Examining the average scores of nursing teamwork subscales in an acute private medical ward

How interventions to maintain services during the COVID-19 pandemic strengthened systems for delivery of maternal and child health services: a case-study of Wakiso District, Uganda

BACKGROUND

Health systems are resilient if they absorb, adapt, and transform in response to shocks. Although absorptive and adaptive capacities have been demonstrated during the COVID-19 response, little has been documented about their transformability and strengthened service delivery systems. We aimed to describe improvements in maternal and child health service delivery as a result of investments during the COVID-19 response.

METHODS

This was a descriptive case study conducted in Wakiso District in central Uganda. It included 21 nurses and midwives as key informants and 32 mothers in three focus group discussions. Data were collected using an interview guide following the Systems Engineering Initiative for Patient Safety theoretical framework for service delivery.

RESULTS

Maternal and child health service delivery during the pandemic involved service provision without changes, service delivery with temporary changes and outcomes, and service delivery that resulted into sustained changes and outcomes. Temporary changes included patient schedule adjustments, community service delivery and negative outcomes such as increased workload and stigma against health workers. Sustained changes that strengthened service delivery included new infrastructure and supplies such as ambulances and equipment, new roles involving infection prevention and control, increased role of community health workers and outcomes such as improved workplace safety and teamwork.

CONCLUSIONS

In spite of the negative impact the COVID-19 pandemic had on health systems, it created the impetus to invest in system improvements. Investments such as new facility infrastructure and emergency medical services were leveraged to improve maternal and child health services delivery. The inter-departmental collaboration during the response to the COVID-19 pandemic resulted into an improved intra-hospital environment for other service delivery. However, there is a need to evaluate lessons beyond health facilities and whether these learnings are deliberately integrated into service delivery. Future responses should also address the psychological and physical impacts suffered by health workers to maintain service delivery.

Impacts of interprofessional education on collaborative practice of healthcare professionals: A systematic review and meta-analysis

OBJECTIVE

To investigate and statistically synthesise data on the effects of interprofessional education on healthcare professionals' collaborative practice among healthcare professionals.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

Seven databases and the grey literature were searched to collect relevant studies from database inception to 15 May 2023.

REVIEW METHODS

A random-effects model was used to assess the pooled effect size. Each pooled analysis was tested for publication bias using Egger's regression test.

RESULTS

Eleven studies were included in the final analysis. The evaluation of pooled results showed that interprofessional education significantly enhanced attitudes towards or mutual respect among healthcare professionals (pooled standardized mean difference: 0.14; 95 % Confidence Interval: 0.01-0.28; p = 0.04) and interprofessional knowledge (pooled standardized mean difference: 0.43; 95 % Confidence Interval: 0.22-0.65; p < 0.001).

CONCLUSIONS

Interprofessional education is a feasible approach to enhance attitudes towards or mutual respect among healthcare professionals as well as their interprofessional knowledge. Future research is needed to consider the inclusion of a module designed to develop mutual interests and communication to enhance students' perspectives on the importance of the interprofessional education approach.

Multidisciplinary Teamwork Perceptions When Mobilizing Ventilated Neurosurgery Patients

ABSTRACT

BACKGROUND: Multidisciplinary teamwork is essential in delivering holistic care to critically ill populations, including ventilated neurosurgery patients. Although it is considered a safe and feasible aspect of patient care, mobilization is often missed in this population because of negative healthcare provider perceptions regarding barriers and patient safety. Nurse-led teamwork has been suggested to overcome these barriers and to achieve earlier mobilization for patients, as well as positive provider perceptions, which may affect the culture and frequency of mobilization on neurointensive care units. Quantitative studies analyzing multidisciplinary teamwork perceptions to mobilize ventilated neurosurgery patients with or without a nurse-led protocol have not been previously conducted. Analyzing such perceptions may provide insight to team-related barriers related to missed mobility. This pilot quasi-experimental study aimed to determine whether the use of a nurse-led mobility protocol affects teamwork perceptions when mobilizing ventilated neurosurgery patients. METHODS: A sample of multidisciplinary teams, composed of nurses, patient care technicians, and respiratory therapists, mobilized ventilated neurosurgery patients according to either standard of care (for the control group) or a nurse-led mobility protocol (for the interventional group). Teamwork perceptions were measured via the reliable and valid Nursing Teamwork Survey tool. RESULTS: Linear mixed model analyses revealed that multidisciplinary teams in the nurse-led mobility protocol group had significantly higher levels of overall perceived teamwork than those in the control group, t3 = -3.296, P = .038. Such differences were also noted for teamwork variables of team leadership and mutual trust. CONCLUSION: Nurse-led mobility protocols should be considered to increase teamwork when performing multidisciplinary teamwork-based mobility for ventilated neurosurgery patients. Future studies should continue to evaluate teamwork perceptions after nurse-led mobility.

Nursing teamwork is essential in promoting patient-centered care: a cross-sectional study

BACKGROUND

There has been little research regarding nursing teamwork, despite its important role in multidisciplinary teamwork in healthcare settings and its significance in ensuring high-quality nursing care. This study aimed to determine the teamwork levels of Korean nurses and examine the relationship between nursing teamwork and patient-centered care while controlling for other individual and work-related factors.

METHODS

We conducted a cross-sectional analysis of online survey data. The study population consisted of 992 Korean registered nurses employed in hospitals who had a minimum of six months of clinical experience. We performed latent profile analysis to identify latent teamwork subgroups based on response patterns. We performed analysis of variance and Chi-square tests to examine differences in individual and work-related characteristics according to teamwork group. We used multiple linear regression to investigate how nursing teamwork could affect patient-centered care after controlling for covariates.

RESULTS

We identified three nursing teamwork subgroups: low, mid, and high. Nurses with a higher level of teamwork in their units tended to work fewer hours with more adequate staffing (F = 5.88, p = 0.003 for working hours; F = 7.68, p < 0.001 for staffing adequacy). There was a significant positive association between nursing teamwork and patient-centered care after controlling for personal and work-related characteristics. Compared with low teamwork, mid and high teamwork increased patient-centered care scores by 0.32 (95% confidence interval [CI] = 0.23-0.40) and 0.57 (95% CI = 0.48-0.66), respectively.

CONCLUSION

Our findings indicate that enhancing nursing teamwork can serve as an effective strategy for promoting patient-centered care. Providing nurse education and training to equip nurses with the necessary knowledge and skills for effective teamwork is a crucial step. Additionally, fostering management commitment to create a supportive working environment, including adequate staffing, can facilitate improved nursing teamwork and, subsequently, patient-centered care.

Hospital staff reports of coworker positive and unprofessional behaviours across eight hospitals: who reports what about whom?

BACKGROUND

Workplace behaviours of healthcare staff impact patient safety, staff well-being and organisational outcomes. A whole-of-hospital culture change programme, Ethos, was implemented by St. Vincent's Health Australia across eight hospitals. Ethos includes a secure online submission system that allows staff across all professional groups to report positive (Feedback for Recognition) and negative (Feedback for Reflection) coworker behaviours. We analysed these submissions to determine patterns and rates of submissions and identify the coworker behaviours reported.

METHOD

All Ethos submissions between 2017 and 2020 were deidentified and analysed. Submissions include structured data elements (eg, professional role of the reporter and subjects, event and report dates) and a narrative account of the event and coworker behaviours. Descriptive statistics were calculated to assess use and reporting patterns. Coding of the content of submissions was performed to classify types of reported coworker behaviours.

RESULTS

There were a total of 2504 Ethos submissions, including 1194 (47.7%) Recognition and 1310 (52.3%) Reflection submissions. Use of the submission tool was highest among nurses (20.14 submissions/100 nursing staff) and lowest among non-clinical services staff (5.07/100 non-clinical services staff). Nurses were most frequently the subject of Recognition submissions (7.56/100 nurses) while management and administrative staff were the least (4.25/100 staff). Frequently reported positive coworker behaviours were non-technical skills (79.3%, N=947); values-driven behaviours (72.5%, N=866); and actions that enhanced patient care (51.3%, N=612). Medical staff were the most frequent subjects of Reflection submissions (12.59/100 medical staff), and non-clinical services staff the least (4.53/100 staff). Overall, the most frequently reported unprofessional behaviours were being rude (53.8%, N=705); humiliating or ridiculing others (26%, N=346); and ignoring others' opinions (24.6%, N=322).

CONCLUSION

Hospital staff across all professional groups used the Ethos messaging system to report both positive and negative coworker behaviours. High rates of Recognition submissions demonstrate a strong desire of staff to reward and encourage positive workplace behaviours, highlighting the importance of culture change programmes which emphasise these behaviours. The unprofessional behaviours identified in submissions are consistent with behaviours previously reported in surveys of hospital staff, suggesting that submissions are a reliable indicator of staff experiences.

Predictors and influencing factors of emotional intelligence among nurses in the North East England, United Kingdom

BACKGROUND

Recognising that high levels of emotional intelligence (EI) are required for involvement in the nursing practice, this study was conducted to assess the traits of emotional intelligence, perception of emotional intelligence and factors associated with emotional intelligence among nursing teams in Northeast England.

MATERIALS AND METHODS

For this descriptive cross-sectional study, a concurrent mixed method was employed (qualitative and quantitative method) using a convenience sampling technique. Data were obtained from one hundred and ten (110) staff nurses practicing with the National Health Service via a validated semi-structured questionnaire and in-depth interview. Data collected through questionnaires (online- Google form link) were retrieved via Ms excel spreadsheet and then imported to Statistics Package for Social Sciences (SPSS) version 25 for analyses. Interviews recorded were transcribed word for word as Nvivo software (version 12) was utilised for thematic analysis and rapid analysis was also adopted to validate the responses.

RESULTS

Majority (77%) of the respondents were females, and about half (46%) have work experience between one to five years. The mean emotional intelligence trait score for each domain was self-awareness (20.20), self-regulation (38.15), self-motivation (20.54), empathy (18.78), and social skills (29.60), as 82% of the nurses had high emotional intelligence trait. There was a statistically significant relationship between empathy, and race of the respondents (P = 0.040). Also, from the qualitative data; cultural differences, personality traits, self-care, family support, and organisational structure are key predictors of emotional intelligence traits among nurses.

CONCLUSION

Enhancing emotional intelligence traits among nursing teams is significant, as it may serve as an intervention strategy to manage changes and still increase level of morale and productivity among nurses. Hence, creating a more supportive environment, encouragement from team leads or supervisors, and training on stress management strategies can help to reduce burnout, anxiety and stress in nurses.

The relationship between teamwork, moral sensitivity, and missed nursing care in intensive care unit nurses

BACKGROUND

Teamwork, moral sensitivity, and missed nursing care are important healthcare challenges for Intensive Care Unit (ICU) nurses and the existence of a relationship between these variables can be useful for developing better care improvement strategies. This study aimed to determine the relationship between teamwork, moral sensitivity, and missed nursing care in ICU nurses.

METHODS

This is a descriptive cross-sectional study conducted on a total of 200 ICU nurses working at teaching hospitals affiliated to Semnan and Shahroud Universities of Medical Sciences, Semnan, Iran in 2022. Sampling was conducted using the census method. Data collection was conducted using a demographic checklist, the TeamSTEPPS Team Perception Questionnaire (T-TPQ), Lützén Moral Sensitivity Questionnaire (L-MSQ), and Kalisch and Williams Missed Nursing Care (MISSCARE) Survey. The examination of the relationship between the three variables was conducted using Pearson's correlation coefficient and multiple regression analysis.

RESULTS

The mean and standard deviation of teamwork, moral sensitivity, and missed nursing care was 3.47 ± 0.69, 64.19 ± 13.43, and 55.04 ± 34.10, respectively. The variable of teamwork had a significant positive relationship with moral sensitivity (p < .001) and a significant negative relationship with missed nursing care (p < .001). Teamwork was also a positive predictor of moral sensitivity (p < .001) and a negative predictor of missed nursing care (p < .001). The clinical experience of ICU nurses was a positive predictor of teamwork (p = .01) and a negative predictor of missed nursing care (p = .001). The age of ICU nurses was a positive predictor of moral sensitivity (p = .001) and a negative predictor of missed nursing care (p = .008).

CONCLUSION

The findings showed that a higher level of teamwork was associated with increased moral sensitivity and reduced missed nursing care among ICU nurses. Therefore, focusing on planning interventions on teamwork improvement can lead ICU nurses to improve moral sensitivity, lower missed nursing care, and promote the quality of patient care.

Congruence of Effective Leadership Values between Nurse Leaders and Staff Nurses in a Multicultural Medical City in Saudi Arabia: A Sequential Mixed-Methods Study

This study explores the perceived congruence of effective values of nursing leadership between the nurse leaders and the staff nurses in a multicultural tertiary hospital.

METHODS

This is a descriptive sequential mixed-methods study conducted in a multicultural medical city in Saudi Arabia. Purposive sampling was used in the qualitative phase, while stratified sampling was used for the quantitative part. There were 70 participants in the qualitative phase, including 33 nurse leaders and 37 staff nurses. The quantitative phase had 571 participants, including 105 nurse leaders and 466 staff nurses.

RESULTS

Congruent values were categorised into six emerging themes: (1) cascading deference; (2) paragon of probity; (3) professional competence; (4) compassionate presence; (5) team diversity and inclusion; (6) calibrated communication. The quantitative survey confirmed that the values identified from the interviews were considered to be vital by both nurse leaders and staff nurses, and there were no statistically significant differences between staff nurses' and nurse leaders' perceptions, regardless of their nationality, as demonstrated by one-way ANOVA, with p-values less than 0.05 deemed to be statistically significant.

CONCLUSION

Both nurse leaders and staff nurses in the multicultural institution have congruent leadership values that are perceived as essential to achieve institutional goals and, ultimately, safe and high-quality patient care.

Attitudes of Critical Care Nurses towards Teamwork and Patient Safety in Saudi Arabia: A Descriptive Cross-Sectional Assessment

The study aimed to assess the teamwork and safety attitudes among the critical care unit (CCU) nurses in Saudi Arabia. A descriptive cross-sectional study was carried out in public tertiary hospitals in Al-Madinah, Saudi Arabia. All participants answered a three-part questionnaire that included demographic data, a teamwork attitude questionnaire (T-TAQ), and the Safety Attitudes Questionnaire (SAQ). The analysis revealed that the majority of the nurses were female, n = 52 (76.5%), and almost half of the nurses were aged from 29 to 39 years, n = 29 (42.6%). Teamwork attitude values are found to be relatively stable in all subscales, ranging from 1.63 (SD = 1.23) to higher at 2.92 (SD = 1.32). Of the six dimensions of SAQ, job satisfaction (M = 70, SD 21.46) had the highest positive rate and was approached with a positive attitude, followed by teamwork (M = 66.09, SD 15.12) and safety climate (M = 67.11, SD 17.70). The analysis also shows work experience was the influencing factor of teamwork attitude and safety attitude of nurses, recording beta values of 0.24, p < 0.05 and 0.10, p < 0.001, respectively. The results also identified an association between teamwork and safety attitudes. The study reflected the positive attitudes towards teamwork and less positive attitudes toward patient safety among critical care nurses in Saudi Arabia. Collaborative team performance among nurses improves the medical care quality and patients’ safety, decreasing the occurrence rate of adverse events.

Predictors of patient safety competency among emergency nurses in Iran: a cross-sectional correlational study

AIMS

This study aimed to assess predictors of patient safety competency among emergency nurses.

BACKGROUND

The role of emergency nurses is to provide high-quality health care to patients and ensure their safety. The patient safety competency includes the absence of unnecessary or potential harm when providing health care to patients. In providing health care, effective teamwork can affect patient safety and outcomes. Psychological safety is essential to effective teamwork. Psychological safety allows health care workers to accept the interpersonal risks needed to perform effective teamwork and maintain patient safety.

METHODS

This study was cross-sectional correlational research. Using convenience sampling methods, 254 emergency department nurses from five educational hospitals were enrolled in the study. Patient Safety in Nursing Education Questionnaire was used to measure the patient safety competency, the teamwork questionnaire to examine the teamwork, and Edmondson psychological safety questionnaire was used to measure psychological safety. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson's r correlation coefficient, and multivariate stepwise linear regression analysis were applied using SPSS 14.0.

RESULTS

Participants' mean patient safety competency score was 2.97 (1-4). Between 18 independent variables evaluated in the multiple regression analysis, seven had a significant effect on the patient safety competency of emergency nurses (R²: 0.39, p < .001).

CONCLUSIONS

The patient safety competency of emergency department nurses was primarily related to the structure and leadership of the team and secondary to psychological safety and experience in patient safety activity. The results demonstrated that policymakers and hospital managers should improve and enhance team structure and leadership via supervision and cooperation with the nursing staff. The development of training programs in patient safety activities, improvement, and increase of psychological safety at the levels of the nursing units is essential to increase patient safety competencies in the emergency nursing program.