Nurses and Interprofessional Teamwork. Where do we stand? Roberta Heale, Associate Editor, EBN @robertaheale Join Twitter Chat Wed, Sept 3, 8-9pm UK time #ebnjc

The past decade has seen a push toward the evaluation of teamwork in healthcare, particularly interprofessional teamwork. The World Health Organization indicates that ‘interprofessional collaboration in education and practice…will play an important role in mitigating the global health workforce crisis” (2010, p. 7). In addition, Effective teamwork promotes a work environment that has a positive impact on both staff and patients. However, simply working together doesn’t necessarily mean that there will be effective teamwork (Kalisch & Lee, 2009).

There is a wealth of research data related to interprofessional teamwork. There is recognition of interprofessional teamwork in acute care and a primary healthcare reform across the globe that includes the development of interprofessional teams. So…what does interprofessional teamwork mean to nurses?

Nurses have traditionally worked within teams. Hospital units are characterized by teams of nursing staff who are often the ‘permanent’ staff on a unit. Other health care providers including physicians, social workers, respiratory care etc. filter in and out of the unit and work in collaboration with the nursing staff to ensure optimal patient care. Research has found that positive teamwork was associated with greater staff retention and less job stress and burnout (Rafferty et al., 2001). However, there are many barriers to positive interprofessional teamwork. Collaboration among team members is one of the ongoing issues of teamwork. For example, a poor physician/nurse relationship was the number one reason for intention to leave the nursing profession in a research study of nurses in Europe (Heinen et al., 2013).

Barriers and facilitators to interprofessional teamwork are understood, however, the impact of these on team functioning isn’t well known. I, along with colleagues, developed the Interprofessional Team Functioning Survey. It captures a team members’ perception on how well a team is functioning. Items reflect the typical barriers to teamwork including communication, education about teamwork, an understanding of other team member’s roles and organizational policies to facilitate teamwork. Also included is a question about the member’s perception of hierarchy among team members. A study of primary health care nurse practitioners in Ontario, Canada demonstrated well functioning interprofessional teams, however, there is a need for better organizational support and formal education about interprofessional teams to facilitate better teamwork.

This is a brief snapshot into the perceptions of a small group of specialized nurses.  Given the prevalence of inter professional teamwork, it is helpful to explore this phenomenon among all nurses.

EBN’s Twitter Chat on Wednesday, September 3 from 8-9 pm UK time will focus on nurses’ experience with interprofessional teamwork.

Points to consider for the chat:

1. What has your experience been with interprofessional teams?

2. Do interprofessional teams help, or hinder nursing care and patient health outcomes?

3. What work needs to be done to improve interprofessional team functioning?

Participating in the EBN Twitter Journal Chat

To participate in the EBN twitter chat, if you do not already have one, you require a Twitter account; you can create an account at www.twitter.com. Once you have a Twitter account contributing is straightforward:

• You can follow the discussion by searching for links to #ebnjc or @EBNursingBMJ in Twitter

• Or contribute to the discussion by sending a tweet starting with @EBNursingBMJ and ending with #ebnjc (the EBN chat hashtag). NB not including #ebnjc means people following the chat won’t be able to see your contribution.

References

Heale, R., Dickieson, P., Wenghofer, E., & Carter, L. (2013). Nurse practitioners’ perceptions of interprofessional team functioning with implications for nurse managers. Journal of Nursing Management. DOI: 10.1111/jonm.12054

Heinen, M. M., van Achterberg, T., Schwendimann, R., Zander, B., Matthews, A., Kózka, M., et al. (2013). Nurses’ intention to leave their profession: A cross sectional observational study in 10 European countries. International Journal of Nursing Studies, 50(2), 174–184. doi:10.1016/j.ijnurstu.2012.09.019

Kalisch, B.J. & Lee, H. (2009). Nursing teamwork, staff characteristics, work schedules, and staffing. Health Care Management Review, 34(4), 323-333.

Rafferty, A.M., Ball, J., & Aiken, L.H. (2001). Are teamwork and professional autonomy compatible, and do they result in improved hospital care? Quality in Health Care, 10, ii32-ii37. World Health Organization (WHO) (2010) Framework for Action on Interprofessional Education and Collaborative Practice Available at: http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf

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