Nurse-Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses

Intensive Care Unit Nurses' Professional Autonomy: A Scoping Review

Intensive care unit (ICU) nurses' professional autonomy is a critical factor affecting their ability to sustainably provide high-quality care to patients who are critically ill and to their families. However, in the absence of a systematic or scoping review of ICU nurses' professional autonomy, limited information and evidence are available on this topic. The aim of this scoping review was to clarify the extent and type of evidence on ICU nurses' professional autonomy. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The following research questions were addressed: (1) Which areas of interest and trends regarding ICU nurses' professional autonomy have been explored in studies published in scientific journals? And (2) What is known about ICU nurses' professional autonomy? The data sources included MEDLINE, CINAHL Ultimate, PsycINFO, Cochrane Library, and Ichushi-Web of the Japan Medical Abstracts Society databases. Identified studies were mapped based on their aim, design, methodology, and key findings and categorized according to their focus areas. Of the 734 identified studies, 16 were analyzed. The identified categories were as follows: "relationship between professional autonomy and mental issues," "experiences and processes of exercising professional autonomy," "relationship between professional autonomy and nurse-physician collaboration," "relationship between professional autonomy and demographic characteristics," "concept of professional autonomy," "barriers to professional autonomy," and "team approach to improve professional autonomy." Most studies have focused on the relationship between professional autonomy and mental health issues and nurse-physician collaboration and few included interventions to enable or promote the exercise of professional autonomy, highlighting a research gap. Future research should identify factors that inhibit the professional autonomy of ICU nurses and that can be changed through interventions and should develop educational and organizational change-based interventions to modify the factors.

The Impact of the COVID-19 Pandemic on the Professional Autonomy of Anesthesiological Nurses and Trust in the Therapeutic Team of Intensive Therapy Units-Polish Multicentre Study

INTRODUCTION

The COVID-19 pandemic as well as the rate of spread of this particular pathogen around the world have caused the number of patients requiring medical attention and intensive care to exceed the capacity of even the best organized health care systems. This resulted in the need to hire employees who had not previously worked in intensive care units. Experience and knowledge have become particularly important in the context of mutual trust in the ICU team. At the same time, it could affect the level of professional autonomy of nurses, understood as the freedom to perform work based on knowledge, skills and competence without the need to submit to other medical professions. The pandemic status has required that nurses are always involved in their work by participating in training. Faced with the dangers of COVID-19, there is no doubt that by the end of the pandemic, both nursing and healthcare will be better equipped to face future challenges.

METHODS

The study lasted from July to September 2021. The data collection procedure started with the consent of the heads of the institutions where the data was collected. The study was conducted using the Dempster Practice Behavior Scale (DPBS), which examines work autonomy. The survey using the proprietary questionnaire was conducted among 225 nurses working in eleven ICUs in five voivodeships in Poland.

RESULTS

The autonomy of nurses during the COVID-19 pandemic was assessed at a high level. Younger respondents rated autonomy as being higher. Almost half of the respondents assessed the level of professional independence as high, including 52% of nurses, and significantly less, including 34% of doctors. A group of 47% of respondents assessed that trust had decreased and 28% said that trust had improved slightly.

CONCLUSIONS

Professional independence allows you to perform work independently on others, taking responsibility for decisions and actions. The COVID-19 pandemic, through the influx of new staff members into treatment teams, had an impact on both nursing autonomy and the level of trust in a team, as shown in this study.

Nurse-Physician Inter-Professional Collaboration and Associated Factors at Public Hospitals in Dessie City, Amhara, Northeastern Ethiopia, 2021

Introduction

Nurse–physician collaboration is an integral part of quality improvement in health care. Collaboration enables individuals to work together to achieve defined and common health purposes. There is limited evidence related to nurse–physician inter-professional collaboration and its associated factors in Ethiopia, particularly in Dessie city public hospitals.

Objective

To assess nurse–physician inter-professional collaboration and associated factors at public hospitals in Dessie city, Ethiopia, 2021.

Methods

An institutional-based cross-sectional study was conducted among nurses and physicians at public hospitals in Dessie city. A self-administered questionnaire was used for data collection. Stratified simple random sampling techniques were used to select study participants proportional to the sample size allocation. The final sample size was 260 and allocated proportionally to Dessie Comprehensive Specialized Hospital and Boru Meda General Hospital. The data were entered and analyzed using EPI-data version 4.6 and SPSS version 26 software respectively. During analysis, p-values less than 0.25 in binary logistic regression were entered into multivariable logistic regression. Finally, p-values less than 0.05 in multi-variable logistic regression were considered statically significant.

Results

The mean score for inter-professional collaboration was 97.40 ± 19.6SD. In this study, inter-professional collaboration among nurses and physicians was 44.2%. This study showed that favorable attitude [AOR=3.205; CI: 1.781–5.766], respondents working in the gynecological department [AOR=0.210; CI: 0.052–0.849], satisfied organizational support [AOR=2.062; CI: 1.140–3.729] and urban residents [AOR=3.996; CI: 1.069–14.931] were factors associated with nurse–physician inter-professional collaboration.

Conclusion

In this study, nurse–physician inter-professional collaboration was low. Training on the importance of health teamwork, timely monitoring and evaluation of organizational support, and professional empowerment towards a favorable attitude of nurse–physician inter-professional collaboration shall be provided at hospital levels. Routine assessment and timely intervention of the gynecological department for nurse–physician inter-professional collaboration shall be done at hospital levels. Moreover, both quantitative and qualitative research shall be performed for future research.

Association Between Interdisciplinary Collaboration and Leadership Ability in Intensive Care Unit Nurses: A Cross-Sectional Study

BACKGROUND

Interdisciplinary collaboration in the intensive care unit (ICU) is crucial for improving the quality of patient care. Furthermore, interdisciplinary team members need to establish team leadership to function effectively in solving problems. However, the influence of improving leadership ability in nurses on interdisciplinary collaboration efficacy is uncertain.

PURPOSE

This study was designed to clarify the relationship between nursing leadership ability and interdisciplinary collaboration.

METHODS

This cross-sectional study included 3,324 nurses with > 3 years of experience working in an ICU in Japan as participants. The investigation period was from April to September 2016. The developed questionnaire addressed leadership ability (Self-Assessment Inventory of Leadership role for staff nurses) and activities and perceptions related to multidisciplinary collaboration (Collaboration and Satisfaction About Care Decisions). The questionnaires were then collected and mailed.

RESULTS

The 2,063 valid questionnaire responses gave a valid response rate of 61%. Nursing leadership ability was found to be significantly higher in advanced practice nurses (APNs; 78.8 ± 9.5, p < .001) and nurses in higher positions (74.9 ± 8.9, p < .001) than in non-APNs. However, no differences were found in terms of ICU management systems (p = .116). In addition, higher levels of nursing leadership were associated with greater team coordination (β = .212), higher levels of interdisciplinary collaboration in the ICU (β = .196), and the perception of many medical staff members, as well as patients and family members, to be team members (β = .140) and APNs (β = .128; p < .001).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Improving the leadership ability of critical care nurses may impact interdisciplinary collaboration positively. Leadership ability in nurses was shown to be related to a high level of cooperation among multiple healthcare providers. To enhance leadership ability in critical care nurses, nurses must increase their level of knowledge and ability. However, examining and implementing educational methods, including the improvement of coordination ability mainly by APNs, remain a challenge.

The Relationship Between Professional Autonomy and Job Stress Among Intensive Care Unit Nurses: A Descriptive Correlational Study

BACKGROUND

Autonomy is an essential factor in the nursing profession. Nurses' autonomy can improve care quality, decrease mortality in patients, and attenuate job stress. This study aimed to investigate professional autonomy and its relationship with job stress among nurses working in Intensive Care Units (ICUs).

MATERIALS AND METHODS

This descriptive correlational study was conducted at Urmia nursing school in Iran in 2020. Three hundred ninety-eight nurses working at the ICUs entered the study. Data was collected using the Dempster Practice Behavior Scale (DPBS) and the Health and Safety Executive (HSE) questionnaire. Independent t-test and analysis of variance (ANOVA) were used to examine the relationship between demographics and study variables. Pearson's correlation coefficient was used to investigate the relationship between professional autonomy and job stress of nurses.

RESULTS

The mean (SD) of total professional autonomy and job stress score of nurses was, respectively, 102. 11(91. 88), and 115. 53(12. 42), indicating moderate autonomy and job stress. Professional autonomy had a significant positive correlation with job stress (r = 0.51, p < 0.001). It also had a significant positive correlation with work experience in ICU (r = 0.12, p = 0.014).

CONCLUSIONS

ICU nurses have moderate autonomy and job stress, and their autonomy is a significant positive predictor of their job stress. University authorities are recommended to develop practical strategies to enhance nurses' autonomy and eliminate factors that cause job stress in ICU nurses in order to preserve nurses' health, improve the quality of nursing care, and increase patient safety.

Job stress and its relationship with nurses' autonomy and nurse-physician collaboration in intensive care unit

AIMS

To determine nurses' job stress and its relationship with professional autonomy and nurse-physician collaboration in intensive care unit (ICU).

BACKGROUND

Low professional autonomy, high job stress and lack of nurse-physician collaboration can affect nursing care in ICU and the main reasons ICU nurses leave the occupation or transfer to other clinical units.

METHODS

A cross-sectional, correlational study was conducted on 398 nurses in teaching hospitals in Urmia, Iran, in 2020. Data were collected using the Dempster Practice Behaviors Scale, the Health and Safety Executive tool and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration.

RESULTS

The mean job stress (115.53 ± 12.42) and professional autonomy (102.19 ± 11.88) of ICU nurses were 'moderate', and nurse-physician collaboration (74.25 ± 5.10) was 'good'. There was a positive relationship between professional autonomy and job stress (r = .506) and nurse-physician collaboration (r = .242). Professional autonomy was a predictor of job stress in nurses (p < .000), and work experience in ICU can cause job stress in nurses (p = .024).

CONCLUSION

Increasing nurses' professional autonomy causes an increase in job stress and improves nurse-physician collaboration in ICU.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers should implement practical strategies to improve nurses' autonomy, enhance nurse-physician collaboration and decrease their job stress.

Effect of nurses' perception to workplace civility climate on nurse-physician collaboration

AIMS

To assess the effect of nurses' perception to workplace civility climate on nurse-physician collaboration and determine whether the largest contributor to changing the climate of the workplace are the employees or top management.

DESIGN

This study used non-experimental descriptive cross-sectional study design, which using purposive sample (139 nurses) working at Health Insurance Hospital.

METHOD

The current study data were collected by using self-administered questionnaires including three tools: (a) a structured interview questionnaire includes personal data; (b) perceived workplace civility climate scale (15 items); and (c) Nurse Physician Collaboration Scale (27 items).

RESULTS

Main result of this study reveals that there was a positive statistically significant correlation between workplace civility climate and collaboration (0.208* ). Studied nurses were perceived top management with the high score (87.5) than employees (65.2).

CONCLUSION

Workplace civility climate was demanded for well collaboration between nurses and physicians to provide high-quality services; when nurses and physicians have increase chance to work in civility climate, combining with response to incivility and low intolerance for it, they will be more collaborated.

RECOMMENDATION

Policies and procedures are very important in healthcare settings to address uncivil actions and establish a civilized climate.

The attitudes of healthcare professionals towards nurse-physician collaboration

Aims

The current study aims to examine the attitudes of healthcare professionals towards nurse–physician collaboration and to explore the level of satisfaction concerning the quality of collaboration among them.

Design

A descriptive comparative study design was used to demonstrate attitudes of 338 participants (158 internship nurses, 139 nurses and 41 physicians) working in intensive care units, surgical department and medical department.

Methods

Two instruments were used, socio‐demographic data sheet and Jefferson scale of attitude towards nurse–physician collaboration (JSANPC), it consisted of 15 items under 4 dimensions.

Results

The internship nurses have the high score (38.6%) in poor level of satisfaction regarding quality of collaboration between nurses and physicians comparing to staff nurses and physicians. Physicians are satisfied (61%) with the level of collaboration between them and nurses. Staff nurses have the high positive attitude (48.45 (4.03)) towards collaboration between nurses and physicians comparing to physicians and internship nurses.

Conclusion

Internship nurses were not satisfied with the level of collaboration between nurses and physicians.

Collaboration and Autonomy: Mere Buzzwords?

How to cite this article: Samavedam S. Collaboration and Autonomy: Mere Buzzwords? Indian J Crit Care Med 2019;23(4):164.