Interprofessional ward rounds in an adult intensive care unit: an appreciative inquiry into the central collaboration between the consultant and the bedside nurse.

IF 1.9 3区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Journal of Interprofessional Care Pub Date : 2024-05-01 Epub Date: 2021-11-30 DOI:10.1080/13561820.2021.1985441
Clair Merriman, Della Freeth
{"title":"Interprofessional ward rounds in an adult intensive care unit: an appreciative inquiry into the central collaboration between the consultant and the bedside nurse.","authors":"Clair Merriman, Della Freeth","doi":"10.1080/13561820.2021.1985441","DOIUrl":null,"url":null,"abstract":"<p><p>Done well, ward rounds (WRs) promote effective, safe care and collaboration; but WR quality varies. An improvement-focused appreciative inquiry (AI) into a large intensive care unit's WR practices identified a pivotal axis of collaboration between the most senior medical role (the consultant) and the bedside nurse (BSN). This paper examines that axis of interprofessional collaboration (IPC) to deepen understanding of its implications. Data included ethnographic observations, interviews, and co-constructed AI with groups of staff. Four key concepts emerged from cyclical interpretive analysis: \"need,\" \"presence,\" \"ability\" and \"willingness.\" BSNs and consultants <i>needed</i> the interprofessional WR to enable their work; WR effectiveness was affected by whether they were both <i>present</i>, then <i>able</i> and <i>willing</i> to participate in IPC. BSN <i>presence</i> was necessary for effective and efficient IPC between these key roles. Indirect contributions, based on prior exchanges with colleagues or through written notes, reduced the joint problem-solving through discussion and negotiation that characterizes IPC to less efficient asynchronous interprofessional <i>coordination</i>. Factors affecting \"presence,\" \"ability\" and \"willingness\" are discussed alongside potential mitigations and acknowledgment of asymmetric power. Appreciative examination of interprofessional WRs identified mechanisms supporting and undermining effective WR IPC and the centrality of consultants' and BSNs' collaboration.</p>","PeriodicalId":50174,"journal":{"name":"Journal of Interprofessional Care","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interprofessional Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13561820.2021.1985441","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/11/30 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Done well, ward rounds (WRs) promote effective, safe care and collaboration; but WR quality varies. An improvement-focused appreciative inquiry (AI) into a large intensive care unit's WR practices identified a pivotal axis of collaboration between the most senior medical role (the consultant) and the bedside nurse (BSN). This paper examines that axis of interprofessional collaboration (IPC) to deepen understanding of its implications. Data included ethnographic observations, interviews, and co-constructed AI with groups of staff. Four key concepts emerged from cyclical interpretive analysis: "need," "presence," "ability" and "willingness." BSNs and consultants needed the interprofessional WR to enable their work; WR effectiveness was affected by whether they were both present, then able and willing to participate in IPC. BSN presence was necessary for effective and efficient IPC between these key roles. Indirect contributions, based on prior exchanges with colleagues or through written notes, reduced the joint problem-solving through discussion and negotiation that characterizes IPC to less efficient asynchronous interprofessional coordination. Factors affecting "presence," "ability" and "willingness" are discussed alongside potential mitigations and acknowledgment of asymmetric power. Appreciative examination of interprofessional WRs identified mechanisms supporting and undermining effective WR IPC and the centrality of consultants' and BSNs' collaboration.

成人重症监护病房的跨专业查房:对顾问和床边护士之间核心合作的赞赏式探究。
查房(WR)做得好,可以促进有效、安全的护理和协作;但查房的质量却参差不齐。通过对一家大型重症监护病房的查房实践进行以改进为重点的赞赏式探究(AI),发现了最高级医疗角色(顾问)与床旁护士(BSN)之间合作的关键轴心。本文对这一跨专业协作轴(IPC)进行了研究,以加深对其影响的理解。数据包括人种学观察、访谈以及与员工小组共同构建的人工智能。通过循环解释性分析,得出了四个关键概念:"需求"、"存在"、"能力 "和 "意愿"。BSN 和顾问需要跨专业 WR 来开展工作;WR 的有效性受到他们是否在场、是否有能力以及是否愿意参与 IPC 的影响。要使这些关键角色之间的 IPC 切实有效,BSN 必须在场。根据与同事的事先交流或通过书面记录做出的间接贡献,降低了通过讨论和协商共同解决问题的能力,而这正是 IPC 的特点,使其成为效率较低的异步专业间协调。在讨论影响 "在场"、"能力 "和 "意愿 "的因素的同时,还讨论了潜在的缓解措施,并承认了权力的不对称。对跨专业 WR 的欣赏性研究发现了支持和破坏有效 WR IPC 的机制,以及顾问和 BSN 合作的核心作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Interprofessional Care
Journal of Interprofessional Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.80
自引率
14.80%
发文量
124
审稿时长
6-12 weeks
期刊介绍: The Journal of Interprofessional Care disseminates research and new developments in the field of interprofessional education and practice. We welcome contributions containing an explicit interprofessional focus, and involving a range of settings, professions, and fields. Areas of practice covered include primary, community and hospital care, health education and public health, and beyond health and social care into fields such as criminal justice and primary/elementary education. Papers introducing additional interprofessional views, for example, from a community development or environmental design perspective, are welcome. The Journal is disseminated internationally and encourages submissions from around the world.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信