[New paths to interprofessional collaboration: collaboration between assistant practitioners and practice nurses in general and occupational health care].

Emma Vossen, Frederieke G Schaafsma, Joost W J van der Gulden, Cornelis A de Kock, Rosanne Schaap, Johannes R Anema, Joost A G M van Genabeek
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Abstract

Background: To this date, there is little to no interprofessional collaboration between professionals in general and occupational health care in the Netherlands. Where earlier initiatives for improvement focused on general practitioners (GPs) and occupational physicians (OPs), we examine the role that professionals working under task delegation of GPs and OPs can play in addressing problems on multiple life domains as well as in interprofessional collaboration.Methods: We conducted three focus group interviews with 7 assistant practitioners (APs) in general practice, 11 practice nurses (PNs) in general practice and 8 APs in occupational health practice.Results: All PNs and APs in our study are confronted with multi-domain problems and see a role for themselves in addressing these problems. Moreover, in case of multi-domain problems, they acknowledge the relevance of interprofessional collaboration to provide good care. At this moment, however, there is practically no collaboration at the level of PNs and APs. Challenges are found in the formal task delegation and role identity of the APs in occupational health practice, unfamiliarity and prejudices among especially general practice PNs and APs regarding occupational health care, and practical barriers as privacy laws and reachability.Conclusion: Interprofessional collaboration among PNs and APs in general and occupational health care is possible, provided that a solution is found for fundamental and practical challenges. Potential solutions are to shift the focus from sharing medical information to communicating about the needs of working patients to function healthily on multiple life domains, to address interprofessional collaboration in educations, to adapt consultation protocols to include work and to organize joint meetings between professionals in general and occupational health practice. Finally, addressing structural barriers such as privacy laws and financing requires political action.

[跨专业合作的新途径:全科和职业卫生保健助理执业护士之间的合作]。
背景:到目前为止,荷兰一般专业人员与职业卫生保健之间几乎没有专业间的合作。早期的改进举措集中在全科医生(gp)和职业医生(OPs)身上,我们研究了在全科医生和职业医生任务授权下工作的专业人员在解决多个生命领域的问题以及跨专业合作中所起的作用。方法:对7名全科助理医师(ap)、11名全科执业护士(PNs)和8名职业卫生执业助理医师进行3次焦点小组访谈。结果:在我们的研究中,所有的pn和ap都面临着多域问题,并看到了自己在解决这些问题中的作用。此外,在多领域问题的情况下,他们承认跨专业合作提供良好护理的相关性。然而,目前在pn和ap层面上实际上没有合作。挑战存在于职业卫生实践中助理医生的正式任务授权和角色认同,特别是全科执业执业医师和助理医生对职业卫生保健的不熟悉和偏见,以及隐私法和可及性等实际障碍。结论:如果能找到解决基本和实际挑战的办法,初级保健医生和初级保健医生在一般和职业卫生保健方面的跨专业合作是可能的。潜在的解决办法是将重点从共享医疗信息转移到沟通工作患者在多个生命领域健康运作的需求,解决教育方面的跨专业协作,调整咨询协议以包括工作,并组织一般专业人员与职业健康实践之间的联合会议。最后,解决隐私法和融资等结构性障碍需要采取政治行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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