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Nobrega S, Zhang Y. Let's Learn Together! A Mixed-Methods Study to Assess Readiness for Interprofessional Education on Total Worker Health® Practice. Workplace Health Saf 2024; 72:223-233. [PMID: 38217437 PMCID: PMC11132934 DOI: 10.1177/21650799231217320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Occupational safety and health (OSH) professionals increasingly need interdisciplinary collaborative practice competencies to respond to complex worker safety, health, and well-being risks. Effective collaboration with non-OSH-trained professionals (e.g., health promotion, human resources) is critical for planning integrated interventions that address work and non-work risks, consistent with a "Total Worker Health" (TWH) approach. Interprofessional education (IPE) pedagogy offers skill-building for interdisciplinary collaboration, but little attention has been given to IPE in OSH education and training literature. The goal of this study was to assess OSH professionals' perceptions about IPE to guide application in postgraduate TWH education. METHODS The mixed-methods study involved 210 U.S. professionals in safety (31%), industrial hygiene (16%), occupational nursing (12%) and medicine (11%), and related disciplines (30%). Participants completed a 12-item Readiness for Interprofessional Education Scale (RIPLS) adapted for TWH. Nineteen survey-takers also participated in virtual focus groups to share opinions about IPE benefits, barriers, and desirable course features. FINDINGS Occupational safety and health professionals reported high overall readiness for IPE (RIPLS, 4.45 ± 0.47), endorsing IPE for interdisciplinary skill-building. Salient IPE motivators were learning new perspectives from diverse disciplines and industries; gaining new subject expertise; developing common ground across disciplines; and learning TWH best practices. Participants recommended case studies to practice interdisciplinary problem-solving through group work. CONCLUSIONS/APPLICATION TO PRACTICE Interprofessional education is a promising pedagogy for OSH continuing education to promote interdisciplinary collaboration skills needed for TWH practice in the workplace. Occupational safety and health educators need to build competency in IPE pedagogical theory and practice to ensure effective training design and evaluation.
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Bulut A, Sengül H, Mumcu Çİ, Mumcu B. Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors. Nurs Ethics 2024:9697330241252971. [PMID: 38768998 DOI: 10.1177/09697330241252971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. OBJECTIVES In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. DESIGN The present study utilized a cross-sectional survey design following quantitative methods. METHODS This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59 years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. ETHICAL CONSIDERATION Research ethics approval was obtained from the researcher's university. RESULTS Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). DISCUSSION Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. CONCLUSION Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.
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Benjamins J, de Vet E, Haveman-Nies A. Enhancing interprofessional teamwork between youth care professionals using an electronic health record; a mixed methods intervention study. J Interprof Care 2024; 38:553-563. [PMID: 38414288 PMCID: PMC11018063 DOI: 10.1080/13561820.2024.2314461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
We aimed to investigate whether using a shared electronic patient record (EPR-Youth) strengthened interprofessional teamwork among professionals in youth care and child healthcare. Using a mixed-methods design, we compared two partly overlapping samples of professionals, who completed questionnaires before the introduction of EPR-Youth (n = 117) and 24 months thereafter (n = 127). Five components of interprofessional teamwork (interdependence, newly created professional activities, flexibility, collective ownership of goals, and reflection on processes) were assessed for this study. Midway through the study period, focus groups were held with 12 professionals to examine how EPR-Youth contributed to interprofessional teamwork. Professionals reported significantly more flexibility after the introduction of EPR-Youth than before. Professionals scored slightly -but not significantly- more positively on the other components of teamwork. Focus group participants reported that using EPR-Youth strengthened their sense of interdependence and collective ownership of goals, and contributed to newly created professional activities. At baseline, levels of interprofessional teamwork differed between organizations. Focus group participants confirmed these differences and attributed them to differences in facilitation of interprofessional teamwork. Our findings suggest that using EPR-Youth can foster interprofessional teamwork. Organizational differences underline that implementing an EPR alone is inadequate: shared definitions of teamwork and organizational facilities are needed to strengthen interprofessional teamwork.
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Affiliation(s)
- Janine Benjamins
- Icare JGZ, department Jeugdgezondheidszorg, Meppel, the Netherlands
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, the Netherlands
| | - Emely de Vet
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, the Netherlands
| | - Annemien Haveman-Nies
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, the Netherlands
- GGD Noord- en Oost-Gelderland, department Jeugdgezondheid, Warnsveld, the Netherlands
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Woodbridge HR, Norton C, Jones M, Brett SJ, Alexander CM, Gordon AC. Clinician and patient perspectives on the barriers and facilitators to physical rehabilitation in intensive care: a qualitative interview study. BMJ Open 2023; 13:e073061. [PMID: 37940149 PMCID: PMC10632869 DOI: 10.1136/bmjopen-2023-073061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES The objective of this study is to explore patient, relative/carer and clinician perceptions of barriers to early physical rehabilitation in intensive care units (ICUs) within an associated group of hospitals in the UK and how they can be overcome. DESIGN Qualitative study using semi-structured interviews and thematic framework analysis. SETTING Four ICUs over three hospital sites in London, UK. PARTICIPANTS Former ICU patients or their relatives/carers with personal experience of ICU rehabilitation. ICU clinicians, including doctors, nurses, physiotherapists and occupational therapists, involved in the delivery of physical rehabilitation or decisions over its initiation. PRIMARY AND SECONDARY OUTCOMES MEASURES Views and experiences on the barriers and facilitators to ICU physical rehabilitation. RESULTS Interviews were carried out with 11 former patients, 3 family members and 16 clinicians. The themes generated related to: safety and physiological concerns, patient participation and engagement, clinician experience and knowledge, teamwork, equipment and environment and risks and benefits of rehabilitation in intensive care. The overarching theme for overcoming barriers was a change in working model from ICU clinicians having separate responsibilities (a multidisciplinary approach) to one where all parties have a shared aim of providing patient-centred ICU physical rehabilitation (an interdisciplinary approach). CONCLUSIONS The results have revealed barriers that can be modified to improve rehabilitation delivery in an ICU. Interdisciplinary working could overcome many of these barriers to optimise recovery from critical illness.
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Affiliation(s)
- Huw R Woodbridge
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | | | - Stephen J Brett
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Caroline M Alexander
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Anthony C Gordon
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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Pantha S, Jones M, Gray R. Stakeholders' Perceptions of How Nurse-Doctor Communication Impacts Patient Care: A Concept Mapping Study. NURSING REPORTS 2023; 13:1607-1623. [PMID: 37987412 PMCID: PMC10661264 DOI: 10.3390/nursrep13040133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/26/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions on how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. A total of 20 patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size, suggesting that each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) on 09.07.2020 (osf.io/9np8v/) prior to recruiting the first participant.
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Affiliation(s)
- Sandesh Pantha
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Noorie, SA 5608, Australia;
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;
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Mäurer M, Staudacher J, Meyer R, Mäurer I, Lazaridis L, Müther M, Huber T, Sommer NP, Fleischmann DF, Käsmann L, Ziegler S, Kropf-Sanchen C, Wikert J, Pietzner K, Holzgreve A, Nestler T, Siech C, Sturm MJ, Sulzer S, Heinrich K, Stahler A. Importance of interdisciplinarity in modern oncology: results of a national intergroup survey of the Young Oncologists United (YOU). J Cancer Res Clin Oncol 2023; 149:10075-10084. [PMID: 37261525 PMCID: PMC10423150 DOI: 10.1007/s00432-023-04937-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE Modern, personalized treatment concepts in oncology require an interdisciplinary and multiprofessional collaboration. In addition to its relevance in patient care, interdisciplinary collaboration is also becoming increasingly important in clinical research as well as medical education and resident training in oncology. METHODS Between November 2021 and March 2022, an online survey was conducted among German early career research groups, represented by Young Oncologists United (YOU). The aim was to identify the status and need for interdisciplinarity at clinic, educational, and research levels. RESULTS A total of 294 participants completed the questionnaire in full. 90.7% of the respondents fully or predominantly agreed with the statement that interdisciplinary work plays a major role in their daily clinical work. 78.9% wished for more interdisciplinary collaboration. Of the 49.7% of participants who have never participated in an interdisciplinary research project, 80.1% said they would like to participate in such a study project in the future. Lack of time resources, too much organizational effort, and possible political conflicts between institutions were identified as factors that make practical implementation difficult. 74.1% declared their willingness to become active in an oncology early career research group. CONCLUSION Interdisciplinary collaboration has become increasingly important in oncology. Networks that span different disciplines could help to promote interdisciplinary research projects among young scientists and improve exchange in professional practice and education with the implication of improved patient care.
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Affiliation(s)
- Matthias Mäurer
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Jena, Germany.
| | - Jonas Staudacher
- Department of Gastroenterology, Rheumatology and Infectiology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Meyer
- Institute of Human Genetics and Genomic Medicine, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, University Hospital Aachen, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Bonn, Germany
| | - Irina Mäurer
- Department of Neurology, Neurooncology Center, University Hospital Jena, Jena, Germany
| | - Lazaros Lazaridis
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Medicine Essen, University Duisburg-Essen, Essen, Germany
| | - Michael Müther
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Tobias Huber
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - Nils P Sommer
- Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Daniel F Fleischmann
- Clinic and Polyclinic for Radiotherapy and Radiooncology, LMU Clinic Munich, LMU Munich, Munich, Germany
| | - Lukas Käsmann
- Clinic and Polyclinic for Radiotherapy and Radiooncology, LMU Clinic Munich, LMU Munich, Munich, Germany
| | - Sonia Ziegler
- Clinic and Polyclinic for Radiation Therapy and Radiooncology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Julia Wikert
- Clinic and Polyclinic for Palliative Medicine, LMU Klinikum München, Munich, Germany
| | - Klaus Pietzner
- Department of Gynecology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Adrien Holzgreve
- Clinic and Polyclinic for Nuclear Medicine, University Hospital Munich, LMU Munich, Munich, Germany
| | - Tim Nestler
- Clinic for Urology, Bundeswehr Central Hospital Koblenz, Koblenz, Germany
| | - Carolin Siech
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Max-Johann Sturm
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Jena, Germany
| | - Sabrina Sulzer
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
| | - Kathrin Heinrich
- Medical Clinic and Polyclinic III, University Hospital Munich, LMU Munich, Munich, Germany
| | - Arndt Stahler
- Charité University Medicine, Medical Clinic m. S. Hematology, Oncology and Tumor Immunology, Berlin, Germany
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Coelho N, Neves A, Gregório J. Physicians and nurses professional relationship with criminal investigation in dealing with survivors of sexual abuse: a scoping review. HEALTH & JUSTICE 2023; 11:33. [PMID: 37615818 PMCID: PMC10464451 DOI: 10.1186/s40352-023-00235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023]
Abstract
Survivors of sexual abuse and their families seek help from criminal law enforcement agencies and health professionals to obtain justice and health care. Many communities have implemented multi-professional collaborative models so that the victim's well-being is assured and the truth is established. However, there is a general lack of evidence on how to best articulate these teams with the healthcare professionals caring for the survivors.Therefore, this Scoping Review was conducted in order to analyze and to map the barriers and facilitators of the relationship between health professionals and the criminal investigation team in the care of survivors of sexual abuse. The methodology proposed by the Joanna Briggs Institute for Scoping Reviews was used, and the Bronstein five dimension model of interprofessional collaboration served as the basis for the analysis of barriers and facilitators. Quantitative, qualitative and mixed studies, primary and secondary sources, text and opinion documents were included. Content analysis was performed on the main findings of the collected studies. Twelve articles were identified and analyzed. Collaboration, communication, hierarchy, skills, confidentiality, and leadership emerged as key themes. Multidisciplinary Sexual Assault Nurse Examiner (SANE) and Sexual Assault Response Teams (SARTs) were implemented to coordinate care, but conflicting goals and values among professionals posed challenges. Communication failures and inadequate information sharing hindered collaboration. Neutral leaders who coordinate teams, minimize groupthink, and improve decision-making were found to be valuable. Engaging across disciplinary boundaries and addressing power dynamics were challenging but could be addressed through facilitation and conflict resolution. This review highlights the importance of effective collaboration and interaction within teams and with other professionals in the care of sexual abuse survivors.
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Affiliation(s)
- Nuno Coelho
- Instituto de Polícia Judiciária e Ciências Criminais (Institute for Judiciary Police and Criminal Science), Loures, Portugal.
- Center for Research in Biosciences and Health Technologies, CBIOS. Lusófona University, Lisbon, Portugal.
- Health Sciences PhD Program, U Alcalá, Madrid, Spain.
| | - Anabela Neves
- Instituto Nacional de Medicina Legal e Ciências Forenses (National Institute of Forensic Medicine and Forensic Science), Coimbra, Portugal
- Medical and Forensic Office of North Lisbon Area, Lisbon, Portugal
| | - João Gregório
- Center for Research in Biosciences and Health Technologies, CBIOS. Lusófona University, Lisbon, Portugal
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Dahlawi HH, Al Obaidellah MM, Rashid NA, Alotaibi AA, Al-Mussaed EM, Cheung MMM, Abuaish S, Cordero MAW. Defining Physician-Nurse Efforts toward Collaboration as Perceived by Medical Students. Healthcare (Basel) 2023; 11:1919. [PMID: 37444753 DOI: 10.3390/healthcare11131919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Collaboration between physicians and nurses is essential to healthcare delivery and is associated with high-quality patient care, greater patient satisfaction, and better health outcomes. Hence, it is imperative that doctors and nurses have a particular set of interprofessional collaboration skills. This descriptive cross-sectional study assessed how medical students in the pre-clinical and clinical years perceived attitudes toward collaboration between physicians and nurses in a hospital setting. The Jefferson Scale of Attitude toward Physician-nurse Collaboration (JSAPNC) was reverse-translated into Arabic for the current study. The results showed a total JSAPNC mean score of 46.55, lower than other medical students in other universities. In general, the results of the study showed no significant difference in the total JSAPNC score among medical students when analyzed according to age, clinical exposure, and year level, except in the two factors of JSAPNC: shared education and teamwork (p = 0.038) and caring as opposed to curing (p = 0.043). The findings of this study suggest the necessity of integrating interprofessional education (IPE) across the medical school curriculum because, as future physicians, medical students would be well equipped to treat their patients in partnership with their nursing colleagues.
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Affiliation(s)
- Hanan H Dahlawi
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - May M Al Obaidellah
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Najwa Abdur Rashid
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Amal A Alotaibi
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Eman M Al-Mussaed
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Mary Mae M Cheung
- College of Arts and Sciences, Notre Dame of Dadiangas University, General Santos City 9500, Philippines
| | - Sameera Abuaish
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Mary Anne Wong Cordero
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
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Penta S. Interdisciplinary Collaboration in International Crisis Medical Relief: A Look at the Nepal Earthquake and Ebola Relief Efforts. Disaster Med Public Health Prep 2023; 17:e305. [PMID: 36789768 DOI: 10.1017/dmp.2022.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE This study explores interprofessional collaboration among medical and non-medical personnel planning and implementing international crisis health and medical relief efforts, and how disciplinary and professional background influences these activities. METHODS This study analyzes semi-structured interviews with individuals involved in organizations medical or health services to the Ebola epidemic in West Africa (2014-2016) or the 2015 Nepal earthquake. RESULTS Disciplinary background, sometimes coupled with organization role, shaped how relief workers engaged in the process of planning and implementing crisis medical relief. There were 3 thematic areas where these differences emerged: issue focus, problem -solving approaches, and decision-making approaches. Solutions from the field emerged as a fourth theme. CONCLUSIONS The study demonstrates medical relief required collaboration across medical and non-medical professions and highlights the importance of relief workers' disciplinary background in shaping the planning and implementation of crisis medical relief. Successful collaboration requires that people involved in crisis relief communicate the relevance of their own expertise, identify limits of their own and others' disciplinary perspective(s), seek out strengths in others' expertise, and can identify/ respond appropriately to others who do not see their own disciplinary limits, as well as learn these skills before engaging in relief.
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Affiliation(s)
- Samantha Penta
- Department of Emergency Management and Homeland Security, University at Albany, State University of New York, Albany, NY, USA
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Kallio H, Salminen J, Tuominen M. Preparing students for interprofessional collaboration in services for children with special needs in Finland: A document analysis. INTERNATIONAL JOURNAL OF CARE COORDINATION 2023. [DOI: 10.1177/20534345231153813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction Multiple types of support and expertise are needed for the benefit of children with special needs, with the collaboration between psychologists, social workers and special education teachers playing a key role. Here, we studied the extent of their academic training in interprofessional collaboration. Methods A document analysis of 24 curricula with 1699 courses from eight Finnish universities was applied. The courses focused on interprofessional collaboration were selected for the analysis. The course information was analysed with descriptive statistical methods, content analysis and qualitative quantification. Results A total of 38 courses focused on interprofessional collaboration. The courses were often mandatory; however, in psychology, they were often optional. The content of the courses included the basis of interprofessional collaboration, collaboration skills, and service systems and network familiarity. Two courses were common for the social work, psychology and special education programmes. Various learning methods were used, with five courses being based on independent online self-study. Discussion Considering the need for studies focusing on interprofessional collaboration, it was contradictory that these were largely maintained within one discipline and some were realised as independent self-studies. The variability of the curricula may reflect on students’ professional skills. For the collaboration of professionals working with children with special needs, it is also needed to deepen familiarity with cross-sectional services and the school system.
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Affiliation(s)
- Hanna Kallio
- Faculty of Medicine, Sote Academy, University of Turku, Turku, Finland
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland
| | - Jaanet Salminen
- Faculty of Medicine, Sote Academy, University of Turku, Turku, Finland
- Faculty of Education, Department of Teacher Education, Centre for Research on Learning and Instruction (CERLI), University of Turku, Turku, Finland
| | - Miia Tuominen
- Faculty of Medicine, Sote Academy, University of Turku, Turku, Finland
- Faculty of Medicine, Department of Public Health Science, University of Turku, Turku, Finland
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Karukivi J, Leino-Kilpi H, Kuokkanen L, Kuusisto H, Rautava P, Seppänen L, Sulosaari V, Stolt M. Association between work empowerment and interprofessional collaboration among health care professionals working in cancer care settings. J Interprof Care 2023; 37:21-28. [PMID: 34979858 DOI: 10.1080/13561820.2021.1997949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study aimed to analyze work-related empowerment and interprofessional collaboration and to identify possible associations among healthcare professionals working in cancer care settings. A cross-sectional survey design was employed in this study. Healthcare professionals (n = 175) in one Finnish Cancer Center participating in the care of patients with cancer at least on a monthly basis took part in the study. The data were collected with three instruments: Interprofessional Collaboration and Leadership, Performance of an Empowered Personnel (PEN), and Work-related Empowerment Promoting Factors (WEP). The data were analyzed with descriptive statistics, Pearson and Spearman's correlation coefficients and multivariate analysis using generalized liner models. Healthcare professionals rated their work empowerment as rather high. Performance of an Empowered Personnel (PEN) was perceived as high (mean 4.08, SD 0.47). Promoting factors for Work Empowerment (WEP) were also assessed as high (mean 3.98, SD 0.61). Interprofessional collaboration in the cancer care setting was perceived as moderate (mean 2.94, SD 0.36). Managerial position explained work empowerment based on multivariate analysis. Work empowerment and interprofessional collaboration had a strong correlation. The results can be used in the leadership and management of interprofessional collaboration and in developing new structures to support health professionals' work empowerment. In the future, work empowerment needs to be promoted by constructing solutions and practices that support interprofessional collaboration and thus improve the quality of cancer care.
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Affiliation(s)
- Johanna Karukivi
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Liisa Kuokkanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Hannele Kuusisto
- Environmental and Energy Engineering, Turku University of Applied Sciences, Turku, Finland
| | - Päivi Rautava
- Public Health, University of Turku, Turku, Finland.,Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Laura Seppänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Virpi Sulosaari
- Department of Nursing Science, University of Turku, Turku, Finland.,Health and Well-being, Turku University of Applied Sciences, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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12
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Yılmaz G, Kıran Ş, Bulut HK. The mediating role of nurse-physician collaboration in the effect of organizational commitment on turnover intention. J Interprof Care 2023; 37:66-72. [PMID: 34978245 DOI: 10.1080/13561820.2021.2004099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite extensive research having been carried out on nurse-physician collaboration, there remains a paucity of evidence on how collaboration interacts with organizational commitment and its effect on turnover intention. This study aims to determine the mediating role of nurse-physician collaboration on the effect of organizational commitment on turnover intention. We used a cross-sectional design based on voluntary paper surveys from the inpatient clinics of six public hospitals in the north of Turkey. Data including measures of nurse-physician collaboration, organizational commitment, and turnover intention were collected from a convenience sample of the nurses (n = 212) and physicians (n = 109). Pearson's correlation analysis was used to determine the relationships between variables, and the mediating effect was analyzed with PROCESS Macro "Model 4" for IBM SPSS. Statistical significance was specified at 95% confidence intervals and two-tailed P values of <0.05 for all tests. While most of the participants were nurses (66%), 34% were physicians. For both nurses and physicians, organizational commitment and nurse-physician collaboration negatively affected the turnover intention. However, the mediating role of nurse-physician collaboration was only significant for nurses (b = -0.025). The results demonstrate the importance of harmony, joint decision-making, and responsibility-sharing between nurses and physicians concerning dedication, engagement, and job satisfaction, especially for nurses.
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Affiliation(s)
- Gökhan Yılmaz
- Department of Health Management, Karadeniz Technical University, Trabzon, Turkey
| | - Şafak Kıran
- Department of Health Management, Karadeniz Technical University, Trabzon, Turkey.,Department of Health Management, Sakarya University, Sakarya, Turkey
| | - Hacer Kobya Bulut
- Department of Nursing, Karadeniz Technical University, Trabzon, Turkey
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13
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Sørensen CA, Jeffery L, Falhof J, Harbig P, Roelsgaard K, Gram S, Olesen C. Developing and piloting a cross-sectoral hospital pharmacist intervention for patients in transition between hospital and general practice. Ther Adv Drug Saf 2023; 14:20420986231159221. [PMID: 36949765 PMCID: PMC10026123 DOI: 10.1177/20420986231159221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/06/2023] [Indexed: 03/19/2023] Open
Abstract
Background Healthcare is challenged by a rapidly growing group of patients with multi-morbidity and polypharmacy. Increasing activity and specialization puts pressure on healthcare sectors. Medication errors in cross-sectoral transition of patients are often seen. The aim of the study was to explore drug-related problems (DRPs) in the transition of patients between sectors and to develop and pilot-test a cross-sectoral hospital pharmacist intervention to overcome some of these problems. Methods DRPs in cross-sectoral transitions were explored from four perspectives; the literature, the primary and secondary healthcare sector and the patients. An intervention was developed from the findings through co-creation between pharmacists, doctors and a nurse. The intervention was piloted and evaluated from data on the included patients and the activities performed. Results DRPs in transitions from general practice (GP) to hospital were caused by inadequate focus on updating the Shared Medication Record (SMR). For patients being discharged, DRPs were described with multiple facets; for example, missing information on medication changes, lacking patient involvement and problems with dose-dispensed medicine or electronic prescriptions. An intervention with a pharmacist in a shared employment between Hospital Pharmacy and GP was developed and piloted. The intervention included medication reconciliation and updating SMR for patients referred to hospital; and medication review, overview of medication changes and follow-up telephone calls for patients discharged from hospital. The intervention identified and solved several DRPs; in this way, medication errors were avoided. Access to health records in both sectors was important in the identification and resolution of DRPs. Conclusion DRPs in cross-sectoral transitions are multifaceted and the experiences depend on the point of view. The cross-sectoral hospital pharmacist intervention identified and solved several DRPs and medication errors were avoided. The intervention made sense to both healthcare sectors and patients. Shared employment and unique access to health records in both sectors showed to be of importance in the identification and resolution of DRPs. Plain language summary Development and pilot-test of a pharmacist intervention for patients in transition between hospital and general practice Background: Healthcare is challenged by a rapidly growing group of patients with multiple chronic diseases treated with several drugs at the same time. The aim of the study was to explore drug-related problems in the transition of patients between the hospital and patients' general practitioner and to develop and pilot-test a pharmacist intervention to overcome some of these problems.Methods: Drug-related problems in patient transitions were explored from the perspectives of the hospital, the general practitioner, the patients and the literature. An intervention was developed from the findings by pharmacists, doctors and a nurse. The intervention was pilot-tested and evaluated from the descriptions of the included patients and activities performed.Results: Drug-related problems in transitions from general practice to hospital were caused by inadequate focus on updating the Shared Medication Record.For patients being discharged, drug-related problems were related to for examplemissing information on medication changessparse involvement of the patient in their own treatmentproblems with medicine dispensed on a dose dispensing machine at the local pharmacy.An intervention with a pharmacist in a shared employment between Hospital Pharmacy and general practice was developed and piloted. The intervention includedtalking to the patient about their medication and updating the Shared Medication Record for patients referred to hospitalmedication review, overview of medication changes and follow-up telephone calls for patients discharged from hospital to general practice.The intervention identified and solved several drug-related problems. Access to health records in both the general practice and at the hospital was important in the identification of drug-related problems.Conclusions: Drug-related problems in cross-sectoral transitions are multifaceted. The pharmacist intervention identified and solved several drug-related problems. The intervention made sense to the general practitioner, hospital and patients. Shared employment and unique access to health records in both the general practice and at the hospital showed to be of importance in the identification of drug-related problems.
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Affiliation(s)
| | - Linda Jeffery
- Hospital Pharmacy Central Denmark Region,
Clinical Pharmacy, Silkeborg, Denmark
| | | | - Philipp Harbig
- Research Unit for General Practice, Aarhus
University, Aarhus, Denmark
| | | | - Solveig Gram
- Emergency Department, Randers Regional
Hospital, Randers, Denmark
| | - Charlotte Olesen
- Hospital Pharmacy Central Denmark Region,
Research & Development, Aarhus, Denmark
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14
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Wnuk M. Beneficial Effects of Spiritual Experiences and Existential Aspects of Life Satisfaction of Breast and Lung Cancer Patients in Poland: A Pilot Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:4320-4336. [PMID: 35748968 PMCID: PMC9569296 DOI: 10.1007/s10943-022-01601-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Spiritual and existential issues are important factors for oncology patients' well-being. This study aimed to examine the beneficial role of spiritual experience, hope, and meaning in life for life satisfaction in patients diagnosed with breast and lung cancer. It was hypothesized that spiritual experiences and life satisfaction are indirectly related through hope, as well as meaning in life mediates the relationship between hope and life satisfaction. It was a pilot study with a sample consisting of 4 men and 46 women, 24-83 years of age oncology patients. The following measures were used: Cantril Ladder, Purpose in Life Test, Herth Hope Index as well as Daily Spiritual Experiences Scale. A sample of Polish patients with breast and lung cancer confirmed the beneficial effects of spiritual experiences and existential aspects of life for their life satisfaction. According to obtained results, hope was indirectly related to life satisfaction through meaning in life. Also, spiritual experiences were positively indirectly related to life satisfaction through the pathway of hope and meaning in life. Theoretical and practical implications of the achieved results were discussed.
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Affiliation(s)
- Marcin Wnuk
- Department of Work and Organizational Psychology, Adam Mickiewicz University, Szamarzewskiego Street 89AB, 60-568, Poznań, Poland.
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15
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Janke N, Shaw JR, Coe JB. Veterinary technicians contribute to shared decision-making during companion animal veterinary appointments. J Am Vet Med Assoc 2022; 260:1993-2000. [PMID: 36227805 DOI: 10.2460/javma.22.08.0380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe and compare veterinary professionals' use of shared decision-making during companion animal appointments. DESIGN Multi-practice cross-sectional study. SAMPLE A purposive sample of 4 companion animal veterinary clinics in a group practice in Texas. PROCEDURES A convenience sample of veterinary appointments were recorded January to March 2018 and audio-recordings were analyzed using the Observer OPTION5 instrument to assess shared decision-making. Each decision was categorized by veterinary professional involvement. RESULTS A total of 76/85 (89%) appointments included at least 1 decision between the client and veterinary professional(s), with a total of 129 shared decisions. Decisions that involved both a veterinary technician and veterinarian scored significantly higher for elements of shared decision-making (OPTION5 = 29.5 ± 8.4; n = 46), than veterinarian-only decisions (OPTION5 = 25.4 ± 11.50; P = .040; n = 63), and veterinary technician-only decisions (OPTION5 = 22.5 ± 7.15; P = .001; n = 20). Specific elements of shared decision-making that differed significantly based on veterinary professional involvement included educating the client about options (OPTION5 Item 3; P = .0041) and integrating the client's preference (OPTION5 Item 5; P = .0010). CLINICAL RELEVANCE Findings suggest that clients are more involved in decision making related to their pet's health care when both the veterinary technician and veterinarian communicate with the client. Veterinary technicians' communication significantly enhanced client engagement in decision-making when working collaboratively with the veterinarian.
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Affiliation(s)
- Natasha Janke
- 1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Jane R Shaw
- 1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Jason B Coe
- 2Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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16
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McLaughlin D, Hasson F, Reid J, Brazil K, Rutherford L, Stone C, van der Steen JT, Ballentine J. Evaluating a partnership model of hospice enabled dementia care: A three-phased monitoring, focus group and interview study. Palliat Med 2022; 36:1351-1363. [PMID: 36065098 PMCID: PMC9606481 DOI: 10.1177/02692163221116763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND People with dementia and their caregivers often lack equitable access to hospice care which is a concern internationally. Domains of best practice in palliative care for this population exist and hospices are urged to become dementia friendly. AIM This study aimed to evaluate the model of 'Hospice Enabled Dementia Partnership' mapped to international domains of best practice. DESIGN Three-phased monitoring, group interview and individual interview study using a formative evaluation framework. SETTINGPARTICIPANTS The partnership model was a collaboration between a large specialist palliative care hospice, a dementia charity and a Health Care Trust in the United Kingdom. Service documents were subjected to documentary review of monitoring activity and key indicators of service success. Group interviews and individual interviews took place with family carers (n = 12), health care professionals involved in delivering the service (n = 32) and senior professionals (n = 5) responsible for service commissioning in palliative or dementia care. RESULTS One hundred people with dementia were referred to the service between May 2016 and December 2017. Thirty-eight of the 42 people who died, achieved their preferred place of care and died at home. Four themes were derived from the data 'Impact of Dementia', 'Value of the Service', 'Information and Learning Needs' and 'Working in Partnership'. CONCLUSIONS Positive outcomes resulted from this best practice model; achievement of preferred place of care and death at home, dual benefits of therapies for patients and families and partnership in cross working and learning between services. Replication of this model should be considered internationally.
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Affiliation(s)
- Dorry McLaughlin
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University, Belfast, Northern Ireland
| | - Felicity Hasson
- Institute of Nursing and Health Research, Ulster University, Shore Road, Newtownabbey, Northern Ireland
| | - Joanne Reid
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University, Belfast, Northern Ireland
| | - Kevin Brazil
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University, Belfast, Northern Ireland
| | - Lesley Rutherford
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University, Belfast, Northern Ireland.,Belfast Health and Social Care Trust, Marie Curie Hospice, Belfast, Northern Ireland
| | - Carol Stone
- Belfast Health and Social Care Trust, Marie Curie Hospice, Belfast, Northern Ireland
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
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17
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Gallagher AL, Eames C, Roddy R, Cunningham R. The invisible and the non-routine: a meta-ethnography of intersectoral work in schools from the perspective of speech and language therapists and occupational therapists. J Interprof Care 2022; 37:662-673. [DOI: 10.1080/13561820.2022.2108774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Caitriona Eames
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Rosalie Roddy
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Roisin Cunningham
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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18
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Ikeda K, Sasada S. Development of a new scale for the measurement of interprofessional collaboration among occupational therapists, physical therapists and speech-language therapists. Hong Kong J Occup Ther 2022; 35:146-153. [DOI: 10.1177/15691861221111439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background/Objective The purpose of this study is to develop and validate an instrument to assess interprofessional collaboration by occupational therapists, physical therapists, and speech-language therapists. Methods Item development consisted of a review of interprofessional collaboration and group interviews with occupational therapists, physical therapists, and speech-language therapists. The developed items were surveyed on a 4-point Likert scale among occupational therapists, physical therapists, and speech-language therapists. Ceiling effects, floor effects, and item-total correlation analysis for each item, as well as constructs, internal consistency, and cross-cultural validity of the scales were evaluated. Results A total of 47 items were extracted for evaluation and 28 items with five factors (“team-oriented behavior,” “exchange of opinions,” “flexible response,” “sharing the whole picture of the patient,” and “coordination of support methods”) were retained after the evaluation. The correlation coefficients of the five factors ranged from 0.48 to 0.72. The total score of each factor and the total score of all 28 items were compared for occupational therapists, physical therapists, and speech-language therapists, and the result showed that was no statistically significant difference between the total scores of all factors and the job titles. The Cronbach’s alpha coefficients for the five factors are 0.842, 0.840, 0.805, 0.732, and 0.734 for the first, second, third, fourth, and fifth factors, respectively. Conclusions The developed scale includes items aimed at facilitating patients' activities of daily living through interprofessional collaboration, and its content reflects the expertise of occupational therapists, physical therapists, and speech-language therapists.
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Affiliation(s)
- Kohei Ikeda
- Department of Health & Social Work, School of Rehabilitation Div. Occupational Therapy, Kanagawa University of Human Services, Yokosuka, Japan
| | - Satoshi Sasada
- Department of Health & Social Work, School of Rehabilitation Div. Occupational Therapy, Kanagawa University of Human Services, Yokosuka, Japan
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19
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Zumstein-Shaha M, Grace PJ. Competency frameworks, nursing perspectives, and interdisciplinary collaborations for good patient care: Delineating boundaries. Nurs Philos 2022; 24:e12402. [PMID: 35761762 PMCID: PMC10078421 DOI: 10.1111/nup.12402] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 04/29/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. These are some of the reasons behind current movements to develop competency frameworks that can enhance cross-disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care.
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Affiliation(s)
- Maya Zumstein-Shaha
- Department of Health, Master of Science in Nursing Program, Adjunct Head of Program, Bern University of Applied Sciences, Bern, Switzerland.,Department of Nursing, Faculty for Health, University of Witten/Herdecke, Witten, Germany
| | - Pamela J Grace
- Boston College, William F. Connell School of Nursing, Boston, Massachusetts, USA
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20
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Horlait M, De Regge M, Baes S, Eeckloo K, Leys M. Exploring non-physician care professionals' roles in cancer multidisciplinary team meetings: A qualitative study. PLoS One 2022; 17:e0263611. [PMID: 35113976 PMCID: PMC8812975 DOI: 10.1371/journal.pone.0263611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/21/2022] [Indexed: 12/14/2022] Open
Abstract
The growing complexity of cancer care necessitates collaboration among different professionals. This interprofessional collaboration improves cancer care delivery and outcomes. Treatment decision-making within the context of a multidisciplinaire team meeting (MDTMs) may be seen as a particular form of interprofessional collaboration. Various studies on cancer MDTMs highlight a pattern of suboptimal information sharing between attendants. To overcome the lack of non-medical, patient-based information, it might be recommended that non-physician care professionals play a key patient advocacy role within cancer MDTMs. This study aims to explore non-physician care professionals' current and aspired role within cancer MDTMs. Additionally, the perceived hindering factors for these non-physician care professionals to fulfil their specific role are identified. The analysis focuses on nurses, specialist nurses, head nurses, psychologists, social workers, a head of social workers and data managers. The results show that non-physician care professionals play a limited role during case discussions in MDTMs. Neither do they actively participate in the decision-making process. Barriers perceived by non-physician care professionals are classified on two main levels: 1) team-related barriers (factors internally related to the team) and 2) external barriers (factors related to healthcare management and policy). A group of non-physician care professionals also belief that their information does not add value in the decision-making proces and as such, they underestimate their own role in MDTMs. To conclude, a change of culture is needed towards an interdisciplinary collaboration in which knowledge and expertise of different professions are equally assimilated into an integrated perspective to guarantee a true patient-centred approach for cancer MDTMs.
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Affiliation(s)
- Melissa Horlait
- Faculty of Medicine and Pharmacy, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Melissa De Regge
- Faculty of Economics and Business Administration, Department of Marketing, Innovation and Organisation, Ghent University, Ghent, Belgium
- Strategic Policy Cell, Ghent University Hospital, Ghent, Belgium
| | - Saskia Baes
- Faculty of Medicine and Pharmacy, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kristof Eeckloo
- Strategic Policy Cell, Ghent University Hospital, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Mark Leys
- Faculty of Medicine and Pharmacy, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
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21
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Sohrabizadeh S, Yousefian S, Jahangiri K, Mehrabi Y. Assessment of intraorganizational collaboration in the health sector during disasters: Exploring a valid and reliable assessment tool for disaster risk management. Int J Prev Med 2022; 13:10. [PMID: 35281987 PMCID: PMC8883676 DOI: 10.4103/ijpvm.ijpvm_696_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Collaboration, as a key factor in disaster risk management, is a mechanism that prevents the loss of time, investment, and resources. The variety of units in the health sector has made collaboration a major challenge. The present study aimed at developing a tool for assessing collaboration in the health sector during disasters. Methods: In this mixed-methods study, a questionnaire was developed by integrating the findings of a systematic literature review and a qualitative study. Face and content validation were performed. The reliability of the tool was tested through a 15-day interval test–retest by Cronbach's alpha and intraclass correlation coefficient (ICC) with 30 participants. Confirmatory factor analysis was done to test the validity and reliability of instrument using SmartPLS in a case study with 450 health sector staff. Results: The factors affecting intraorganizational collaboration of the health sector were identified in six categories and 19 subcategories by searching 46 articles in the systematic review and content analysis of 16 semistructured interviews with health sector staff. The results of content validity ratio (=0.81), content validity index (=0.92), Cronbach's alpha (=0.975), and ICC (=0.970) confirmed the validity and reliability of the tool. Convergent validity, discriminant validity, and reliability were approved by AVE (average variance extracted) >0.5, Fornell and Larcker matrix, and CR (composite reliability) >0.7. According to the positive result of R2, Q2, and goodness-of-fit (GOF) criteria, the model fit was confirmed. Conclusion: The results of validity and reliability measurements approved the proposed tool. The use of this tool is recommended for developing collaboration in the health sectors of different countries.
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22
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Kunze M, Machalicek W. Interdisciplinary teams: A model to support students with autism. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Megan Kunze
- Department of Special Education and Clinical Sciences University of Oregon Eugene Oregon USA
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23
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Allen D. Interdisciplinary leadership council: A model for excellence in improving interprofessional collaboration. Nurs Manag (Harrow) 2021; 52:51-54. [PMID: 34596618 DOI: 10.1097/01.numa.0000792052.82959.3d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Darcy Allen
- Darcy Allen is the chief nurse executive and vice president of operations at Health Park Medical Center in Fort Myers, Fla
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24
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Siekkinen M, Kuokkanen L, Kuusisto H, Leino-Kilpi H, Rautava P, Rekunen M, Seppänen L, Stolt M, Walta L, Sulosaari V. Work empowerment among cancer care professionals: a cross-sectional study. BMC Health Serv Res 2021; 21:502. [PMID: 34034734 PMCID: PMC8146678 DOI: 10.1186/s12913-021-06528-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 05/13/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND There is a growing understanding that empowerment of interprofessional personnel is linked to job satisfaction levels and quality of care, but little is known about empowerment in the context of cancer care. This study describes how interprofessional cancer care personnel perceive their performance and factors that promote work empowerment. METHODS This cross-sectional study enrolled 475 (45.2%) of the 1050 employees who work at a regional cancer centre. The participants used two self-administered questionnaires - the Performance of an Empowered Personnel (PEN) questionnaire and Work Empowerment Promoting Factors (WEP) questionnaire - to report perceptions of work empowerment. Both questionnaires' categories comprise moral principles, personal integrity, expertise, future orientation, and sociality. The data were analyzed using IBM SPSS Statistics, Versions 24 and 25. RESULTS Overall, the performance of work empowerment was evaluated as being rather high (overall sum score mean: 4.05; range: 3.51-4.41; scale: 1-5). The category that rated highest was moral principles (4.41), and the one rated lowest was the social category (3.51). The factors that promoted work empowerment also ranked high (3.93; range: 3.55-4.08; scale: 1-5), with personal integrity (4.08) the highest and future orientation (3.55) the lowest. Performance and factors that promoted work empowerment correlated positively, moderately, and highly statistically significantly (r = 0.531; p < 0.001). Statistically significant associations also were found between empowered performance of personnel and empowerment promoting factors (sex, education, leadership position, belonging to an interprofessional team, and time elapsed since training in interprofessional cooperation). CONCLUSION The personnel rated their performance and the factors perceived to promote work empowerment rather highly. Personal empowerment can be promoted through teamwork training and supportive management in interprofessional cancer care.
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Affiliation(s)
- Mervi Siekkinen
- Turku University Hospital, FICAN West Cancer Centre, P.O. Box 52, FI-20521, Turku, Finland.
| | | | | | - Helena Leino-Kilpi
- University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland
| | - Päivi Rautava
- University of Turku, Public Health and Turku University Hospital, Clinical Research Services, Turku, Finland
| | - Maijastiina Rekunen
- Turku University Hospital, FICAN West Cancer Centre, P.O. Box 52, FI-20521, Turku, Finland
| | - Laura Seppänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Minna Stolt
- University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland
| | - Leena Walta
- Turku University of Applied Sciences, Turku, Finland
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25
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Tschannen D, Alexander C, Taylor S, Tovar EG, Ghosh B, Zellefrow C, Milner KA. Quality improvement engagement and competence: A comparison between frontline nurses and nurse leaders. Nurs Outlook 2021; 69:836-847. [PMID: 33993986 DOI: 10.1016/j.outlook.2021.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nurses play a pivotal role in improving patient care. To maximize nurses' impact on quality, nurses must have quality improvement (QI) competence and engage fully in QI initiatives. PURPOSE To describe QI competence (knowledge, skills, and attitudes) among frontline nurses and leaders; and compare variations in competence among nursing roles, experience, and specialty areas. METHODS A total of 681 nurses at one heath system fully completed the Nursing Quality Improvement Practice tool electronically. FINDINGS Half of the respondents reported QI engagement (53.6%). Mean knowledge scores were 5.08 (SD 1.16, 7 items). Skill proficiency was low (M = 2.82, SD = 1.03; range 1-6) although QI attitudes were favorable (M = 3.76, SD = 0.63; range 1-5). Significant differences in skills and attitudes were identified by role. QI competence among nurses employed in various specialty areas were similar. DISCUSSION Strategies for increasing QI competence and engagement of nurses must be created and deployed in order to improve quality and safety.
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Affiliation(s)
- Dana Tschannen
- University of Michigan, School of Nursing, Ann Arbor, MI.
| | | | - Sarah Taylor
- University of Michigan Health System, Trauma Burn ICU, Ann Arbor MI
| | - Elizabeth G Tovar
- DNP Primary Care Track Coordinator University of Kentucky, Lexington, KY
| | | | - Cindy Zellefrow
- Academic Core at The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus, OH
| | - Kerry A Milner
- Sacred Heart University, Davis & Henley College of Nursing, Fairfield, CT
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Notko M, Husso M, Piippo S, Fagerlund M, Houtsonen J. Intervening in domestic violence: interprofessional collaboration among social and health care professionals and the police. J Interprof Care 2021; 36:15-23. [PMID: 33657958 DOI: 10.1080/13561820.2021.1876645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Encountering domestic violence victims, perpetrators and witnesses in the multiprofessional fields of health and social care and policing includes various challenges. Each professional group perceives domestic violence from its own perspective, linked to its position in the field, core tasks, institutional practices and organizational structures. In this study, we examine interprofessional collaboration among Finnish social and health care professionals and police officers, focusing on the practices and conceptions concerning domestic violence interventions. The data consists of 16 focus group interviews, involving a total of 67 interviewees from social and health care professions and the police. The results indicate that successful interprofessional collaboration requires comprehensive knowledge and education on domestic violence as a phenomenon, on the tasks and the duties of different professionals, as well as tolerance and flexibility in their joint efforts. However, the emphasis on professional relationships often shifts the focus from the institutional and structural challenges of interprofessional collaboration to individual interactions. Organizational barriers and differences in goals may impede good intentions from being materialized into concrete outcomes. These findings challenge all organizations and professionals working on domestic violence intervention to reconsider their training, practices and organizational arrangements.
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Affiliation(s)
- Marianne Notko
- Department of Social Sciences and Philosophy, University of Jyväskylä, Finland
| | - Marita Husso
- Faculty of Social Sciences, Tampere University, Finland
| | - Sisko Piippo
- Department of Social Sciences, University of Eastern Finland, Finland
| | - Monica Fagerlund
- Institute of Criminology and Legal Policy, University of Helsinki, Finland
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Austin-McClellan LE, Lisi AJ. An overview of the medical specialties most relevant to chiropractic practice and education. THE JOURNAL OF CHIROPRACTIC EDUCATION 2021; 35:72-79. [PMID: 32471312 PMCID: PMC7958654 DOI: 10.7899/jce-18-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 02/27/2019] [Accepted: 08/26/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The purpose of this article is to present an overview of the key medical and surgical specialties most likely relevant to chiropractic practice in the United States. Understanding the similarities and differences in the training and typical practices of these medical providers may enhance a chiropractor's likelihood to collaborate and increase participation in team-based care. METHODS This was a descriptive analysis to develop preliminary content on US medical physician specialties. Selection was informed by the authors' clinical experience with medical collaboration, along with results of previously published work on medical specialties most commonly reported to be involved in referral patterns with US chiropractors. Data from the Accreditation Council for Graduate Medical Education and individual specialty boards were synthesized through an iterative process, and supplemented by qualitative input from subject matter experts. Data were entered into tabular format for review and analysis. RESULTS We propose that the medical and surgical specialties most relevant to typical US chiropractic practice are internal medicine, family medicine, emergency medicine, physical medicine and rehabilitation, neurology, pain medicine, rheumatology, radiology, orthopedic surgery, and neurological surgery. There is overlap in scope of conditions and diagnostic and therapeutic tools utilized by various medical specialties. CONCLUSION This work describes 8 medical and 2 surgical specialties proposed to be most relevant to general chiropractic practice in the United States. The results may have relevance to interprofessional education and collaboration.
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Hazzard E, Walton K, McMahon AT, Milosavljevic M, Tapsell L. Collaborative, interprofessional nutritional care within head and neck cancer teams: an international multi-site qualitative study. J Interprof Care 2021; 35:813-820. [PMID: 33587011 DOI: 10.1080/13561820.2020.1865290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Evidence-based guidelines (EBGs) for patients with head and neck cancer (HNC) recommend that nutritional care is delivered by an interprofessional team inclusive of dietitians, doctors, nurses, and speech pathologists. Barriers to collaboration exist within interprofessional teams. However, research on this is currently lacking in the HNC setting, particularly with regard to the provision of nutritional care. This study aimed to explore what facilitates collaborative nutritional care for patients with HNC from the perspectives of different healthcare professionals. This qualitative study used a grounded theory approach. Healthcare professionals from two radiotherapy departments in the United States and two in Australia were interviewed. Forty-six interviews were completed with 17 radiation-oncologists, 12 nurses, eleven dietitians, and 6 speech-pathologists. Collaborative nutritional care for patients with HNC was underpinned by three categories and six sub-categories: access to dietitians (facilitated by funding for dietitians and the strength of evidence), communication (facilitated by team meetings, communication systems, and multidisciplinary clinics), and role-clarity (facilitated by non-clinical activities and respect). This study highlights opportunities for enhancing collaborative nutritional care within HNC teams. Further studies on the impact of the dietitian, interprofessional education, team meetings, and multidisciplinary clinics are required to promote collaborative nutritional care for HNC patients.
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Affiliation(s)
- Emily Hazzard
- Department of Nutrition and Dietetics, The Wollongong Hospital Illawarra Shoalhaven Local Health District, NSW, Australia.b School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW,
| | - Karen Walton
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia, .
| | - Anne-Therese McMahon
- Clinical Associate Professor, The Wollongong Hospital, School of Health and Society, University of Wollongong, Northfields Ave, Wollongong NSW, Australia
| | - Marianna Milosavljevic
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Linda Tapsell
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia,g School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW,
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Lemetti T, Puukka P, Stolt M, Suhonen R. Nurse-to-nurse collaboration between nurses caring for older people in hospital and primary health care: A cross-sectional study. J Clin Nurs 2021; 30:1154-1167. [PMID: 33460490 DOI: 10.1111/jocn.15664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/01/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Terhi Lemetti
- Department of Nursing Science, University of Turku, Turku, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Pauli Puukka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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Kaifi A, Tahir MA, Ibad A, Shahid J, Anwar M. Attitudes of nurses and physicians toward nurse-physician interprofessional collaboration in different hospitals of Islamabad-Rawalpindi Region of Pakistan. J Interprof Care 2021; 35:863-868. [PMID: 33430669 DOI: 10.1080/13561820.2020.1853079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Interprofessional collaboration (IPC) is crucial to efficient patient management in the modern healthcare setting. We sought to determine the attitudes of physicians and nurses working in different hospitals in the Islamabad-Rawalpindi region of Pakistan. We employed the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), a 15-item questionnaire that quantifies these attitudes in a meaningful way. Higher scores indicate a more positive attitude toward IPC. Four domains (shared education and teamwork, caring vs. curing, nurses' autonomy, and physicians' dominance) represent the intricate factors that influence IPC in a hospital setting. A total of 374 healthcare professionals responded. Nurses had significantly better opinions about IPC compared to physicians (mean: 50.81 vs. 47.48, p<.01). Nurses also outscored physicians in all four domains of the JSAPNC (education and collaboration 24.87 vs. 23.72 p<.001, caring vs. curing 10.88 vs. 9.42 p<.001, nurse's autonomy 10.89 vs. 10.51 p=.004, and physician's authority 4.17 vs. 3.82 p=.044). The results show that nurses in Pakistan value IPC more than their physician colleagues. Inculcating the importance of IPC through educational methods might help improve these attitudes.
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Affiliation(s)
- Abdullah Kaifi
- Final Year Medical Student, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Muhammad Abdullah Tahir
- Final Year Medical Student, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Almeera Ibad
- Final Year Medical Student, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Jannat Shahid
- Final Year Medical Student, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Mujahid Anwar
- Final Year Medical Student, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
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Abstract
Aim: To evaluate person-centred home visits as an interprofessional learning (IPL) activity for undergraduate students during clinical placements in primary healthcare. Background: Interprofessional collaboration is known to improve patient safety, increase job satisfaction, and reduce stress among healthcare professionals. Students should already during their basic training experience interprofessional collaboration. Methods: Students from six different educational programmes and supervisors and adjunct clinical lecturers from different professions participated in the learning activity. The students read a description of the patient history before the visit together with a supervisor. During the home visit, the students were responsible for history-taking and for performing relevant examinations. Afterwards, the students made a joint care plan for the patient. Students, supervisors, and adjunct clinical lecturers discussed the outcomes in a seminar and reflected on each other’s professional roles. The students and the patients answered a questionnaire about the activity, and the supervisors and the adjunct clinical lecturers were interviewed in focus groups. Findings: Thirty interprofessional home visits were conducted, involving 109 students from six different healthcare professions. The students reported that they had gained insights into how different professions could collaborate and an increased understanding of teamwork. All patients were satisfied with the visits and felt that they had been listened to. The interview analysis showed one overarching theme: ‘Interprofessional home visits in primary healthcare were an appreciated and effective pedagogical learning activity with a sustainability dependent on organisational factors’. Conclusions: The students felt that participation in the activity increased their understanding of collaboration and of other professions’ skills. The supervisors found the home visits to be an appreciated and effective learning activity. The results indicate that this learning activity can be used in primary healthcare settings to promote students’ IPL, but organisational factors need to be considered in order to support sustainability.
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Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, Ellwood L. Implications for COVID-19: A systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic. Int J Nurs Stud 2020; 111:103637. [PMID: 32919358 PMCID: PMC7206441 DOI: 10.1016/j.ijnurstu.2020.103637] [Citation(s) in RCA: 379] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. OBJECTIVES To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. DESIGN This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. DATA SOURCES A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. REVIEW METHODS All studies describing nurses' experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. RESULTS Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. CONCLUSIONS Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses' require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Heidi Lord
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Laura Ellwood
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia.
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Turnbull LL, Carr SM. The Collaboration Compass: A Preliminary Model for Navigating Collaborative Practice. J Multidiscip Healthc 2020; 13:1107-1120. [PMID: 33116557 PMCID: PMC7548325 DOI: 10.2147/jmdh.s257160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the meaning and manifestation of collaboration in practice including the experience and outcomes for patients and professionals. Methods Grounded theory was used to investigate collaboration in an integrated outpatient parenteral antimicrobial therapy (OPAT) service. The sample consisted of staff and patients with experience of OPAT. Interviews and focus groups were used to generate data, and grounded theory methods were used to progress the study through constant comparative analysis and theoretical sampling to data saturation. Coding, categorizing, and techniques of situational analysis were used to analyze data and develop theory. Results The relationship between the influences in the situation and the interaction which takes place between individuals was found to produce four different types of collaboration: developing, maintaining, limiting, and disrupting collaboration. The collaboration compass model was developed to illustrate and aid interactive navigation of collaborative situations. Discussion The findings present the complexity of practice, and a model to explain the multiple influences and interaction which shape collaboration. In this model, patients are part of collaboration, and this ensures that patients’ views and experiences, as well as those of professionals, are included and represented in knowledge about collaboration. This adds a new dimension to existing interprofessional presentations of collaborative practice and examines collaboration as it is operationalized in practice and co-constructed between patients and professionals during day to day practice.
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Affiliation(s)
- Lindy L Turnbull
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Susan M Carr
- Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Kruse JA, Litten JP, Kujawa J, Chatman N, Didion J. Project REACH: A multi-level, interdisciplinary approach to enhance student retention and success. J Prof Nurs 2020; 36:364-371. [PMID: 33039071 DOI: 10.1016/j.profnurs.2020.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND An escalating nursing shortage brought attention to nursing student retention and success including graduation and licensure. PURPOSE The purpose of this Health Resources and Services Administration (HRSA) project, Realizing Educational Attainment and Careers in Healthcare (REACH), was to increase nursing progression and graduation rates for undergraduate nursing students from diverse and/or under-resourced backgrounds. METHODS REACH goals focused on four levels: 1) Individual: Neutralize the impact of economic-environmental factors that are barriers for diverse and under-resourced populations to pursue a BSN, 2) Group: Bridge gaps within a social determinants framework to achieve progression and graduation, 3) Institutional: Broaden the cultural competence of faculty on campus and 4) Community: Expand the knowledge and skills of the social determinants of health and cultural competence for nurses within the largest nursing employer in the community. RESULTS 92% (35/38) of participants graduated with a BSN and 91% (32/35) of these graduates are employed as registered nurses. Sixty percent (n = 35) of participants are employed in HRSA designated Health Professional Shortage Areas or in Medically Underserved Areas/Populations as compared to 24% (n = 79) of College of Nursing students. CONCLUSION An interdisciplinary approach to addressing social determinant needs allowed this project to successfully diversify the nursing workforce.
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Affiliation(s)
- Julie A Kruse
- Oakland University, School of Nursing, 433 Meadow Brook Road, Rochester, MI 48309-4452, United States of America.
| | - Joyce P Litten
- Lourdes University, College of Social Sciences, 6832 Convent Boulevard, Sylvania, OH 43560-2898, United States of America.
| | - Jean Kujawa
- Lourdes University, College of Business and Leadership, 6832 Convent Boulevard, Sylvania, OH 43560-2898, United States of America.
| | - Nydia Chatman
- Lourdes University, College of Nursing, 6832 Convent Boulevard, Sylvania, OH 43560-2898, United States of America.
| | - Judy Didion
- Oakland University, School of Nursing, 433 Meadow Brook Road, Rochester, MI 48309-4452, United States of America.
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Moilanen T, Leino-Kilpi H, Kuusisto H, Rautava P, Seppänen L, Siekkinen M, Sulosaari V, Vahlberg T, Stolt M. Leadership and administrative support for interprofessional collaboration in a cancer center. J Health Organ Manag 2020; ahead-of-print. [PMID: 32894012 DOI: 10.1108/jhom-01-2020-0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The interprofessional collaboration is a key practice for providing cancer care. However, the realization of collaboration requires effective leadership and administrative support. In this study, the aim was to analyze healthcare professionals' perceptions of leadership and administrative support (strategic and management) in interprofessional collaboration for developing practices in cancer care. DESIGN/METHODOLOGY/APPROACH A descriptive survey design was used to collect data from healthcare professionals (n = 350, response rate 33.3%), including nurses, physicians and other professionals participating in patient care in one Finnish cancer center (out of five) in 05/2018-10/2018. The data were analyzed using descriptive and inferential statistics. The instrument focused on leadership in the work unit and administrative support including organization strategy and organizational management. FINDINGS Healthcare professionals perceived leadership in the work unit, organization strategy and management for the support of interprofessional collaboration as weak. However, the ratings of male respondents and those in leading positions were more positive. The findings indicate that healthcare professionals in the cancer care setting are dissatisfied with the leadership and administrative support. RESEARCH LIMITATIONS/IMPLICATIONS Interprofessional collaboration, including its leadership, requires systematic and constant evaluation and development. ORIGINALITY/VALUE Healthcare leaders in the cancer care setting can use the results to identify factors that might be in need of attention and development in the field of interprofessional collaboration.
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Affiliation(s)
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | | | - Päivi Rautava
- University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Laura Seppänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Virpi Sulosaari
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Sciences, Turku, Finland
| | - Tero Vahlberg
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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Auvinen KJ, Räisänen J, Voutilainen A, Jyrkkä J, Mäntyselkä P, Lönnroos E. Interprofessional Medication Assessment has Effects on the Quality of Medication Among Home Care Patients: Randomized Controlled Intervention Study. J Am Med Dir Assoc 2020; 22:74-81. [PMID: 32893136 DOI: 10.1016/j.jamda.2020.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Multimorbidity and complex medications increase the risk of medication-related problems, especially in vulnerable home care patients. The objective of this study was to examine whether interprofessional medication assessment has an effect on medication quality among home care patients. DESIGN The FIMA (Finnish Interprofessional Medication Assessment) study was a randomized, controlled study comparing physician-led interprofessional medication assessment and usual care. SETTING AND PARTICIPANTS The FIMA study was conducted in home care settings in Finland. The participants were ≥65-year-old home care patients with ≥6 drugs daily, dizziness, orthostatic hypotension, or a recent fall. METHODS Primary outcome measures over the 6-month follow-up were number of drugs, drug-drug-interactions, medication-related risk loads, and use of potentially inappropriate medications (PIMs) examined by SFINX, RENBASE, PHARAO, and Meds75+ databases. The databases classified information as follows: A (no known pharmacologic or clinical basis for an increased risk), B (evidence not available/uncertain), C (moderately increased risk which may have clinical relevance), and D (high risk, best to avoid). Logistic regression adjusted for age, sex, and the baseline level of the outcome measure served as statistical methods. RESULTS The mean number of all drugs for home care patients (n = 512) was 15. The odds of drug-induced impairment of renal function (RENBASE D, P = .020) and medication-related risk loads for bleeding (PHARAO D, P = .001), anticholinergic effects (PHARAO D, P = .009), and constipation (PHARAO D, P = .003) decreased significantly in the intervention group compared with usual care. The intervention also reduced the odds of using PIMs (Meds75+ D, P = .005). There were no significant changes in drug-drug-interactions or number of drugs. CONCLUSIONS AND IMPLICATIONS FIMA intervention improved the medication quality of home care patients. Risks for renal failure, anticholinergic effects, bleeding, constipation, and the use of PIMs were reduced significantly.
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Affiliation(s)
- Kati J Auvinen
- The East Savo Hospital District, Savonlinna, Finland; Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Johanna Räisänen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Johanna Jyrkkä
- Assessment of Pharmacotherapies, Finnish Medicines Agency, Kuopio, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; Kuopio University Hospital, Primary Health Care Unit, Kuopio, Finland
| | - Eija Lönnroos
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Alvarez C, Saint-Pierre C, Herskovic V, Sepúlveda M, Prieto F. Analysis of the relationship between treatment networks and the evolution of patients with Type 2 Diabetes Mellitus. J Biomed Inform 2020; 108:103497. [PMID: 32621884 DOI: 10.1016/j.jbi.2020.103497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 04/21/2020] [Accepted: 06/24/2020] [Indexed: 11/28/2022]
Abstract
Type 2 Diabetes Mellitus (T2DM) is a chronic disease that has been increasing in prevalence in recent years and that can cause severe complications. To ensure patient care is administered correctly, it is necessary for medical treatment teams to be both multidisciplinary and cohesive. The analysis of health processes is a constant challenge due to their high variability and complexity. This paper proposes a method based on the analysis of social networks to detect treatment networks, and to identify a relationship between these networks and patient evolution, as measured by glycated hemoglobin (HbA1c) levels. The networks were segmented based on patient adherence to their medical appointments and their mean time of delay. We applied this method on a sample of 1574 patients diagnosed with T2DM. Results show that participatory treatment -in which a patient sees a particular group of professionals on a recurrent basis - together with high levels of adherence are associated to those patients who improve their HbA1c levels in the case of high levels of adherence, while those who continually experience referrals to different professionals, remain unstable and, in some cases, get worse. On the other hand, in order to maintain a patient as stable, continuous control of the patient is enough, regardless of the recurrence to the same professionals.
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Affiliation(s)
- Camilo Alvarez
- Computer Science Department, School of Engineering, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Santiago, Chile.
| | - Cecilia Saint-Pierre
- Computer Science Department, School of Engineering, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Santiago, Chile.
| | - Valeria Herskovic
- Computer Science Department, School of Engineering, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Santiago, Chile.
| | - Marcos Sepúlveda
- Computer Science Department, School of Engineering, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Santiago, Chile.
| | - Florencia Prieto
- Family Medicine Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Courtenay M, Burnett E, Castro-Sánchez E, Du Toit B, Figueiredo RM, Gallagher R, Gotterson F, Kennedy H, Manias E, McEwen J, Ness V, Olans R, Padoveze MC. Preparing nurses for COVID-19 response efforts through involvement in antimicrobial stewardship programmes. J Hosp Infect 2020; 106:176-178. [PMID: 32531230 PMCID: PMC7283056 DOI: 10.1016/j.jhin.2020.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 10/25/2022]
Affiliation(s)
- M Courtenay
- School of Health Sciences, Cardiff University, Cardiff, UK.
| | - E Burnett
- School of Health Sciences, University of Dundee, Scotland, UK
| | - E Castro-Sánchez
- NIHR Health Protection Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK
| | - B Du Toit
- Mediclinic Southern Africa, Stellenbosch, South Africa
| | | | | | - F Gotterson
- The University of Melbourne, National Centre for Antimicrobial Stewardship, Australia
| | | | - E Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Australia
| | | | - V Ness
- Glasgow Caledonian University, Glasgow, UK
| | - R Olans
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - M C Padoveze
- School of Nursing, University of São Paulo, Brazil
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Klode K, Ringer A, Hølge-Hazelton B. Interprofessional and intersectoral collaboration in the care of vulnerable pregnant women: An interpretive study. J Interprof Care 2020:1-10. [PMID: 32436756 DOI: 10.1080/13561820.2020.1761306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/27/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
'Vulnerable' is a term often used for pregnant women in need of extended antenatal care, although the term is not well defined. This study focuses on healthcare professionals' interpretations and understanding of vulnerability in pregnancy, including their own role, to understand the practices of interprofessional and intersectoral collaboration in antenatal care for vulnerable pregnant women. Intrepretive Description informed the methodology of the study and the theoretical framework was inspired by Symbolic Interactionism. It was found that definitions of vulnerability in pregnancy are fluid, being based on the healthcare professional's individual assessment of the pregnant woman´s personal resources, personal characteristics and psychological factors, and that these definitions also depend on the healthcare professional's role in relation to the pregnant woman. The different interprofessional teams' identification of what constitutes vulnerability in a pregnant woman was complex and relied on different components. Interprofessional collaboration was influenced by the relationships between professionals and sectors involved in antenatal care for pregnant women and was thereby influenced by the settings and structures in place for interprofessional and intersectoral collaboration. Insight into the healthcare professionals' perspectives of vulnerability in pregnancy can help develop and improve the interprofessional and intersectoral collaboration in antenatal care of vulnerable pregnant women and their unborn babies.
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Affiliation(s)
- Karina Klode
- Management of Psychiatry, Psyhciatry, Region Zealand, Slagelse, Denmark
| | - Agnes Ringer
- Research Center in Health Promotion, Roskilde University, Roskilde, Denmark
| | - Bibi Hølge-Hazelton
- Research Support Unit, Zealand University Hospital, Roskilde, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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40
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Feng S, Kirkley A. Mixing Patterns in Interdisciplinary Co-Authorship Networks at Multiple Scales. Sci Rep 2020; 10:7731. [PMID: 32382037 PMCID: PMC7206138 DOI: 10.1038/s41598-020-64351-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022] Open
Abstract
There are inherent challenges to interdisciplinary research collaboration, such as bridging cognitive gaps and balancing transaction costs with collaborative benefits. This raises the question: Does interdisciplinary research collaboration necessarily result in disciplinary diversity among collaborators? We aim to explore this question by assessing collaborative preferences in interdisciplinary research at multiple scales through the examinination of disciplinary mixing patterns at the individual, dyadic, and team level in a coauthor network from the field of artificial intelligence in education, an emerging interdisciplinary area. Our key finding is that disciplinary diversity is reflected by diverse research experiences of individual researchers rather than diversity within pairs or groups of researchers. We also examine intergroup mixing by applying a novel approach to classify the active and non-active researchers in the collaboration network based on participation in multiple teams. We find a significant difference in indicators of academic performance and experience between the clusters of active and non-active researchers, suggesting intergroup mixing as a key factor in academic success. Our results shed light on the nature of team formation in interdisciplinary research, as well as highlight the importance of interdisciplinary training.
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Affiliation(s)
- Shihui Feng
- Unit of Human Communication, Development, and Information Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, China
| | - Alec Kirkley
- Department of Physics, University of Michigan, Ann Arbor, USA.
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41
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Retrouvey H, Zhong T, Gagliardi AR, Baxter NN, Webster F. How Ineffective Interprofessional Collaboration Affects Delivery of Breast Reconstruction to Breast Cancer Patients: A Qualitative Study. Ann Surg Oncol 2020; 27:2299-2310. [PMID: 32297084 DOI: 10.1245/s10434-020-08463-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite the benefits of breast reconstruction (BR), health care professionals do not consistently integrate it as an option in the treatment of breast cancer patients. Interprofessional collaboration (IPC) amongst professionals may facilitate the elaboration of comprehensive oncological treatment plans. As the application of IPC in the delivery of BR has not yet been studied, we undertook a qualitative study to explore the perceptions of physicians and administrators on IPC in breast cancer care and how these impact BR delivery. METHODS Interviews were conducted with 30 participants (22 physicians and 8 administrators). Physician interviews focused on their personal beliefs and values regarding BR, while administrator interviews explored their institutional treatment regimens as well as the availability of a BR program. Our thematic analysis was informed by the Canadian Interprofessional Health Collaborative (CIHC) competency framework. RESULTS IPC challenges were thought by participants to affect the delivery of BR. At the physician level, a lack of role clarity as well as the absence of an explicitly established leader negatively influence collaboration in BR delivery. In addition, varying views on the usefulness of BR and on the role of plastic surgeons in breast oncological teams discourage positive collaboration, rendering the delivery of BR more difficult. CONCLUSIONS The delivery of BR is overall impaired due to a lack of effective IPC. IPC could be improved through clarifying physician roles, establishing clear leadership, and aligning viewpoints on quality oncological care in collaborative teams; ultimately, this may promote equitable BR delivery for breast cancer patients.
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Affiliation(s)
- Helene Retrouvey
- Division of Plastic and Reconstructive Surgery, Toronto General Hospital, Toronto, ON, Canada.
| | - Toni Zhong
- Division of Plastic and Reconstructive Surgery, Toronto General Hospital, Toronto, ON, Canada
| | | | - Nancy N Baxter
- Department of Surgery and LiKa Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | - Fiona Webster
- Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Canada
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42
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Flores-Sandoval C, Sibbald S, Ryan BL, Orange JB. Healthcare teams and patient-related terminology: a review of concepts and uses. Scand J Caring Sci 2020; 35:55-66. [PMID: 32236976 DOI: 10.1111/scs.12843] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/26/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Discussions concerning health care teams and patient-related terminology remain an ongoing debate. Terms such as interdisciplinary, multidisciplinary and transdisciplinary, as well as interprofessional are ambiguously defined and frequently used, rightly or wrongly, interchangeably. Also, clarification on the terminology regarding patients is rarely explicitly addressed in the health care team's literature, potentially resulting in confusion among health professional students, novice researchers, and practitioners. METHODS A structured literature review was conducted. Electronic searches were performed from August 2018 to September 2019 on the following databases: CINHAL, Scopus, Science Direct, PubMed, Nursing and Allied Health and JSTOR. The following terms were used: 'terminology', 'team(s)', 'nursing', 'health', 'medical', 'education', 'interprofessional', 'interdisciplinary', 'multidisciplinary', 'transdisciplinary', 'collaboration', 'patient', 'client', 'customer', 'user' and 'person'. RESULTS Small but significant nuances in the use of language and its implications for patient care can be made visible for health professional education and clinical practice. Healthcare is necessarily interdisciplinary and therefore we are obligated, and privileged, to think more critically about the use of terminology to ensure we are supporting high-quality evidence and knowledge application. CONCLUSION To avoid confusion and lack of consistency in the peer-review literature, authors should be encouraged to offer brief definitions and the rationale for the use of a particular term or group of term. In addition, a deeper understanding of the values that each patient-related term represents for particular disciplines or health care professions is essential to achieve a more comprehensive conceptual rigour.
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Affiliation(s)
- Cecilia Flores-Sandoval
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Shannon Sibbald
- Department of Family Medicine, Faculty of Health Sciences, School of Health Studies, Schulich School of Medicine and Dentistry, The Schulich Interfaculty Program in Public Health, Western University, London, ON, Canada
| | - Bridget L Ryan
- Centre for Studies in Family Medicine, Department of Family Medicine, Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Joseph B Orange
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, ON, Canada.,School of Communication Sciences and Disorders, Western University, London, ON, Canada.,Canadian Centre for Activity and Aging, Western University, London, ON, Canada
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43
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Samuriwo R, Laws E, Webb K, Bullock A. "I didn't realise they had such a key role." Impact of medical education curriculum change on medical student interactions with nurses: a qualitative exploratory study of student perceptions. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:75-93. [PMID: 31392511 PMCID: PMC7018789 DOI: 10.1007/s10459-019-09906-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 07/29/2019] [Indexed: 05/05/2023]
Abstract
Interprofessional teamwork between healthcare professionals is integral to the delivery of safe high-quality patient care in all settings. Recent reforms of medical education curricula incorporate specific educational opportunities that aim to foster successful interprofessional collaboration and teamwork. The aim of this study was to explore the impact of curriculum reform on medical students' perceptions of their interactions and team-working with nurses. We gathered data from 12 semi-structured individual narrative interviews with a purposive sample of male (n = 6) and female (n = 6) medical students from fourth year (n = 6 following an integrated curriculum) and fifth year (n = 6 following a traditional curriculum). Data were subject to narrative analysis which was undertaken using NVivo software. Overall, there was no notable difference in the responses of the participants on the traditional and integrated curricula about their interactions and team work with nurses. However, the introduction of an integrated medical curriculum was viewed positively but a lack of interprofessional education with nursing students, removal of a nursing placement and shorter clinical placements were perceived as lost opportunities for the development of educationally beneficial relationships. The participants reported that nurses play a number of roles in clinical practice which underpin patient safety including being medical educators who provide a valuable source of support for medical students. The participants highlighted different factors that could hinder or foster effective working relationships such as a lack of understanding of nurses' different professional roles and mutual respect. Medical education needs to provide students with more structured opportunities to work with and learn from nurses in clinical practice. Further research could explore how to foster positive relationships between medical students and nurses.
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Affiliation(s)
- Ray Samuriwo
- School of Healthcare Sciences, Cardiff University, Ty Dewi Sant, Heath Park Campus, Cardiff, CF14 4XN UK
- Wales Centre for Evidence Based Care, Cardiff University, Cardiff, UK
| | - Elinor Laws
- School of Medicine, Cardiff University, Cardiff, UK
| | - Katie Webb
- Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, UK
| | - Alison Bullock
- Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), School of Social Sciences, Cardiff University, Cardiff, UK
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44
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Newman AR, Linder L, Haglund K. The Nurse's Role in Prognosis-Related Communication in Pediatric Oncology Nursing Practice. J Pediatr Oncol Nurs 2019; 37:313-320. [PMID: 31833447 DOI: 10.1177/1043454219891989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The experiences of pediatric oncology nurses with prognosis-related communication (PRC) remain largely unknown. The purpose of this article is to report results of focus groups wherein 15 pediatric oncology nurses from three Midwestern pediatric cancer programs provided descriptions of PRC and how they experience PRC within their daily practice. Data from focus groups were analyzed via an interpretive descriptive approach, which resulted in three themes: (1) nurses' operational definition of PRC, (2) nurses' roles in PRC, and (3) nurses' preparation for engagement in PRC. From discussions within the focus groups, nurses recognized that PRC occurs across a continuum. Nurses distinguished that the definition of PRC expands beyond simply reporting life expectancy to describing the consequences of cancer- and treatment-related toxicities and effects. When nurses are not actively invited by their physician partners to participate in PRC, nurses will often develop workarounds to ensure that they understand what was said to patients and families. This allows them to function more effectively as supporters, advocates, and informants. Nurses described little preparation to participate in such challenging conversations. Pediatric oncology nurses need to acknowledge and embrace that they are an integral part of PRC. Interprofessional communication training is necessary to enhance the comfort and confidence of nurses engaging in PRC.
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Affiliation(s)
- Amy R Newman
- Marquette University, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Wauwatosa, WI, USA
| | - Lauri Linder
- University of Utah, Salt Lake City, UT, USA.,Primary Children's Medical Center, Salt Lake City, UT, USA
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45
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Moilanen T, Leino-Kilpi H, Koskela I, Kuusisto H, Siekkinen M, Sulosaari V, Vahlberg T, Stolt M. Healthcare professionals' perceptions of the pre-requisites and realisation of interprofessional collaboration in cancer care. Eur J Cancer Care (Engl) 2019; 29:e13197. [PMID: 31815334 DOI: 10.1111/ecc.13197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/21/2019] [Accepted: 11/21/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this study is to describe the pre-requisites and realisation of interprofessional collaboration as perceived by healthcare professionals working in the cancer care setting and to produce knowledge to support the development of collaborative practices. METHODS This study employed a descriptive survey design. The data were collected in one Finnish cancer centre between May and October 2018 from nurses, physicians and other healthcare professionals using an electronic survey (n = 350). The survey focused on the pre-requisites of interprofessional collaboration (appreciation and competence) and its realisation in cancer care. The data were analysed using descriptive and interferential statistics. RESULTS The pre-requisites of interprofessional collaboration were perceived as good and the collaboration was well realised in the cancer centre. The perceptions of pre-requisites and realisation were associated with each other. Male respondents, physicians and professionals belonging to interprofessional teams had more positive perceptions of the pre-requisites and realisation of interprofessional collaboration than others. CONCLUSION The findings indicate that the pre-requisites of interprofessional collaboration and its realisation seem to be well implemented in the cancer care setting. However, the ongoing evaluation of interprofessional collaboration requires further attention from healthcare administration and professionals to support the systematic development of collaborative practices.
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Affiliation(s)
- Tanja Moilanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Inka Koskela
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Mervi Siekkinen
- Western Finland Cancer Centre FICAN West, Turku University Hospital, Turku, Finland
| | - Virpi Sulosaari
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Sciences, Turku, Finland
| | - Tero Vahlberg
- Department of Clinical Medicine, Biostatistics, University of Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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46
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Kriegel J, Rissbacher C, Pölzl A, Tuttle-Weidinger L, Reckwitz N. Levers for integrating social work into primary healthcare networks in Austria. Health Policy 2019; 124:75-82. [PMID: 31810579 DOI: 10.1016/j.healthpol.2019.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The integrated healthcare of patients with support needs in primary healthcare in Austria has insufficient structural and procedural features in terms of the quality and security of care. The aim is therefore to develop solution- and patient-oriented services that take into account both the patients' requirements as well as the medical, nursing, therapeutic and economic perspectives. The question arises: What relevant levers can support the active participation of social work in the primary healthcare of patients with support needs in Austria? METHODS An adapted Analytic Hierarchy Process (AHP) was used to investigate the levers for integrating social work into primary healthcare networks in Austria. In addition to a semi-structured literature search, subjective expert and user priorities were surveyed, cause-and-effect relationships were visualized, an extended cycle of success was developed and relevant control levers were identified by means of a pair comparison matrix and an effectiveness front. RESULTS This results in the targeted development and optimization of the complex integration of social work into primary healthcare in Austria, the relevant levers being the professionalization of social work, competences of social work, communication and cooperation of stakeholders. CONCLUSION The identified levers have to be processed conceptually and operationally. For this purpose, an integrated concept has to be developed, which, in addition to innovative organizational instruments, includes special communication approaches as well as inter-professional process and knowledge management.
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Affiliation(s)
- Johannes Kriegel
- Institute for Management and Economics in Healthcare, UMIT - University for Health Sciences, Medical Informatics & Technology, 6060, Hall i.T., Austria; University of Applied Sciences Upper Austria, School of Applied Health and Social Sciences, Linz, Austria.
| | - Clemens Rissbacher
- Institute of Integrated Healthcare, tirol kliniken, Innrain 98, 6020, Innsbruck, Austria
| | - Alois Pölzl
- Austrian Association of Social Workers, Mariahilferstraße 81/I/14, 1060, Wien, Austria
| | - Linda Tuttle-Weidinger
- University of Applied Sciences Upper Austria, School of Applied Health and Social Sciences, Linz, Austria
| | - Nanni Reckwitz
- Emergency Department, St. Willibrord Hospital, Willibrordstraße 9, 46446, Emmerich, Germany
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Cleary M, Foong A, Kornhaber R, McLean L, Visentin DC. Interprofessional Collaborations for Improved Health Care. Issues Ment Health Nurs 2019; 40:1045-1048. [PMID: 31693424 DOI: 10.1080/01612840.2019.1655367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Michelle Cleary
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, Australia
| | - Andrew Foong
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, Australia
| | - Rachel Kornhaber
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, Australia
| | - Loyola McLean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, Australia.,School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.,Westmead Psychotherapy Programme for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, Australia
| | - Denis C Visentin
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, Australia
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48
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Auvinen K, Räisänen J, Merikoski M, Mäntylä A, Kumpusalo-Vauhkonen A, Enlund H, Liukkonen T, Jyrkkä J, Lönnroos E, Mäntyselkä P. The Finnish Interprofessional Medication Assessment (FIMA): baseline findings from home care setting. Aging Clin Exp Res 2019; 31:1471-1479. [PMID: 30519976 PMCID: PMC6763522 DOI: 10.1007/s40520-018-1085-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/21/2018] [Indexed: 10/30/2022]
Abstract
PURPOSE Medication-related problems and declined functional capacity are closely associated factors among older people. The purpose of this study is to describe the procedure of interprofessional medication assessment in home care context and the baseline characteristics of the study population. METHODS The FIMA study was a randomized, controlled intervention study comparing general practitioner-led interprofessional medication assessment and usual care. Patients' chronic diagnoses and medication use as well as physical and cognitive functions were investigated. Performance in daily activities, use of care services and help from family and relatives, self-rated health and health-related quality of life, and adverse effects commonly related to medication were assessed. RESULTS The home care patients (n = 512) had significant disease burden and functional limitations. The mean number of all medicines was 15 and that of regularly taken medicines 10. The majority of patients (87%) had excessive polypharmacy. The most commonly used (97%) ATC medicine class was nervous system medicines. Clinically relevant (class C or D SFINX record) drug-drug interactions were seen in 74% of the patients. The most frequent risks of adverse effects were risk of bleeding (66%), constipation (58%) and orthostatism (54%) occurring in over half of the patients. Medicines affecting renal function were used by 85% of the patients. CONCLUSIONS There is an evident need and justification for medication assessments in home care. In most cases, home care patients fulfill the criteria for regular medication assessments.
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49
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Dawson AJ, Rossiter C, Doab A, Romero B, Fitzpatrick L, Fry M. The Emergency Department Response to Women Experiencing Intimate Partner Violence: Insights From Interviews With Clinicians in Australia. Acad Emerg Med 2019; 26:1052-1062. [PMID: 30820993 DOI: 10.1111/acem.13721] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Emergency departments (EDs) are essential providers of compassionate, immediate treatment and referral for women experiencing intimate partner violence (IPV). IPV, largely perpetrated by men against women, exerts a substantial burden on the health systems and economies of all nations. There is little known about how staff in Australian EDs respond to the challenges such violence generates. We therefore examined the clinical team response to women experiencing IPV in two large Australian metropolitan hospital EDs. METHODS We undertook qualitative semistructured interviews and focus group discussions with 35 social workers, nurses, and doctors. Transcripts were recorded and transcribed verbatim. We analyzed the data thematically. We first undertook line-by-line coding and organized content into descriptive categories. Latent and manifest patterns were identified across the data and mapped to key themes in negotiation with all authors. RESULTS Respondents emphasized challenges identifying IPV resulting from professional uncertainty or discomfort and women's fear of the ramifications of disclosure. Emergency clinicians routinely referred women to social workers after medical treatment and described effective collaboration across professions. Social workers outlined difficulties coordinating care with health and community agencies. Staff highlighted challenges maintaining nonjudgmental attitudes and managing their own feelings-especially clinicians who had personally experienced violence. CONCLUSIONS Emergency departments can provide caring environments for women experiencing IPV. Effective interprofessional teamwork across nursing, medical, and social work professionals may mitigate the need for formal screening tools. Supportive workforce environments can improve staff understanding, reduce stigma, enhance appropriate treatment, and counsel health professionals experiencing violence. However, staff training and advocacy and referral relationships with local programs require strengthening. A connected multisystems-level response is required to coordinate and resource services for all affected by violence.
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Affiliation(s)
- Angela J. Dawson
- The Australian Centre for Public and Population Health Research Sydney
| | - Chris Rossiter
- The Centre for Health Services Management Faculty of Health University of Technology Sydney Sydney
| | - Anna Doab
- The Australian Centre for Public and Population Health Research Sydney
| | | | | | - Margaret Fry
- Faculty of Health University of TechnologySydney
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50
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Ylitörmänen T, Turunen H, Mikkonen S, Kvist T. Good nurse-nurse collaboration implies high job satisfaction: A structural equation modelling approach. Nurs Open 2019; 6:998-1005. [PMID: 31367424 PMCID: PMC6650654 DOI: 10.1002/nop2.279] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 02/16/2019] [Accepted: 03/14/2019] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Tuija Ylitörmänen
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
- South Karelia Social and Health Care DistrictLappeenrantaFinland
| | - Hannele Turunen
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
- Kuopio University HospitalKuopioFinland
| | - Santtu Mikkonen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Tarja Kvist
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
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