Healthcare professionals' perceptions of interprofessional teamwork in the emergency department: a critical incident study

Pre-hospital emergency care personnel's challenges in providing care in mass casualty incidents: A qualitative study

BACKGROUND

In incidents with mass casualties, pre-hospital emergency medical services personnel (prehospital EMS personnel) face challenges that can impact their management of the scene and, by extension, their professional performance. The present study investigated the challenges faced by prehospital EMS personnel in mass casualty incidents in the south of Iran.

METHODS

This is a qualitative-descriptive study. The subjects were selected via purposeful sampling. Accordingly, 23 prehospital EMS personnel were interviewed in 23 semi-structured, individual, in-depth interviews. Graneheim and Lundman's method was used to collect the data.

RESULTS

Three themes and eight subthemes emerged from the qualitative data analysis. The three main themes were challenges related to professional capabilities, challenges related to organizational management inefficiency, and challenges related to lack of effective inter-organizational coordination and cooperation in crisis management.

CONCLUSION

The challenges faced by prehospital EMS personnel in mass casualty incidents encompasses challenges related to professional capabilities, challenges related to organizational management inefficiency, and challenges related to lack of effective inter-organizational coordination and cooperation in crisis management. The results of this study can be used by senior medical emergency services managers to identify the challenges of pre-hospital emergency care personnel in mass casualty incidents and take the necessary measures to eliminate them to improve the quality of pre-hospital care in mass casualty incidents.

Gap analysis of strategies for promoting interprofessional teams in healthcare units

PURPOSE

A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap.

DESIGN/METHODOLOGY/APPROACH

This study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population.

FINDINGS

Based on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas.

PRACTICAL IMPLICATIONS

This research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units.

ORIGINALITY/VALUE

Improving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.

Understand nurse's perspectives on communication with Chinese-speaking cardiac patients

OBJECTIVES

To explore communication experiences, resource accessibility/quality, and communication strategies cardiac nurses use when caring for Chinese-speaking patients.

METHODS

In this exploratory qualitative study, nurses were recruited from professional association members and interviewed on communication barriers/facilitators, resource accessibility/quality, and communication strategies used when caring for Chinese-speaking cardiac patients. Transcripts were thematically analysed.

RESULTS

Nurses (n = 11) were primarily female (7/11), with 2/11 Chinese-speaking. The themes discussed centred on two areas that created difficulty in communication, including the lack of a common language and uncertainty of the Chinese culture. Dependence on interpreters was highlighted and challenges noted included limited availability and difficulty scheduling, variable quality and approaches, and lack of communication resources leading to a dependence on poor quality materials. Nurses were uncertain about Chinese culture and how to communicate, particularly in relation to family-centred beliefs, mental and sexual health, medication, and diet.

CONCLUSIONS

Health communication with Chinese-speaking patients needs to address multiple challenges to be effective.

PRACTICE IMPLICATIONS

The findings emphasise the need to optimise interpreting services and provide nurses with cultural competency training and tailored resources to improve their understanding of Chinese immigrants' needs. These recommendations will support nurses to address identified language and cultural uncertainties.

Leadership conceptions of nurses and physicians in emergency care: A scoping review

BACKGROUND

The Emergency Department (ED) is a setting where teamwork and leadership is imperative, however, the literature to date is mostly discipline (nursing or medical) specific. This scoping review aimed to map what is known about nurses' and physicians' conceptions of leadership in the ED to understand similarities, differences, and opportunities for leadership development and research.

METHOD

Guided by the Joanna Briggs Institute approach, and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines, a systematic search of three electronic databases was performed. The Mixed Methods Assessment Tool was used for quality appraisal of included articles.

RESULTS

In total, 37 articles were included. Four key findings emerged: 1) leadership was rarely explicitly defined; 2) nurse leaders tended to be characterised as agents of continuity whilst physician leaders tended to be characterised as agents of change and continuity; 3) the clarification of expectations from nurse leaders was more evident than expectations from physician leaders; and 4) leadership discourse tended to be traditional rather than contemporary.

CONCLUSION

Despite the proliferation of studies into ED nurse, physician and interprofessional leadership, opportunities exist to integrate learnings from other sectors to strengthen the development of current and next generation of ED leaders.

Design and evaluation of collaborative decision-making application for patient care in the emergency department

Background and Aims

Collaboration has become a crucial element of effective healthcare delivery in the emergency department (ED). In high-pressure environments, healthcare providers can prioritize patients by consulting with other specialists to gain diverse perspectives and arrive at a shared understanding of the best course of action. It was conducted for the purpose of designing and evaluating the collaborative decision-making application for patient care in the ED.

Methods

The present applied research study was conducted between April 1, 2021 and May 31, 2023 at Imam Reza Hospital of Tabriz University of Medical Sciences. The study was conducted in three phases: exploration, development, and evaluation, utilizing modern technologies such as Flutter and Node.js to design and program the application. The effectiveness of the system was evaluated using established measures, including the think-aloud protocol, user experience questionnaire, and Likert-scale questionnaires developed by Ghadri et al.

Results

The average scale for attractiveness was 2.03, perspicuity was 2.90, efficiency was 2.40, dependability was 1.93, stimulation was 2.48, and novelty was 2.78. Additionally, 71% of physicians gave a very good rating to the accessibility of necessary information at any time, motivation to use the system for accessing information, usefulness of the system compared to the time spent using it throughout the day. Furthermore, 57% of physicians gave a very positive rating to sharing information and knowledge, ease of using the search function and accessing the system, user control and monitoring, free access to the system, and support from colleagues and system users.

Conclusion

The study suggests that introducing Information and Communication Technology such as medical apps can improve healthcare delivery by streamlining patient care, promoting effective teamwork, and reducing medical errors and treatment delays.