Background Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work. Method Data from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators’ reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software. Results Four major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange. Conclusions Our findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.
Background Inter-professional health care teams represent the nucleus of both patient care and the clinical education of novices. Both activities depend upon the'talk' that team members use to interact with one another. This study explored team members' interpretations of tense team communications in the operating room (OR). Methods The study was conducted using 52 team members divided into 14 focus groups. Team members comprised 13 surgeons, 19 nurses, nine anaesthetists and 11 trainees. Both uni-disciplinary (n = 11) and multi-disciplinary (n = 3) formats were employed. All groups discussed three communication scenarios, derived from prior ethnographic research. Discussions were audio-recorded and transcribed. Using a grounded theory approach, three researchers individually analysed sample transcripts, after which group discussions were held to resolve discrepancies and confirm a coding structure. Using the confirmed code, the complete data set was coded using the 'NVivo' qualitative data analysis software program. Results There were substantial differences in surgeons', nurses', anaesthetists', and trainees' interpretations of the communication scenarios. Interpretations were accompanied by subjects' depictions of disciplinary roles on the team. Subjects' constructions of other professions' roles, values and motivations were often dissonant with those professions' constructions of themselves. Conclusions Team members, particularly novices, tend to simplify and distort others' roles and motivations as they interpret tense communication. We suggest that such simplifications may be rhetorical, reflecting professional rivalries on the OR team. In addition, we theorise that novices' echoing of role simplification has implications for their professional identity formation.
<p>Background: The coronavirus disease-2019 (COVID-19) pandemic has implications for students who are also nurses. Purpose and Methods: This qualitative descriptive study used a practice development approach to explore the intersection between academic and professional work experiences for undergraduate Post-Diploma Registered Practical Nurses bridging to Registered Nurse Bachelor of Science in Nursing students and Master of Nursing graduate nursing students during the first wave of the COVID-19 pandemic. The study incorporated critical aesthetic reflections that focused on the personal and aesthetic ways of knowing, as a data collection approach and knowledge dissemination strategy. Results: Analysis of the narrative component of participants’ reflections revealed the following themes: sensing a “call to duty,” experiencing a myriad of emotions, shifting societal and individual perceptions of nursing, and learning in an uncertain environment. Conclusions: The results of the study can inform educational strategies and academic policies to support this unique nursing population, who are frontline practitioners as well as student learners.</p> <p><br></p>
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.
Global trends in the aging population will increase the demands for long-term care (LTC) resources. Due to recent pressures to deliver more complex care, there is further risk to resident safety in LTC. Emphasis on the management and the delivery in safe and quality resident care in LTC is required.The purpose of this study was to describe nurses' experiences with patient safety incident (PSI) management involving residents living in LTC.Using a qualitative descriptive approach, 9 nurses were recruited in 3 LTC homes. Semistructured interviews were conducted, and data were analyzed using inductive content analysis.Three main categories emerged: commitment to resident safety, workplace culture, and emotional reaction.Providing nurses with an opportunity to share their PSI management experiences highlights the current factors influencing frontline resident safety in LTC. Study results can inform nursing practice and policy development to support PSI identification and management.
Buildings contribute in crucial ways to how students experience learning spaces. Four schools within a faculty (nursing, nutrition, occupational and public health, and midwifery) moved into a new Health Sciences building Fall of 2019. This new building created a unique opportunity to explore the intersection between higher education and learning space design, informed by concepts of space and place, and students’ profession specific and interprofessional learning experiences in a new Health Sciences building. A qualitative descriptive design was used. All undergraduate and graduate students within the four schools were invited to participate. Focus groups were undertaken to gain a rich understanding of students’ experiences and views of their space and place of learning. Data collection involved focus group data from profession specific participant users and interprofessional participant users. Inductive thematic analysis of focus group transcripts generated an initial coding scheme, key themes, and data patterns. Codes were sorted into categories and then organized into meaningful clusters. A building planning development project document relating to the vision, intentions, design, and planning for the new building provided content from which to view the study findings. The study data contributed to the conversation about space and place and its influence on higher learning within specific intraprofessional and interprofessional student groups and provided insight into the process of actualizing a vision for a new learning space and the resultant experiences and perceptions of students within that space/place.
Despite the call for open and team-based approaches to error disclosure, the participation beyond physicians and managers is not a common practice in health care settings. Moreover, within the growing literature base on error disclosure, team-based error disclosure is an emerging concept. To address this knowledge gap, a study was undertaken to explore the perceptions associated with an educational simulation intervention for team-based error disclosure.
Methods
A qualitative study that involved analysis of data obtained from semi-structured interviews with a sample of 6 physicians, 6 surgeons, and 12 nurses recruited from the three participating hospitals.
Results
Perceptions from study participants elucidated a tension between team-based error disclosure as an unrealistic, forced practice and as a realistic, beneficial practice. This tension was highly contextual and differentiated by study participants9 perceptions of the nature of the error; patient9s preferences; and prevailing cultural and professional norms. Regardless of the view, study participants described the simulation experience as a new way of relating that departed from existing practice.
Conclusions
Study findings revealed that a team-based approach to disclosure is not realistic or necessary for all error situations, such as when the error involves a single discipline. However, when the error involves a variety of health care professionals interacting with the patient, a team-based approach is beneficial to them and the patient. Further work is required by researchers and administrators to develop and test out interventions that enable health care professionals to practice team-based error disclosure in a safe and supported environment.
The coronavirus disease-2019 (COVID-19) pandemic has implications for students who are also nurses.This qualitative descriptive study used a practice development approach to explore the intersection between academic and professional work experiences for undergraduate Post-Diploma Registered Practical Nurses bridging to Registered Nurse Bachelor of Science in Nursing students and Master of Nursing graduate nursing students during the first wave of the COVID-19 pandemic. The study incorporated critical aesthetic reflections that focused on the personal and aesthetic ways of knowing, as a data collection approach and knowledge dissemination strategy.Analysis of the narrative component of participants' reflections revealed the following themes: sensing a "call to duty," experiencing a myriad of emotions, shifting societal and individual perceptions of nursing, and learning in an uncertain environment.The results of the study can inform educational strategies and academic policies to support this unique nursing population, who are frontline practitioners as well as student learners.
