthcare measurement instruments.

DATA COLLECTION

An Excel spreadsheet version of COSMIN was developed for data collection which included a worksheet for extracting participant characteristics and interpretability data.

DATA SYNTHESIS

Statistical pooling of data was not possible for this review. Therefore, the findings are presented in a narrative form including tables and figures to aid in data presentation. To make a synthesis of the assessments of methodological quality of the different studies, each instrument was rated by accounting for the number of studies performed with an instrument, the appraisal of methodological quality and the consistency of results between studies.

RESULTS

Twenty-one studies of 12 instruments were included in the review. The studies were diverse in their theoretical underpinnings, target population/setting and measurement objectives. Measurement objectives included: investigating beliefs, behaviors, attitudes, perceptions and relationships associated with collaboration; measuring collaboration between different levels of care or within a multi-rater/target group; assessing collaboration across teams; or assessing internal participation of both teams and patients.Studies produced validity or interpretability data but none of the studies assessed all validity and reliability properties. However, most of the included studies produced a factor structure or referred to prior factor analysis. A narrative synthesis of the individual study factor structures was generated consisting of nine headings: organizational settings, support structures, purpose and goals; communication; reflection on process; cooperation; coordination; role interdependence and partnership; relationships; newly created professional activities; and professional flexibility.

CONCLUSIONS

Among the many instruments that measure collaboration within healthcare settings, the quality of each instrument varies; instruments are designed for specific populations and purposes, and are validated in various settings. Selecting an instrument requires careful consideration of the qualities of each. Therefore, referring to systematic reviews of measurement properties of instruments may be helpful to clinicians or researchers in instrument selection.

IMPLICATIONS FOR PRACTICE

Systematic reviews of measurement properties of instruments are valuable in aiding in instrument selection. This systematic review may be useful in instrument selection for the measurement of collaboration within healthcare settings with a complex mix of participant types. Evaluating collaboration provides important information on the strengths and limitations of different healthcare settings and the opportunities for continuous improvement via any remedial actions initiated.

IMPLICATIONS FOR RESEARCH

Development of a tool that can be used to measure collaboration within teams of healthcare professionals and non-professionals is important for practice. The use of different statistical modelling techniques, such as Item Response Theory modelling and the translation of models into Computer Adaptive Tests, may prove useful. Measurement equivalence is an important consideration for future instrument development and validation. Further development of the COSMIN tool should include appraisal for measurement equivalence. Researchers developing and validating measurement tools should consider multi-method research designs.

The Impact of Environmental Design on Teamwork and Communication in Healthcare Facilities: A Systematic Literature Review

The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.

Dougherty M. Effective Individual Contributions on Iranian Nurses Intraprofessional Collaboration Process: A Qualitative Study

Introduction: The staffs' attitudes, beliefs, ideologies and dutifulness, along with their individual characteristics particularly their personality traits are among the factors that are known to affect their performance. The aim of this study was to determine the effect of individual contributions to the process of intraprofessional collaboration among Iranian nurses. Methods: Twenty-three nurses from three different areas, namely Tehran, Tabriz and Ilam hospitals participated in this qualitative study. The participants were selected through purposive sampling. Data were collected using deep and unstructured interviews. Interviews were simultaneously analyzed using conventional content analysis method after being transcribed. Results: Several essential factors contributing to the process of effective collaboration among Iranian nurses were identified: (a) nurses' perspectives and beliefs, (b) personal experiences, (c) individual characteristics and, (d) personal problems. Conclusion: The findings indicate that the features and characteristics of individual contributions are very important and effective on nurses' intraprofessional collaboration. Thus, attention must be paid to these factors in order to overcome problems and obstacles that are encountered on the way of achieving effective collaboration.

Strategies of Iranian nurses to overcome professional discrimination: An explorative qualitative study

Background:

Discrimination is a situation in which individuals receive unequal social benefits in return for equal roles they play. They react to such a situation in different ways.

Objective:

This study aims at identifying the strategies used by Iranian nurses to overcome professional discrimination.

Research design:

This qualitative study was conducted with the participation of 23 nurses who worked in hospitals in the cities of Tehran, Tabriz, and Ilam. They were selected based on purposive sampling. Data were collected using deep and unstructured interviews in a period of time between May 2013 and June 2014. Interviews were simultaneously analyzed using conventional content analysis method after being transcribed.

Ethical consideration:

This study was approved by the Regional Committee of Medical Research Ethics. Also, voluntary participation, anonymity, and confidentiality were considered.

Finding:

“Presenting a positive image of oneself,” “objection,” and “expectation” were three themes extracted through data analysis.

Discussion:

Organizational discrimination puts nurses under stress and pressure. Nurses react to unfair behavior in different ways. These reactions are harmful to an organization and lead to negative consequences.

Conclusion:

Professional discrimination has made nurses adopt strategies which would lead to such consequences, which in turn influences their performance as nurses.

An Enquiry into Nurse-to-Nurse Collaboration Within the Older People Care Chain as Part of the Integrated Care: A Qualitative Study

INTRODUCTION

Health care systems for older people are becoming more complex and care for older people, in the transition between hospital and primary healthcare requires more systematic collaboration between nurses. This study describes nurses' perceptions of their collaboration when working between hospital and primary healthcare within the older people care chain.

THEORY AND METHODS

Using a qualitative approach, informed by grounded theory, six focus groups were conducted with a purposive sample of registered nurses (n = 28) from hospitals (n = 14) and primary healthcare (n = 14) during 2013. The data were analyzed using dimensional analysis.

FINDINGS

Four dimensions of collaboration were identified: 1) Context and Situation, 2) Conditions, 3) Processes and Interactions and 4) The Consequences of nurse-to-nurse collaboration within the older people care chain. These four dimensions were then conceptualized into a model of nurse-to-nurse collaboration.

DISCUSSION AND CONCLUSION

Improved collaboration is useful for the safe, timely and controlled transfer of older people between hospital and primary healthcare organizations and also in healthcare education. The findings in this study of nurse-to-nurse collaboration provides direction and opportunities to improve collaboration and subsequently, the continuity and integration in older people care in the transition between organizations.

Care Coordination Strategies in Reforming Health Care: A Concept Analysis

PROBLEM

With the growing number of individuals with chronic conditions and the associated healthcare costs, there is a need to improve how health care is delivered from an individual provider standpoint as well as a systemwide perspective. Such delivery can be accomplished through improved care coordination.

CONCLUSION

Care coordination is a complex term that encompasses the full array of healthcare delivery activities across all systems of care. This includes organizing the care, improving quality of health care delivered, and achieving cost savings. In working to achieve this goal, the nurse is well suited to provide oversight in this process in assuring that the components of care coordination are conducted efficiently and effectively.

PRACTICE IMPLICATIONS

While the nurse is the optimal provider for this position, the nurse's defined role in this process is not always clear. This article focuses on the term care coordination, which includes the definitions of care coordination, impact on nursing, attributes, antecedents, consequences, and empirical referents for this term. Care coordination is also differentiated from case management to add clarity to the role.

"Discrimination", the Main Concern of Iranian Nurses over Inter-Professional Collaboration: an Explorative Qualitative Study

INTRODUCTION

People in various professions may face discrimination. In the nursing field, discrimination among nurses in the workplace, regardless of race, gender or religion have not been studied; a problem that leads to a reduction in the quality of nursing care and nurse turnover. Discovery of the concerns of nurses about inter-professional collaboration is the purpose of this study.

METHODS

The present study is conducted by using a qualitative content analysis. The data collection process included 22 unstructured and in-depth interviews with nurses between April 2012 and February 2013 in the medical teaching centers of Iran. A purposive sampling method was used. All interviews were recorded, typed, and analyzed simultaneously.

RESULTS

The category obtained from explaining nurses' experiences of inter-professional collaboration was "discrimination" that included two subcategories, namely (1) lack of perspective towards equality in authorities, and (2) professional respect and value deficit.

CONCLUSION

Nurses' experiences are indicating their perception of discrimination that influences the collaboration between nurses, which should be taken into account by managers. The findings of the present study help to managers about decision making on how to deal with staff and can be helpful in preventing nurse turnover and providing better services by nurses.

Professional comportment: the missing element in nursing practice

PURPOSE

The aim of this concept analysis of professional comportment is to elucidate the dimension of nursing practice that fosters cooperation, collaboration, effective communication, and team cohesion among nurses.

BACKGROUND

Professional comportment is a concept that has not been developed or analyzed, and its integration into nursing practice is unclear and not specified. The body of knowledge concentrating on the spectrum of professional comportment, civility, and lateral violence is presently incomplete. Analyzing and developing the concept of professional comportment will satisfy a gap in the literature. A concept analysis of professional comportment will clarify for the nurse the power of words, behaviors, and communication needed to achieve effective communication and civility.

SOURCE

The Walker and Avant framework for concept analysis was used to analyze the concept of professional comportment. An electronic review of the literature through the Cumulative Index to Nursing and Allied Health Literature, Health Sources, Medical Complete, and ProQuest was conducted. This review rendered approximately 300 articles, of which 85 were reviewed. Eighteen articles informed comportment as a definition and are utilized in this analysis. The individual nurse is the level of focus in the analysis, not the organizational culture.

CONCLUSION

Comportment is defined as a dignified manner or conduct. Professional comportment is critical in determining a nurse's effectiveness in relating, communicating, and collaborating with colleagues and members of the healthcare team. In the absence of professional comportment, a culture of incivility, nurse aggression, and compromised patient safety will emerge. Self-regulation and individual accountability are sequelae to professional comportment. The personal assimilation of professional comportment promotes mutual respect, harmony, commitment, and collaboration. The nurse, patient, and healthcare team are the beneficiaries of a nurse who demonstrates professional comportment.

Collaboration between hospital and primary care nurses: a literature review

BACKGROUND

Nurses play an important role in the treatment and care of adults in both hospital and primary health care working within complex and fragmented organizational systems. As the nature of health care changes and hospital and primary care sectors become more closely associated, nurses in both sectors have an obligation to increase their collaboration.

AIMS

This study aimed to increase the understanding of collaboration between nurses working with adults in hospital and primary health care, and to facilitate the future measurement of this collaboration.

METHODS

A literature review was undertaken in July and August 2013 using CINAHL and MEDLINE databases from the earliest to August 2013. The searches produced 4951 citations that were reduced to 22 articles for review using a four-step inclusion strategy. Inductive content analysis was used to analyse the data.

RESULTS

It is suggested that collaboration is a process that contains (1) collaboration precursors: the opportunity to participate, knowledge and shared objectives; (2) elements of collaboration: competency, awareness and understanding of work roles and interaction; and (3) processes and outcomes: the events or behaviours that are the consequences of the collaboration between hospital and primary healthcare nurses.

CONCLUSIONS

The results indicate that collaboration between hospital and primary healthcare nurses is an important and integral part of the work of nurses and a process consisting of several predictable issues leading to useful care outcomes.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Current healthcare changes make it a requirement for hospital and primary healthcare nurses to collaborate when working with adults to continue to meet the needs of patients. The findings of this study can be used to improve collaboration in practice and to devise research to improve collaboration between hospital and primary healthcare nurses.

The meaning of collaboration, from the perspective of Iranian nurses: a qualitative study

BACKGROUND

Interdisciplinary collaboration among nurses is a complex and multifaceted process, an essential element in nursing, which is crucial to maintain an efficient, safe, and viable medical setting. The aim of this study was to explore the meaning of concept of collaboration through conducting a qualitative research approach.

METHOD

The present study is qualitatively conducted in a content analysis approach. The data collection process included 18 unstructured and in-depth interviews with nurses during 2012-2013 in educational medical centers of west and northwest of Iran. A purposive sampling method was used. All the interviews were recorded, transcribed, and finally analyzed using a qualitative content analysis with a conventional method.

RESULT

Categories obtained from analysis of the data to explain the meaning of collaboration consist of (i) prerequisites of collaboration, (ii) actualization of collaboration, and (iii) achievement of a common goal.

CONCLUSION

The results of the present study ended in the discovery of meaning of collaboration that confirm results of other related studies, hence clarifying and disambiguating the concept under study. These results also contribute to the development of collaboration theories and the relevant measurement tools.

Collaboration amongst clinical nursing leadership teams: a mixed-methods sequential explanatory study

AIM

To explore intra-professional collaboration amongst nursing leadership teams at a tertiary referral hospital in Sydney.

BACKGROUND

Effective working within a wide network of alliances is critical to patient outcomes. An understanding of collaboration amongst nursing leadership teams is essential within this context.

METHODS

A sequential explanatory mixed-methods design was used. The Collaborative Behaviour scale was sent to 106 Nurse Unit Managers, Nurse Educators and Clinical Nurse Consultants to measure pairwise collaborative behaviours; two follow-up focus groups with 15 participants were conducted. Data were collected between May 2012 and May 2013. A thematic analysis of focus group data provided a detailed explanation of the questionnaire findings.

RESULTS

The findings identified high collaboration between dyad groups. Two themes emerged from the thematic analysis: (1) professional role and expectations; with sub-themes of transparency and clarity of individual roles; and intra/interpersonal aspects of role functioning; and (2) organisational infrastructure and governance.

CONCLUSION

These leadership teams can be effective and powerful vehicles for change and are central to optimum patient outcomes. Organisational strategic planning and evaluation can benefit from understanding how to promote collaborative behaviours in these nurse leaders.

IMPLICATIONS FOR NURSING MANAGEMENT

To date, little research has explored collaboration amongst nursing leadership teams. Successful collaboration may contribute to the efficient use of nursing resources; improve patient outcomes, and ultimately, nurse satisfaction and retention.

Development and psychometric testing of a scale assessing the sharing of medical information and interprofessional communication: the CSI scale

Background

Interprofessional collaboration is essential in creating a safer patient environment. It includes the need to develop communication and coordination between professionals, implying a better sharing of medical information. Several questionnaires exist in the literature, but none of them have been developed in the French context. The objective was to develop and test the psychometric properties of the communication and sharing information (CSI) scale which assesses specifically interprofessional communication, especially the sharing of medical information and the effectiveness of communication between members of the team.

Methods

The questionnaire construction process used a literature review and involved a panel of voluntary professionals. A list of 32 items explored the quality of shared information delivered to patients and the effectiveness of interprofessional communication. The study was conducted in 16 voluntary units in a University Hospital (France), which included medical, surgical, obstetrics, intensive care, pediatrics, oncology and rehabilitation care. The scale-development process comprised an exploratory principal component analysis, Cronbach’s α-coefficients and structural equation modeling (SEM).

Results

From these 16 units, a total of 503 health professionals took part in the study. Among them, 23.9% were physicians (n = 120), 43.9% nurses (n = 221) and 32.2% nurse assistants (n = 162).

The validated questionnaire comprised 13 items and 3 dimensions relative to “the sharing of medical information” (5 items), “communication between physicians” (4 items) and “communication between nurses and nurse assistants” (4 items). The 3 dimensions accounted for 63.7% of the variance of the final questionnaire. Their respective Cronbach’s alpha coefficients were 0.80, 0.87 and 0.81. SEM confirmed the existence of the 3 latent dimensions but the best characteristics were obtained with a hierarchical model including the three latent factors and a global “communication between healthcare professionals” latent factor, bringing the 8 items linked to communication together. All the structural coefficients were highly significant (P < 0.001).

Conclusions

This self-perception CSI scale assessing several facets of interprofessional communication is the first one developed in the French context. The development study exhibited excellent psychometric properties. Further psychometric analysis is needed to establish test-retest reliability, sensibility to change and concurrent validity.