Objective:Interprofessional care,an aim of institutional healthcare settings globally,promotes safe,cost-effective,quality care.How professionals act to enable interprofessional care has not been described.The nurse p...Objective:Interprofessional care,an aim of institutional healthcare settings globally,promotes safe,cost-effective,quality care.How professionals act to enable interprofessional care has not been described.The nurse practitioner role,with its expertise in both medicine and nursing,is known to enhance collaboration and promote interprofessional care delivery.The objective of this study was to identify,from the healthcare professionals'perspective,nurse practitioner strategies used to enhance interprofessional care.Method:A hermeneutic phenomenology design was employed.Healthcare professionals from acute care hospitals and associated long-term care residences(n=6)in one Canadian province were invited to participate.Individual interviews were held with healthcare professionals(n=52)who regularly work with a nurse practitioner.The participants were asked to share experiences that held significance or value in promoting interprofessional care.Results:Four valued role attributes were identified;consistent role presence,time to focus on the patient,effective communication,and respectful centrality.Identified strategies extending from the attributes included knowledge sharing,respectful negotiation,identifying patient issues,being open and transparent,listening to opinions,bridging professions,and working as the hub of the group.Multiple types of interprofessional relationships were perceived,with the hierarchical type as the most common.Conclusions:Nurse practitioners in acute care hospital and long-term care settings have valued attributes that can promote interprofessional care.Effective strategies to promote interprofessional care emerge from these role attributes.However,the interprofessional relationship type perceived could enhance or impede the contribution of the strategies to interprofessional care promotion.展开更多
Introduction: The study revealed that many healthcare professional students begin their academic studies with positive and high expectations towards interprofessional collaborative studies. Unfortunately, students los...Introduction: The study revealed that many healthcare professional students begin their academic studies with positive and high expectations towards interprofessional collaborative studies. Unfortunately, students lose interest if their initial expectations are not met with consistent opportunities to enhance their communication skills and better understand the different healthcare professions. The study aimed to explore health science and public health students’ attitudes toward IPE. The participants’ backgrounds and demographics were used as the variations for the study. Methods: A pre-post semi-quantitative anonymous survey was designed to assess health science and public health undergraduate students’ attitudes toward IPE. The reason for this design was to capture the participants’ attitudes toward IPE at the start of a semester when they had no academic exposure to IPE. Qualtrics was used to collect the research data. A valid and reliable scale was used to measure attitudes toward IPE. A post-survey was included to measure the participants’ change in attitude toward IPE during the semester. The goal was to measure the IPE curriculum effectiveness. There were 21 survey questions. The questions were divided into four validated subscales. The first seven questions (Questions 1 - 7) pertained to the participants’ demographics s, such as gender, age, race, ethnicity, major field of study, and prior education. Questions 8, 9, 16, & 20 were designed to determine how the participants perceived their roles and responsibilities in their future healthcare careers. Each IPE attitude question’s central tendency and demographic variations were measured. The correlation between demographics and IPE attitudes was measured. Results: The pre-survey had 192 participants, and the post-survey had 97 participants. The pre-survey had 87% of participants in the age group 17 - 25 years, while the post-survey had 82.5% in the same age group. Only 5.7% of the participants were 36 years or older in the pre-survey and 9.3% in the post-survey. The participants were 80.70% female in the pre-survey and 85.6% in the post-survey. The largest healthcare career field concentration was nursing, with 42.7% and 45.4% in the pre- and post-surveys. The other three larger career fields were healthcare administration, community health education, and physician assistant. The participants’ attitudes toward learning with different healthcare career students and becoming more effective members of a healthcare team increased from 4.36 (SD = 0.13) to 4.40 (SD = 0.17). Two negative IPE attitude questions showed an increased value: 1) The function of nursing therapists is mainly to provide support for doctors (3.51, SD = 0.19 to 3.12, SD = 0.24, p-value ≤ 0.004) and 2) Clinical and healthcare problem-solving skills could only be learned with students from the same career field (3.73, SD = 0.13 to 3.31, SD = 0.24, p-value ≤ 0.001). Conclusion: Interprofessional Education in an academic setting is essential to help healthcare students prepare and succeed in their future healthcare careers. The study results show that health science and public health students understand IPE and value academic exposure to the IPE process during their studies. Academic healthcare programs should continue integrating the IPE learning model and content throughout the student’s academic journey. The variations in IPE attitude do not significantly vary based on demographics and healthcare career fields. This study only represents a sample size of the many healthcare careers. Interprofessional communication and collaboration are essential to the future healthcare delivery challenges we face. For this reason, IPE should be integrated into healthcare education for all health science and public health students. It is recommended that more research should be done on creative curriculum design to get students more engaged in various healthcare IPE learning activities.展开更多
Objectives:As Watson's Human Caring Theory continues to evolve and guide the discipline of nursing,the challenge is to find ways to integrate it into practice.The purpose of this study is to describe interprofessi...Objectives:As Watson's Human Caring Theory continues to evolve and guide the discipline of nursing,the challenge is to find ways to integrate it into practice.The purpose of this study is to describe interprofessional team members'perspectives on human caring based on the Ten Caritas Processes(R)/Caritas-Veritas Literacy of Watson's Human Caring Theory within the Unitary Caring Science.Methods:This is a qualitative directed content analysis study,taking place in a Children's Hospital in the United States between November 2017 and April 2018.Information redundancy was utilized to guide the recruitment.Data were collected via a one-time face-to-face individual interview.A qualitative directed content analysis was conducted using Watson's Ten Caritas Processes(R)/Caritas-Veritas Literacy as a coding framework.Results:Twenty-seven healthcare professionals participated in the study.Interprofessional human caring,based on the Ten Caritas Processes(R)/Caritas-Veritas Literacy,was referred to as performing lovingkindness to patients,each other,and self;maintaining faith-hope in teamwork;valuing intersubjective interactions and building trust among team members;cultivating heart-centered-caring relations;acknowledging and processing positive and negative feelings non-judgmentally;applying all ways of knowing in caring;encouraging reciprocal teaching-learning;developing caring-healing environments collaboratively;respecting human dignity of patients and each other;and being open-minded to the unknowns and believing in miracles.Conclusions:Watson's Human Caring Theory can be an underlying guide to enrich human-to-human relations and create a caring-healing environment.When human caring is applied in interprofessional teams,healthcare professionals find a caring consciousness to care for oneself and each other and promote patient care.展开更多
Objective:This investigation evaluated if exposure to interdisciplinary education improves student readiness for interprofessional learning,fundamental to healthcare team development.Methods:A pre-test post-test desig...Objective:This investigation evaluated if exposure to interdisciplinary education improves student readiness for interprofessional learning,fundamental to healthcare team development.Methods:A pre-test post-test design was used to evaluate 308 students from dental medicine,dietetics,medicine,nursing,pharmacy and physical therapy.The Readiness for Interprofessional Learning Scale(RIPLS)was used to evaluate student responsiveness to interprofessional education.Results:Nursing RIPLS mean post-test score was higher compared to the pre-test score(p=0.020).Pharmacy students had higher RIPLS mean pre-test score compared to medical(p=0.010)and nursing students(p=0.018).RIPLS mean pre-test score was higher for dietetics than medical students(p=0.022).Conclusions/Implications:Interdisciplinary learning enhances readiness for interprofessional learning with nursing students.Pharmacy and dietetics students demonstrated a higher level of readiness for interdisciplinary learning compared to other disciplines.Identification of factors influencing readiness for interprofessional learning are key to developing learning strategies targeted to improve teamwork,quality of care and patient outcomes.展开更多
This investigation evaluated if individual student attributes have a predictive impact on readiness for interprofessional education(IPE).An exploratory analysis was conducted with 311 students from dental medicine,die...This investigation evaluated if individual student attributes have a predictive impact on readiness for interprofessional education(IPE).An exploratory analysis was conducted with 311 students from dental medicine,dietetics,medicine,nursing,pharmacy and physical therapy.Discipline,gender,age,academic standing,amount of clinical exposure in academic program and number of years worked in a patient care setting were evaluated as predictors of readiness for IPE using the Readiness for Interprofessional Learning Scale(RIPLS).Medical students had significantly lower RIPLS scores compared to pharmacy(p=0.010)and dietetics students(p=0.022).Male gender(p=0.005)was a single independent predictor of IPE readiness.A higher number of years of practice had a significant interaction predictive of readiness for IPE(p=0.028).Identification of factors influencing readiness for IPE are key to developing teaching and learning strategies targeted to improve teamwork,quality of care and patient outcomes.In this investigation,men with more years of practice was highly predictive of a lower RIPLS score.Based upon our findings,educational planning targeting male medical students with a higher number of years of practice would be a reasonable evidence-based step toward improving the value of IPE programs and curricula.Further work is necessary in developing focus groups,simulation and case-based exercises to influence attitudes and readiness for IPE.展开更多
Introduction: We conducted a multi-occupational team simulation training for medical and nursing students and clarified how professional identity and professionalism attitudes change with interprofessional education (...Introduction: We conducted a multi-occupational team simulation training for medical and nursing students and clarified how professional identity and professionalism attitudes change with interprofessional education (IPE). Methods: Thirty-nine 4<sup>th</sup>-year medical students and 48 2<sup>nd</sup>-year nursing students were enrolled and distributed to the educational intervention group and the control group. We used a vocation identity scale including lower four subscales, a scale for professionalism including lower five subscales, a readiness for inter-professional learning scale (RIPLS), and an interdisciplinary education perception scale (IEPS). Results: Among the medical students, IPE using an advanced patient simulator improved the scores on the vocational identity scale, scale for professionalism, RIPLS, and IEPS. Among the nursing students, IPE improved the scores on the vocational identity scale, scale for professionalism, RIPLS, and IEPS. Conclusion: On-the-job training using simulated clinical training by a multi-occupational team improved vocational identification and professionalism.展开更多
Background: Nurses are significant healthcare team members. It is vital to examine their gains in an interprofessional education (IPE). Purpose: We aimed to examine the perceived benefits of interprofessional team-bas...Background: Nurses are significant healthcare team members. It is vital to examine their gains in an interprofessional education (IPE). Purpose: We aimed to examine the perceived benefits of interprofessional team-based learning (IPTBL) on the entry level nursing students. Methods: Content analysis was adopted to identify categories in the reflections of the entry-level undergraduate nursing student IPTBL experiences. Results: There were 205 (male = 34) undergraduate nursing students (response rate 82.2%) participating in the present study. In line with the Interprofessional Education Collaborative Report (IPEC) core competencies, four categories were identified: 1) Values/Ethics for Interprofessional Practice, 2) Roles/Responsibilities, 3) Interprofessional Communication, and 4) Teams and Teamwork. A new category emerged—individual learning outcomes. Conclusion: Through IP interactions and the expectation of the IP team, the nursing students had built confidence and defined the nurses’ roles.展开更多
This paper explores the contribution of teamwork skills in serious adverse events, using the TeamSTEPPS<sup>®</sup> framework. Adverse events are the undesirable events that are not due to the natu...This paper explores the contribution of teamwork skills in serious adverse events, using the TeamSTEPPS<sup>®</sup> framework. Adverse events are the undesirable events that are not due to the natural course of a disease;they are considered serious when they prolong a hospital stay, lead to a physical disability or to death. Failures in teamwork, particularly with interprofessional teams, can lead to potential risks to patient safety. Using a dataset of de-identified reports of serious adverse events in 2016 in a tertiary teaching hospital, we explored the contribution of teamwork skills according to the TeamSTEPPS<sup>®</sup> framework to these adverse events. We found that 61% of the 41 analyzed events involved failures in teamwork skills, with 80% of these involving communication, 52% in situation monitoring and team structure, 44% in mutual support and 40% in leadership. Sixty-four percent of the events involved more than one teamwork component. Our findings emphasize the need to improve teamwork training in healthcare, focusing not only on communication, but also on other teamwork skills as they often contribute together in adverse events. Future analyses of serious adverse events should include a focus on teamwork competencies, to guide the development of future quality and safety training programs.展开更多
In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-base...In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-based care, 8 core categories (19 categories) were extracted and as actual situations of interprofessional work for dementia care, 8 core categories (13 categories) were obtained. The authors examined a function of interprofessional work model and practice contents using these categories. The results revealed that better interprofessional work can be expected by six specialists of nurses rehabilitation specialists, MSW, pharmacists, dietitians and care workers developing dementia care based on “Family handling function” “ADL maintenance and improved function” “Staff member education and empowerment function”.展开更多
Improvement of relationships among health clinicians is important for reducing adverse clinical outcomes. To improve clinician relationships, the relationship development process is best initiated during health profes...Improvement of relationships among health clinicians is important for reducing adverse clinical outcomes. To improve clinician relationships, the relationship development process is best initiated during health professional education, rather than “refitting” the interrelationship model learned during the health education process. While Interprofessional Education (IPE) has been identified as an effective model to fill the gap for both education and practice, IPE requires moving to an integrative curricular approach with a strong practice component. As a developmental process, IPE implementation faces challenges at every stage. The Interprofessional Education Development: The Roadmap for Getting There article describes the five stages of IPE, discusses important components of creating an IPE culture, suggests strategies for overcoming the challenges for each stage, and describes signs related to achievement of the five developmental stages of IPE.展开更多
In the United States, approximately one in eight (13 percent, or 30 million)individuals aged 12 years or older has bilateral hearing loss. Whenunaddressed and untreated, hearing loss is associated with and contributes...In the United States, approximately one in eight (13 percent, or 30 million)individuals aged 12 years or older has bilateral hearing loss. Whenunaddressed and untreated, hearing loss is associated with and contributesto other significant health issues;specifically, social isolation, depression,stress, and anxiety, incidental falls, dementia and impaired cognition, andreduced quality of life. This is a public health concern. Health and primarycare providers are in a unique position to have a positive impact by probingthe hearing of the patients they see, providing information, and makingappropriate referrals to reduce deleterious effects when this impairmentoccurs.Abbreviations: Hertz (Hz);High frequency hearing loss (HFHL);Personallistening devices (PLDs);Sensorineural hearing loss (SNHL)Format: Small group discussion, classroom and clinical practicum settings.Target audience: The student and practicing health professions (e.g.occupational and physical therapy, psychologists, physician assistants,nursing, and medical) involved and the relevant point in their training andpractice.展开更多
Objective:A collaborative team is necessary to help patients achieve their healthcare goals using complementary medicine.At present,healthcare professionals do not feel sufficiently qualified to provide this service.T...Objective:A collaborative team is necessary to help patients achieve their healthcare goals using complementary medicine.At present,healthcare professionals do not feel sufficiently qualified to provide this service.This study sought to identify competencies and teaching methods for interprofessional training on complementary and integrative medicine at medical schools.Methods:Sixty-five German-speaking experts with various professional backgrounds were invited to take part in a three-round Delphi study.In the first round,predefined competencies were assessed on a seven-point Likert scale,and participants were invited to propose additional competencies that would be evaluated in the subsequent rounds.The competencies were ranked based on the participant assessments and were assigned to four relevance groups.In the second and third rounds,suitable teaching methods were identified using free-text fields and multiple-choice questions.In a final workshop,participants synthesized the outcomes of the previous sessions and derived key competencies that would be a benefit to undergraduate interprofessional training in complementary and integrative medicine at medical schools.Results:The three rounds plus final worksop were attended by 50,40,36 and 11 experts.The competencies that these experts determined to be highly relevant to teaching complementary and integrative medicine emphasized,in particular,the respectful treatment of patients and the importance of taking a medical history.From these highly relevant competencies,three key targets were agreed upon in the final workshop:students are able to 1)classify and assess complementary medical terms and methods;2)work collaboratively and integrate patients into the interprofessional team;3)involve patients and their relatives respectfully and empathetically in all healthcare processes.To achieve these competency goals,the following teaching methods were highlighted:students discuss therapy options based on authentic patient cases with each other and practice empathic patient communication incorporating complementary medicine.Further,the theoretical background of complementary medicines could be provided as online-training,to use the class sessions for hands-on exercises and interprofessional exchange and discussion.Conclusion:Despite the heterogeneous panel of experts,a consensus was reached on the competency orientation and teaching approaches.The results can promote the implementation of interprofessional training for complementary medicine in undergraduate education.展开更多
Objectives:The motives that lead to nurses’workplace silence behaviour are essential to understand,as the failure to voice their concerns and maintain silence may cause various adverse outcomes,including burnout,turn...Objectives:The motives that lead to nurses’workplace silence behaviour are essential to understand,as the failure to voice their concerns and maintain silence may cause various adverse outcomes,including burnout,turnover,job dissatisfaction,low productivity,and mental and moral distress.This study aimed to identify the level and influencing motives of the workplace silence behaviour among nurses at the National Guard Hospital in Madinah.Methods:A descriptive cross-sectional survey was conducted in January and February 2023.The participants completed a questionnaire with two parts:the sociodemographic data form and the Workplace Silence Behavior Nursing Motives Scale.Data analysis was performed by descriptive statistics and the chi-square test.Results:The overall level for all workplace silence behavior motives is moderate(3.29±0.69),with Avoidance Motives dimension receiving the highest scores(3.62±0.75)and Organization-Oriented Motives dimension receiving the lowest(3.15±0.86).Chi-square test showed that Saudi nationality(X^(2)=0.015,P=0.019)and monthly income(X^(2)=0.045,P?0.013)are factors in high-moderate levels of silence behaviour.Conclusions:The overall level of workplace silence behaviour motives was found to be moderate,nurses have higher monthly salaries and non-Saudi nationals tend to have higher levels of workplace silence behaviour motives.The study results provide a reference for nursing managers to pay attention to nurses’workplace silence behavior and take corresponding intervention measures.展开更多
Multidisciplinary and interprofessional collaboration among medical staff is an effective way to reduce the incidence and complication of complex diseases and improve the quality of life.Therefore,it is very important...Multidisciplinary and interprofessional collaboration among medical staff is an effective way to reduce the incidence and complication of complex diseases and improve the quality of life.Therefore,it is very important to carry out interdisciplinary cooperative learning for nursing students in the education stage.This paper expounds the current situation of cross-disciplinary nursing education at home and abroad from the aspects of preparation and influencing factors of cross-disciplinary cooperative learning,teacher team building,teaching content and teaching methods,implementation time and place,in order to put forward suggestions for carrying out cross-disciplinary cooperative learning in college courses,and provide reference for many educators to carry out cross-disciplinary education and improve the comprehensive ability of nursing students.展开更多
Objective:This study assessed the role of the attending medical team in the cost control of the cholecystectomy DRG components.Methods:The association between team structure,workflow,and treatment outcomes was analyze...Objective:This study assessed the role of the attending medical team in the cost control of the cholecystectomy DRG components.Methods:The association between team structure,workflow,and treatment outcomes was analyzed using a mixed-methods approach combining quantitative data and qualitative interviews from 628 patients.Results:Inter-professional teamwork significantly affected length of stay,treatment costs,and recurrence rates,with experienced teams performing better in terms of emergency response and collaborative efficiency.Patient satisfaction was generally high,indicating that good teamwork enhances treatment outcomes.Significance:The study highlights the importance of optimizing team configuration to improve the quality,efficiency,and cost control of healthcare.展开更多
Complementary and integrative healthcare(CIH)is increasingly recognized as a valuable approach to empowering and activating cancer patients.Studies have shown that higher patient activation is positively associated wi...Complementary and integrative healthcare(CIH)is increasingly recognized as a valuable approach to empowering and activating cancer patients.Studies have shown that higher patient activation is positively associated with improved health outcomes and reduced healthcare costs.The CCC-Integrativ study aimed to assess the implementation of an evidence-based counseling service on CIH at four Comprehensive Cancer Centers(CCC)in Germany.In this controlled implementation study,the patient-level intervention included three CIH consultations within a 3-month period delivered by interprofessional teams of physicians and nurses.The primary endpoint was patient activation using the PAM-13 at baseline(T1)and post-intervention(T2),and compared between control(CO,receiving routine care)and the intervention group(IG)using an analysis of covariance.Missing data were handled with multiple imputations.Maintenance effects at 6-month follow-up(T3)were investigated using a linear mixed model.A total of n=1128 oncology patients(CO=443,IG=685)with diverse tumor entities and cancer stages were included in the study.The overall mean baseline PAM-13 score was 69.74(SD=14.24)(n=959(85.0%)).A statistically significant between-group difference in post-intervention PAM-13 scores was observed(F_(group)(1,1866.82)=8.634,P=0.003),with an adjusted mean difference of 2.22 PAM-points.Age,gender,tumor entity,disease stage,or CCC study site did not significantly predict post-treatment PAM-13 scores.The maintenance effect of the intervention was not statistically significant(F_(timeXgroup)(1,3316.04)=2.337,P=0.096).Individually tailored counseling on CIH,offered by specifically trained,interprofessional teams,significantly improved patient activation.Given the established positive effects of higher patient activation,the implementation of such a program at cancer centers may yield beneficial outcomes for both patients and the healthcare system.展开更多
Aims: Research the process of organizational change to understand how interventions such as appearance care can be integrated into daily practice. Background: Typical treatment of breast cancer is surgery, often follo...Aims: Research the process of organizational change to understand how interventions such as appearance care can be integrated into daily practice. Background: Typical treatment of breast cancer is surgery, often followed by chemotherapy. Associated aesthetic ramifications, including hair loss, frequently cause patient distress. Methods: We conducted face-to-face semi-structured hour-long recorded interviews with three nurses. We then analyzed the developmental process according to the core competencies for interprofessional collaborative practice using the thematic content analysis. Results: Nurses worked with interdisciplinary team members with mutual respect and shared values such as concern for patients’ quality of life. Nurses used knowledge of appearance-related side effects combined with beautician-provided coping skills. Intervention involved responsible communication with other health professionals and patients in a team approach. Nurses promoted the developmental process and became program facilitators. Conclusion: This group-intervention program, facilitated by nurses, was integrated into daily practice. Implications for nursing management: Research partnerships between academics, clinical nurses, nurse managers, and beauticians can improve the integration of interventions in routine practice and increase awareness of patients’ needs.展开更多
Objective: To assess current heart failure (HF) care processes and organizational context in long-term care (LTC) homes as a prelude to adapting the Canadian Cardiovascular Society (CCS) HF guidelines for use in these...Objective: To assess current heart failure (HF) care processes and organizational context in long-term care (LTC) homes as a prelude to adapting the Canadian Cardiovascular Society (CCS) HF guidelines for use in these settings. Methods: This research reports on the results of thirteen focus groups (N = 83 participants;average of 60 minutes duration) conducted in three Ontario LTC homes to better understand how HF was managed and how organizational context impacted care. Participants included physicians, nurse practitioners, registered nurses, registered practical nurses, and personal support workers. Results: Focus group findings revealed that the complexity of the LTC environment presents challenges for managing HF. Most residents have multiple advanced chronic conditions that must be managed simultaneously. Culturally, LTC is first and foremost a resident’s home where residents may choose not to comply with care recommendations. Staff routines, scopes of practice, professional hierarchies, available resources and government regulations limit flexibility in providing care. Staff lacked knowledge, skills and resources for managing HF. Nevertheless, all staff viewed LTC as the preferred place for managing HF, avoiding residents’ hospitalizations wherever possible. These data suggest that strategies for improving LTC staff communication and education, strengthening existing relationships between staff, family, residents and community resources, and acquiring additional resources in LTC homes have the potential to improve HF management in this setting. Conclusion: LTC is a complex and dynamic environment that presents many challenges for providing care for residents. This research provides the foundation for subsequent work to develop and test implementation strategies to manage HF in LTC, which are consistent with the CCS HF guidelines and are feasible within LTC staff’s work routines, capacities and resources.展开更多
The aim of this work was to compare multiprofessional and uniprofessional interventions applied to adolescent patients affected by psychiatric disorders. The initial hypothesis is that a multiprofessional intervention...The aim of this work was to compare multiprofessional and uniprofessional interventions applied to adolescent patients affected by psychiatric disorders. The initial hypothesis is that a multiprofessional intervention is more efficacy than a single one. A hundred individuals, 66 males and 34 females, aged between 12 and 19 years affected by emotional and behavioural problems, were selected and divided into 5 groups under the therapeutic treatment. Subjects, after diagnosis (ICD 10) and therapeutic suggestion, were clinically followed for 12 months. The Global Assessment Functioning Scale (GAF) was used to evaluate therapeutic efficacy of interventions. The outcome is associated with the type of intervention: who got clinically better are those patients who underwent multiprofessional integrated therapy rather then a single intervention.展开更多
Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously...Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously ill, and their families may be at risk depending on the patient’s situation. Considering these characteristics of patients and families, there is a strong need for multi-professional collaboration within ICUs. The purpose of this descriptive study was to examine recognition and other factors related to collaboration and satisfaction involving care decisions in Japanese ICUs. A mail survey about collaboration of activities and systems was sent to physicians, clinical engineers, and nurses working in ICUs in Japan, 387 consented to participate in this study. Results showed that satisfaction scores were generally high among the three aforementioned professions, but collaboration scores on deciding care for patients showed significant differences (p < 0.05). The total collaboration score was the highest among physicians (36.7 ± 6.7 points), followed by nurses (32.8 ± 7.4 points), and CEs (32.8 ± 7.4 points). The factors that commonly affected collaboration scores were the satisfaction score and the ability to collaborate with other professionals and set team medical care as a goal. Moreover, it is worth noting that the degree of difficulty in collaboration negatively affected this factor. On the other hand, other factors differed among the three professions, suggesting that the purpose and need for collaboration differ depending on the profession.展开更多
基金Funding for this study was received from the Ontario Ministry of Health and Long Term Care Grant#06658.
文摘Objective:Interprofessional care,an aim of institutional healthcare settings globally,promotes safe,cost-effective,quality care.How professionals act to enable interprofessional care has not been described.The nurse practitioner role,with its expertise in both medicine and nursing,is known to enhance collaboration and promote interprofessional care delivery.The objective of this study was to identify,from the healthcare professionals'perspective,nurse practitioner strategies used to enhance interprofessional care.Method:A hermeneutic phenomenology design was employed.Healthcare professionals from acute care hospitals and associated long-term care residences(n=6)in one Canadian province were invited to participate.Individual interviews were held with healthcare professionals(n=52)who regularly work with a nurse practitioner.The participants were asked to share experiences that held significance or value in promoting interprofessional care.Results:Four valued role attributes were identified;consistent role presence,time to focus on the patient,effective communication,and respectful centrality.Identified strategies extending from the attributes included knowledge sharing,respectful negotiation,identifying patient issues,being open and transparent,listening to opinions,bridging professions,and working as the hub of the group.Multiple types of interprofessional relationships were perceived,with the hierarchical type as the most common.Conclusions:Nurse practitioners in acute care hospital and long-term care settings have valued attributes that can promote interprofessional care.Effective strategies to promote interprofessional care emerge from these role attributes.However,the interprofessional relationship type perceived could enhance or impede the contribution of the strategies to interprofessional care promotion.
文摘Introduction: The study revealed that many healthcare professional students begin their academic studies with positive and high expectations towards interprofessional collaborative studies. Unfortunately, students lose interest if their initial expectations are not met with consistent opportunities to enhance their communication skills and better understand the different healthcare professions. The study aimed to explore health science and public health students’ attitudes toward IPE. The participants’ backgrounds and demographics were used as the variations for the study. Methods: A pre-post semi-quantitative anonymous survey was designed to assess health science and public health undergraduate students’ attitudes toward IPE. The reason for this design was to capture the participants’ attitudes toward IPE at the start of a semester when they had no academic exposure to IPE. Qualtrics was used to collect the research data. A valid and reliable scale was used to measure attitudes toward IPE. A post-survey was included to measure the participants’ change in attitude toward IPE during the semester. The goal was to measure the IPE curriculum effectiveness. There were 21 survey questions. The questions were divided into four validated subscales. The first seven questions (Questions 1 - 7) pertained to the participants’ demographics s, such as gender, age, race, ethnicity, major field of study, and prior education. Questions 8, 9, 16, & 20 were designed to determine how the participants perceived their roles and responsibilities in their future healthcare careers. Each IPE attitude question’s central tendency and demographic variations were measured. The correlation between demographics and IPE attitudes was measured. Results: The pre-survey had 192 participants, and the post-survey had 97 participants. The pre-survey had 87% of participants in the age group 17 - 25 years, while the post-survey had 82.5% in the same age group. Only 5.7% of the participants were 36 years or older in the pre-survey and 9.3% in the post-survey. The participants were 80.70% female in the pre-survey and 85.6% in the post-survey. The largest healthcare career field concentration was nursing, with 42.7% and 45.4% in the pre- and post-surveys. The other three larger career fields were healthcare administration, community health education, and physician assistant. The participants’ attitudes toward learning with different healthcare career students and becoming more effective members of a healthcare team increased from 4.36 (SD = 0.13) to 4.40 (SD = 0.17). Two negative IPE attitude questions showed an increased value: 1) The function of nursing therapists is mainly to provide support for doctors (3.51, SD = 0.19 to 3.12, SD = 0.24, p-value ≤ 0.004) and 2) Clinical and healthcare problem-solving skills could only be learned with students from the same career field (3.73, SD = 0.13 to 3.31, SD = 0.24, p-value ≤ 0.001). Conclusion: Interprofessional Education in an academic setting is essential to help healthcare students prepare and succeed in their future healthcare careers. The study results show that health science and public health students understand IPE and value academic exposure to the IPE process during their studies. Academic healthcare programs should continue integrating the IPE learning model and content throughout the student’s academic journey. The variations in IPE attitude do not significantly vary based on demographics and healthcare career fields. This study only represents a sample size of the many healthcare careers. Interprofessional communication and collaboration are essential to the future healthcare delivery challenges we face. For this reason, IPE should be integrated into healthcare education for all health science and public health students. It is recommended that more research should be done on creative curriculum design to get students more engaged in various healthcare IPE learning activities.
基金This study was supported in part by a Seed Grant from the College of Nursing at East Carolina University received by the first author
文摘Objectives:As Watson's Human Caring Theory continues to evolve and guide the discipline of nursing,the challenge is to find ways to integrate it into practice.The purpose of this study is to describe interprofessional team members'perspectives on human caring based on the Ten Caritas Processes(R)/Caritas-Veritas Literacy of Watson's Human Caring Theory within the Unitary Caring Science.Methods:This is a qualitative directed content analysis study,taking place in a Children's Hospital in the United States between November 2017 and April 2018.Information redundancy was utilized to guide the recruitment.Data were collected via a one-time face-to-face individual interview.A qualitative directed content analysis was conducted using Watson's Ten Caritas Processes(R)/Caritas-Veritas Literacy as a coding framework.Results:Twenty-seven healthcare professionals participated in the study.Interprofessional human caring,based on the Ten Caritas Processes(R)/Caritas-Veritas Literacy,was referred to as performing lovingkindness to patients,each other,and self;maintaining faith-hope in teamwork;valuing intersubjective interactions and building trust among team members;cultivating heart-centered-caring relations;acknowledging and processing positive and negative feelings non-judgmentally;applying all ways of knowing in caring;encouraging reciprocal teaching-learning;developing caring-healing environments collaboratively;respecting human dignity of patients and each other;and being open-minded to the unknowns and believing in miracles.Conclusions:Watson's Human Caring Theory can be an underlying guide to enrich human-to-human relations and create a caring-healing environment.When human caring is applied in interprofessional teams,healthcare professionals find a caring consciousness to care for oneself and each other and promote patient care.
基金Funding in support of this project was provided from the University of Connecticut School of Nursing.
文摘Objective:This investigation evaluated if exposure to interdisciplinary education improves student readiness for interprofessional learning,fundamental to healthcare team development.Methods:A pre-test post-test design was used to evaluate 308 students from dental medicine,dietetics,medicine,nursing,pharmacy and physical therapy.The Readiness for Interprofessional Learning Scale(RIPLS)was used to evaluate student responsiveness to interprofessional education.Results:Nursing RIPLS mean post-test score was higher compared to the pre-test score(p=0.020).Pharmacy students had higher RIPLS mean pre-test score compared to medical(p=0.010)and nursing students(p=0.018).RIPLS mean pre-test score was higher for dietetics than medical students(p=0.022).Conclusions/Implications:Interdisciplinary learning enhances readiness for interprofessional learning with nursing students.Pharmacy and dietetics students demonstrated a higher level of readiness for interdisciplinary learning compared to other disciplines.Identification of factors influencing readiness for interprofessional learning are key to developing learning strategies targeted to improve teamwork,quality of care and patient outcomes.
基金support of this project was provided from the University of Connecticut School of Nursing.
文摘This investigation evaluated if individual student attributes have a predictive impact on readiness for interprofessional education(IPE).An exploratory analysis was conducted with 311 students from dental medicine,dietetics,medicine,nursing,pharmacy and physical therapy.Discipline,gender,age,academic standing,amount of clinical exposure in academic program and number of years worked in a patient care setting were evaluated as predictors of readiness for IPE using the Readiness for Interprofessional Learning Scale(RIPLS).Medical students had significantly lower RIPLS scores compared to pharmacy(p=0.010)and dietetics students(p=0.022).Male gender(p=0.005)was a single independent predictor of IPE readiness.A higher number of years of practice had a significant interaction predictive of readiness for IPE(p=0.028).Identification of factors influencing readiness for IPE are key to developing teaching and learning strategies targeted to improve teamwork,quality of care and patient outcomes.In this investigation,men with more years of practice was highly predictive of a lower RIPLS score.Based upon our findings,educational planning targeting male medical students with a higher number of years of practice would be a reasonable evidence-based step toward improving the value of IPE programs and curricula.Further work is necessary in developing focus groups,simulation and case-based exercises to influence attitudes and readiness for IPE.
文摘Introduction: We conducted a multi-occupational team simulation training for medical and nursing students and clarified how professional identity and professionalism attitudes change with interprofessional education (IPE). Methods: Thirty-nine 4<sup>th</sup>-year medical students and 48 2<sup>nd</sup>-year nursing students were enrolled and distributed to the educational intervention group and the control group. We used a vocation identity scale including lower four subscales, a scale for professionalism including lower five subscales, a readiness for inter-professional learning scale (RIPLS), and an interdisciplinary education perception scale (IEPS). Results: Among the medical students, IPE using an advanced patient simulator improved the scores on the vocational identity scale, scale for professionalism, RIPLS, and IEPS. Among the nursing students, IPE improved the scores on the vocational identity scale, scale for professionalism, RIPLS, and IEPS. Conclusion: On-the-job training using simulated clinical training by a multi-occupational team improved vocational identification and professionalism.
文摘Background: Nurses are significant healthcare team members. It is vital to examine their gains in an interprofessional education (IPE). Purpose: We aimed to examine the perceived benefits of interprofessional team-based learning (IPTBL) on the entry level nursing students. Methods: Content analysis was adopted to identify categories in the reflections of the entry-level undergraduate nursing student IPTBL experiences. Results: There were 205 (male = 34) undergraduate nursing students (response rate 82.2%) participating in the present study. In line with the Interprofessional Education Collaborative Report (IPEC) core competencies, four categories were identified: 1) Values/Ethics for Interprofessional Practice, 2) Roles/Responsibilities, 3) Interprofessional Communication, and 4) Teams and Teamwork. A new category emerged—individual learning outcomes. Conclusion: Through IP interactions and the expectation of the IP team, the nursing students had built confidence and defined the nurses’ roles.
文摘This paper explores the contribution of teamwork skills in serious adverse events, using the TeamSTEPPS<sup>®</sup> framework. Adverse events are the undesirable events that are not due to the natural course of a disease;they are considered serious when they prolong a hospital stay, lead to a physical disability or to death. Failures in teamwork, particularly with interprofessional teams, can lead to potential risks to patient safety. Using a dataset of de-identified reports of serious adverse events in 2016 in a tertiary teaching hospital, we explored the contribution of teamwork skills according to the TeamSTEPPS<sup>®</sup> framework to these adverse events. We found that 61% of the 41 analyzed events involved failures in teamwork skills, with 80% of these involving communication, 52% in situation monitoring and team structure, 44% in mutual support and 40% in leadership. Sixty-four percent of the events involved more than one teamwork component. Our findings emphasize the need to improve teamwork training in healthcare, focusing not only on communication, but also on other teamwork skills as they often contribute together in adverse events. Future analyses of serious adverse events should include a focus on teamwork competencies, to guide the development of future quality and safety training programs.
文摘In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-based care, 8 core categories (19 categories) were extracted and as actual situations of interprofessional work for dementia care, 8 core categories (13 categories) were obtained. The authors examined a function of interprofessional work model and practice contents using these categories. The results revealed that better interprofessional work can be expected by six specialists of nurses rehabilitation specialists, MSW, pharmacists, dietitians and care workers developing dementia care based on “Family handling function” “ADL maintenance and improved function” “Staff member education and empowerment function”.
文摘Improvement of relationships among health clinicians is important for reducing adverse clinical outcomes. To improve clinician relationships, the relationship development process is best initiated during health professional education, rather than “refitting” the interrelationship model learned during the health education process. While Interprofessional Education (IPE) has been identified as an effective model to fill the gap for both education and practice, IPE requires moving to an integrative curricular approach with a strong practice component. As a developmental process, IPE implementation faces challenges at every stage. The Interprofessional Education Development: The Roadmap for Getting There article describes the five stages of IPE, discusses important components of creating an IPE culture, suggests strategies for overcoming the challenges for each stage, and describes signs related to achievement of the five developmental stages of IPE.
文摘In the United States, approximately one in eight (13 percent, or 30 million)individuals aged 12 years or older has bilateral hearing loss. Whenunaddressed and untreated, hearing loss is associated with and contributesto other significant health issues;specifically, social isolation, depression,stress, and anxiety, incidental falls, dementia and impaired cognition, andreduced quality of life. This is a public health concern. Health and primarycare providers are in a unique position to have a positive impact by probingthe hearing of the patients they see, providing information, and makingappropriate referrals to reduce deleterious effects when this impairmentoccurs.Abbreviations: Hertz (Hz);High frequency hearing loss (HFHL);Personallistening devices (PLDs);Sensorineural hearing loss (SNHL)Format: Small group discussion, classroom and clinical practicum settings.Target audience: The student and practicing health professions (e.g.occupational and physical therapy, psychologists, physician assistants,nursing, and medical) involved and the relevant point in their training andpractice.
文摘Objective:A collaborative team is necessary to help patients achieve their healthcare goals using complementary medicine.At present,healthcare professionals do not feel sufficiently qualified to provide this service.This study sought to identify competencies and teaching methods for interprofessional training on complementary and integrative medicine at medical schools.Methods:Sixty-five German-speaking experts with various professional backgrounds were invited to take part in a three-round Delphi study.In the first round,predefined competencies were assessed on a seven-point Likert scale,and participants were invited to propose additional competencies that would be evaluated in the subsequent rounds.The competencies were ranked based on the participant assessments and were assigned to four relevance groups.In the second and third rounds,suitable teaching methods were identified using free-text fields and multiple-choice questions.In a final workshop,participants synthesized the outcomes of the previous sessions and derived key competencies that would be a benefit to undergraduate interprofessional training in complementary and integrative medicine at medical schools.Results:The three rounds plus final worksop were attended by 50,40,36 and 11 experts.The competencies that these experts determined to be highly relevant to teaching complementary and integrative medicine emphasized,in particular,the respectful treatment of patients and the importance of taking a medical history.From these highly relevant competencies,three key targets were agreed upon in the final workshop:students are able to 1)classify and assess complementary medical terms and methods;2)work collaboratively and integrate patients into the interprofessional team;3)involve patients and their relatives respectfully and empathetically in all healthcare processes.To achieve these competency goals,the following teaching methods were highlighted:students discuss therapy options based on authentic patient cases with each other and practice empathic patient communication incorporating complementary medicine.Further,the theoretical background of complementary medicines could be provided as online-training,to use the class sessions for hands-on exercises and interprofessional exchange and discussion.Conclusion:Despite the heterogeneous panel of experts,a consensus was reached on the competency orientation and teaching approaches.The results can promote the implementation of interprofessional training for complementary medicine in undergraduate education.
文摘Objectives:The motives that lead to nurses’workplace silence behaviour are essential to understand,as the failure to voice their concerns and maintain silence may cause various adverse outcomes,including burnout,turnover,job dissatisfaction,low productivity,and mental and moral distress.This study aimed to identify the level and influencing motives of the workplace silence behaviour among nurses at the National Guard Hospital in Madinah.Methods:A descriptive cross-sectional survey was conducted in January and February 2023.The participants completed a questionnaire with two parts:the sociodemographic data form and the Workplace Silence Behavior Nursing Motives Scale.Data analysis was performed by descriptive statistics and the chi-square test.Results:The overall level for all workplace silence behavior motives is moderate(3.29±0.69),with Avoidance Motives dimension receiving the highest scores(3.62±0.75)and Organization-Oriented Motives dimension receiving the lowest(3.15±0.86).Chi-square test showed that Saudi nationality(X^(2)=0.015,P=0.019)and monthly income(X^(2)=0.045,P?0.013)are factors in high-moderate levels of silence behaviour.Conclusions:The overall level of workplace silence behaviour motives was found to be moderate,nurses have higher monthly salaries and non-Saudi nationals tend to have higher levels of workplace silence behaviour motives.The study results provide a reference for nursing managers to pay attention to nurses’workplace silence behavior and take corresponding intervention measures.
文摘Multidisciplinary and interprofessional collaboration among medical staff is an effective way to reduce the incidence and complication of complex diseases and improve the quality of life.Therefore,it is very important to carry out interdisciplinary cooperative learning for nursing students in the education stage.This paper expounds the current situation of cross-disciplinary nursing education at home and abroad from the aspects of preparation and influencing factors of cross-disciplinary cooperative learning,teacher team building,teaching content and teaching methods,implementation time and place,in order to put forward suggestions for carrying out cross-disciplinary cooperative learning in college courses,and provide reference for many educators to carry out cross-disciplinary education and improve the comprehensive ability of nursing students.
文摘Objective:This study assessed the role of the attending medical team in the cost control of the cholecystectomy DRG components.Methods:The association between team structure,workflow,and treatment outcomes was analyzed using a mixed-methods approach combining quantitative data and qualitative interviews from 628 patients.Results:Inter-professional teamwork significantly affected length of stay,treatment costs,and recurrence rates,with experienced teams performing better in terms of emergency response and collaborative efficiency.Patient satisfaction was generally high,indicating that good teamwork enhances treatment outcomes.Significance:The study highlights the importance of optimizing team configuration to improve the quality,efficiency,and cost control of healthcare.
基金supported by the Innovationsfonds of the Federal Joint Committee 2019-2022(No.01NVF18004).
文摘Complementary and integrative healthcare(CIH)is increasingly recognized as a valuable approach to empowering and activating cancer patients.Studies have shown that higher patient activation is positively associated with improved health outcomes and reduced healthcare costs.The CCC-Integrativ study aimed to assess the implementation of an evidence-based counseling service on CIH at four Comprehensive Cancer Centers(CCC)in Germany.In this controlled implementation study,the patient-level intervention included three CIH consultations within a 3-month period delivered by interprofessional teams of physicians and nurses.The primary endpoint was patient activation using the PAM-13 at baseline(T1)and post-intervention(T2),and compared between control(CO,receiving routine care)and the intervention group(IG)using an analysis of covariance.Missing data were handled with multiple imputations.Maintenance effects at 6-month follow-up(T3)were investigated using a linear mixed model.A total of n=1128 oncology patients(CO=443,IG=685)with diverse tumor entities and cancer stages were included in the study.The overall mean baseline PAM-13 score was 69.74(SD=14.24)(n=959(85.0%)).A statistically significant between-group difference in post-intervention PAM-13 scores was observed(F_(group)(1,1866.82)=8.634,P=0.003),with an adjusted mean difference of 2.22 PAM-points.Age,gender,tumor entity,disease stage,or CCC study site did not significantly predict post-treatment PAM-13 scores.The maintenance effect of the intervention was not statistically significant(F_(timeXgroup)(1,3316.04)=2.337,P=0.096).Individually tailored counseling on CIH,offered by specifically trained,interprofessional teams,significantly improved patient activation.Given the established positive effects of higher patient activation,the implementation of such a program at cancer centers may yield beneficial outcomes for both patients and the healthcare system.
文摘Aims: Research the process of organizational change to understand how interventions such as appearance care can be integrated into daily practice. Background: Typical treatment of breast cancer is surgery, often followed by chemotherapy. Associated aesthetic ramifications, including hair loss, frequently cause patient distress. Methods: We conducted face-to-face semi-structured hour-long recorded interviews with three nurses. We then analyzed the developmental process according to the core competencies for interprofessional collaborative practice using the thematic content analysis. Results: Nurses worked with interdisciplinary team members with mutual respect and shared values such as concern for patients’ quality of life. Nurses used knowledge of appearance-related side effects combined with beautician-provided coping skills. Intervention involved responsible communication with other health professionals and patients in a team approach. Nurses promoted the developmental process and became program facilitators. Conclusion: This group-intervention program, facilitated by nurses, was integrated into daily practice. Implications for nursing management: Research partnerships between academics, clinical nurses, nurse managers, and beauticians can improve the integration of interventions in routine practice and increase awareness of patients’ needs.
文摘Objective: To assess current heart failure (HF) care processes and organizational context in long-term care (LTC) homes as a prelude to adapting the Canadian Cardiovascular Society (CCS) HF guidelines for use in these settings. Methods: This research reports on the results of thirteen focus groups (N = 83 participants;average of 60 minutes duration) conducted in three Ontario LTC homes to better understand how HF was managed and how organizational context impacted care. Participants included physicians, nurse practitioners, registered nurses, registered practical nurses, and personal support workers. Results: Focus group findings revealed that the complexity of the LTC environment presents challenges for managing HF. Most residents have multiple advanced chronic conditions that must be managed simultaneously. Culturally, LTC is first and foremost a resident’s home where residents may choose not to comply with care recommendations. Staff routines, scopes of practice, professional hierarchies, available resources and government regulations limit flexibility in providing care. Staff lacked knowledge, skills and resources for managing HF. Nevertheless, all staff viewed LTC as the preferred place for managing HF, avoiding residents’ hospitalizations wherever possible. These data suggest that strategies for improving LTC staff communication and education, strengthening existing relationships between staff, family, residents and community resources, and acquiring additional resources in LTC homes have the potential to improve HF management in this setting. Conclusion: LTC is a complex and dynamic environment that presents many challenges for providing care for residents. This research provides the foundation for subsequent work to develop and test implementation strategies to manage HF in LTC, which are consistent with the CCS HF guidelines and are feasible within LTC staff’s work routines, capacities and resources.
文摘The aim of this work was to compare multiprofessional and uniprofessional interventions applied to adolescent patients affected by psychiatric disorders. The initial hypothesis is that a multiprofessional intervention is more efficacy than a single one. A hundred individuals, 66 males and 34 females, aged between 12 and 19 years affected by emotional and behavioural problems, were selected and divided into 5 groups under the therapeutic treatment. Subjects, after diagnosis (ICD 10) and therapeutic suggestion, were clinically followed for 12 months. The Global Assessment Functioning Scale (GAF) was used to evaluate therapeutic efficacy of interventions. The outcome is associated with the type of intervention: who got clinically better are those patients who underwent multiprofessional integrated therapy rather then a single intervention.
文摘Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously ill, and their families may be at risk depending on the patient’s situation. Considering these characteristics of patients and families, there is a strong need for multi-professional collaboration within ICUs. The purpose of this descriptive study was to examine recognition and other factors related to collaboration and satisfaction involving care decisions in Japanese ICUs. A mail survey about collaboration of activities and systems was sent to physicians, clinical engineers, and nurses working in ICUs in Japan, 387 consented to participate in this study. Results showed that satisfaction scores were generally high among the three aforementioned professions, but collaboration scores on deciding care for patients showed significant differences (p < 0.05). The total collaboration score was the highest among physicians (36.7 ± 6.7 points), followed by nurses (32.8 ± 7.4 points), and CEs (32.8 ± 7.4 points). The factors that commonly affected collaboration scores were the satisfaction score and the ability to collaborate with other professionals and set team medical care as a goal. Moreover, it is worth noting that the degree of difficulty in collaboration negatively affected this factor. On the other hand, other factors differed among the three professions, suggesting that the purpose and need for collaboration differ depending on the profession.
