Examining interprofessional team interventions designed to improve nursing and team outcomes in practice: a descriptive and methodological review

ABSTRACT

Effective interprofessional (IP) team-based care is critical to enhance the delivery of efficient care and improve nursing and IP team outcomes. This study aims to review the most recent IP team intervention studies that focused on outcomes related to nursing and IP teams. PubMed, CINAHL, PsycINFO, and Embase were searched for existing literature published between January 2011 and December 2016. The search strategy was developed through both literature review and consultation with a health sciences librarian. This review included IP team intervention studies published in peer-reviewed journals and written in English. Studies were included if they conducted an IP team intervention for healthcare teams that include nurses and examined outcomes related to nursing and the IP teams. Based on inclusion and exclusion criteria, 41 articles were included for the final review. Two authors extracted data on the characteristics of IP team interventions, assessment methods, and their outcomes related to nursing and IP teams using a data abstraction tool developed by the research team. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. We found that most of the included studies were conducted in the US and on inpatient units. A quasi-experimental study design was most commonly employed. Most studies conducted IP team training such as TeamSTEPPS® as a one-time activity. The most common outcomes measured were attitudes or perceptions about IP teamwork or communication, followed by patient-related outcomes, and knowledge or skills about IP competencies. The quality of the included studies was generally low. The findings from this review will contribute to understanding the characteristics of current IP intervention studies and call for IP scholars to design more rigorous yet realistic IP intervention studies.     

Interruptions during nurses' work: A state‐of‐the‐science review

The purpose of this state‐of‐the‐science review was to examine empirical evidence from studies of interruptions conducted in acute care nurses' work environments. A total of 791 articles published from 2001 through 2011 were reviewed; 31 met the criteria to be included in the sample. Despite sustained multinational and multidisciplinary attention to interruptions during nurses' work, the current findings suggest that beliefs about the ill effects of interruptions remain more conjecture than evidence‐based. Pre‐existing beliefs and biases may interfere with deriving a more accurate grasp of interruptions and their effects. Future research would benefit from examinations of interruptions that better capture their complexity, to include their relationships to both positive and negative outcomes for both patients and health care workers. © 2012 Wiley Periodicals, Inc. Res Nurs Health 36:38–53, 2013     

Knowledge,attitude and practice regarding nursing interruptions among Chinese nurses: A nationwide cross-sectional survey

ObjectivesTo explore the knowledge, attitude and practice of Chinese nurses regarding nursing interruptions and related factors.MethodsA total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge, Attitude and Practice (KAP) Questionnaire of Nursing Interruptions. The questionnaire consists of three dimensions, knowledge, attitude and practice, containing 10, 9 and 7 items, with full score of 50, 45 and 28, respectively.ResultsThe mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05 ± 16.65 (range: 26–123), with scores for the knowledge, attitude, and practice component being 21.74 ± 9.80, 34.83 ± 6.98, and 17.49 ± 4.97, respectively. Among the nurses, 70.8% of them experienced an average level of KAP toward nursing interruptions while 15.5% were at a poor level. The knowledge, attitude, and practice of nursing interruptions were better in chief nurses, managers, nurses with a master degree or above, nurses ever received training, and nurses with a strong agreement to leadership compared to nurses in other groups (P < 0.05). In addition, employment type, professional title, position, standardized training and leaders’ attention were predictors of KAP in nurses.ConclusionChinese nurses have a moderate level of KAP regarding nursing interruptions. Leaders’ attention, standardized training, position, professional title and employment type could predict nurses’ KAP state of nursing interruptions. Thus, a targeted training program should be implemented for clinical nurses by nursing leaders, with a particular focus on feasibility and professionalism.     

高龄孕妇妊娠结局及其分娩相关危险因素研究

目的探讨二胎政策下高龄孕妇妊娠结局及其分娩相关危险因素。方法选取2018年1—12月我院分娩的138例高龄产妇为研究对象,根据妊娠结局分为正常组(n=88)和不良妊娠结局组(n=50),通过问卷调查的方式,调查研究对象的相关信息,采用单因素和多因素logistic回归模型分析分娩相关危险因素与妊娠结局关联情况。结果单因素分析显示,体质量、多次流产、妊娠高血压、孕期保健是不良妊娠结局的危险因素(P<0.05)。多因素logistic分析结果显示,体质量、多次流产、妊娠高血压是不良妊娠结局的独立危险因素(P<0.05),而孕期保健是不良妊娠结局的保护因素(P<0.05)。体质量、流产次数、妊娠高血压与不良妊娠结局及分娩呈正相关(P<0.05),孕期保健与不良妊娠结局及分娩呈负相关(P<0.05)。结论体质量、多次流产、妊娠高血压、孕期保健是引起不良妊娠结局的相关危险因素。因此明确妊娠结局的相关危险因素,提供相应的护理措施,鼓励产妇增加产检次数以及孕期保健,对避免不良妊娠结局的发生具有重要意义。     

Getting it right: Educating professionals to work together in improving health and health care

Dedication

This paper is based on a lecture given by LAH as the 2nd John Horder lecture at Imperial College, London on 11 April 2006. Dr. Horder has been influential in improving patient outcomes in multiple ways, including his contributions to professional education. He was instrumental in the development of the Royal College of General Practitioners, serving as president from 1979–1982 and acting as a key leader in establishing post-graduate training for general practitioners in the United Kingdom. Dr Horder went on to found the Centre for the Advancement of Interprofessional Education, in part because of what he observed about the power of interprofessional collaboration in his own primary care practice. It was an honor to give a lecture in tribute to Dr John Horder. It was an opportunity to reflect on what we know about educating health professionals in training about the improvement of health care, including work I've helped to lead in the United States (where I now serve as the Senior Associate Dean for Education at the University of Missouri-Columbia School of Medicine). This paper also is dedicated to Dr. Horder.     

Finnish nurses' attitudes towards nursing research and related factors

This study was concerned with Finnish nurses' attitudes to nursing research and with the associations of different background factors with these attitudes. The data were collected with a purpose-designed, structured questionnaire. The study was carried out in one central hospital, one central university hospital and 10 community health centres in Finland. A total of 400 nurses took part. The response rate was 67%. The data were analysed using SPSS statistical software. Attitudes to nursing research were generally quite positive, although over half of the nurses felt their own relationship to nursing science was quite distant. There were also shortfalls with respect to the information value and utilisation of research results. Only one-third took the view that doing research is an important part of the nurse's job. Age, the frequency of reading the professional literature, participation in training courses, training received in research and development, and the type of workplace were associated with attitudes. The results underline the importance of paying closer attention to the choice of research objects in the field of nursing science. Greater effort should also be invested in supporting and developing the application of research results. It is recommended that more courses on research methodology and other relevant training be made available to practical nurses.     

Relational coordination among nurses and other providers: impact on the quality of patient care

havens d.s ., vasey j. , gittell j.h . & lin w-t . (2010) Journal of Nursing Management 18, 926–937
Relational coordination among nurses and other providers: impact on the quality of patient care Aim The present study examined nurse reports of relational coordination between nurses and other providers and the impact of relational coordination on patient care quality. Background While communication between providers has been traditionally considered important to improve quality, relational coordination extends this view, emphasising the value of high-quality relationships exemplified by shared goals, shared knowledge and mutual respect; and high-quality communication that is timely, frequent, accurate and problem-solving. Methods Direct care registered nurses (RNs) (n = 747) completed surveys to assess relational coordination across five provider functions and six types of patient care units. Nurses also reported perceptions about patient care quality. Results In all analyses, relational coordination between nurses and other providers was significantly related to overall quality, in the expected directions. As relational coordination increased, nurses reported decreases in adverse events such as hospital-acquired infections and medication errors. Conclusions Enhancing relational coordination between nurses and other providers is central to improving the quality of patient care. Implications for nurse managers and new knowledge The emerging theory of relational coordination provides a useful new research-based framework for managers to use to improve provider relationships, communication and the quality of care.     

Service quality in hospital wards with different nursing organization: nurses' ratings

Title. Service quality in hospital wards with different nursing organization: nurses’ ratings. Aim. This paper is a report of a study to assess: (1) the relations between nursing organization models in hospital wards and nurses’ perception of the quality of patient care and dimensions of the practice environment, and (2) if these relations were modified by variations in local conditions at the ward level. Background. Previous literature is inconclusive concerning what model of nursing organization maximizes the quality of nursing services. Method. A cross‐sectional survey was carried out in a representative sample of Norwegian hospital wards in 2005. Intra‐ward organization models were classified as: (1) Team leader (n = 30), characterized by extensive responsibilities for team leaders, (2) Primary nurse (n = 18), with extensive responsibilities for named nurses, and (3) Hybrid (n = 37), (1) and (2) combined. We prepared multilevel regression models using scales describing quality of patient care, learning climate, job satisfaction, and relationships with physicians as dependent variables. As independent variables, we used variables representing local ward conditions. Results. Eighty‐seven wards and 1137 nurses (55% response rate) provided complete data. The ward level proportion of variance ranged from 0·10 (job satisfaction) to 0·22 (relationships with physicians). The univariate effect of organization models on quality ratings was not statistically significant. Introducing local ward conditions led to a statistically significant effect of primary nurse organization on relationships with physicians, and to a substantial proportional reduction in ward level variance, ranging from 32% (quality of patient care) to 24% (learning climate). Conclusion. Caution is needed about using service quality arguments when considering the possible benefits and drawbacks of different organizational models.