Does interprofessional team-training affect nurses' and physicians' perceptions of safety culture and communication practices? Results of a pre-post survey study

Effectiveness of interprofessional education for medical and nursing professionals and students on interprofessional educational outcomes: A systematic review

AIM AND BACKGROUND

Patient safety is a global health priority as unsafe care is a principal cause of death and disability. Ineffective interprofessional communication and collaboration among nursing and medical professionals and students contribute to unsafe practices. Interprofessional education provides opportunities to strengthen nurse-physician collaboration and enhance patient care. However, there is inconclusive evidence regarding interprofessional education effectiveness. This review aims to systematically evaluate interprofessional education effectiveness for nursing and medical professionals and students on interprofessional educational outcomes (interprofessional attitudes, perceptions, skills, knowledge, behaviours, and organisational and patient outcomes).

DESIGN AND METHODS

PubMed, Cochrane Library, Embase, Scopus, CINAHL, ERIC, PsycInfo, Web of Science were last searched on 13 January 2022. This review included published and unpublished randomised controlled trials, quasi-experimental and mixed-method studies in English examining interprofessional education outcomes among nursing and medical professionals and students. Two reviewers independently appraised studies using the Joanna Briggs Institute Critical Appraisal Tools and extracted data using a modified Joanna Briggs Institute data extraction form. Narrative synthesis was conducted instead of meta-analysis since majority of the included studies had quasi-experimental design, and various interventions and outcomes. Certainty of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluations tool.

RESULTS

This review included 15 studies involving 1185 participants. Improvements were reported in each interprofessional educational outcome after interprofessional education. High-fidelity simulation with multiple scenarios, standardised communication tools, didactic and active learning methods, theoretical frameworks, debriefing sessions and provider training enhanced interprofessional education effectiveness.

CONCLUSIONS

Effectiveness of interprofessional education for nursing and medical professionals and students was demonstrated since improvements were observed for each interprofessional educational outcome. This systematic review addressed literature gaps, demonstrated effectiveness of interprofessional education in clinical practice and academic curricula and provided evidence-based insights that future research can consider to enhance global patient safety standards for optimal patient outcomes and quality of healthcare. Caution is advised in interpreting findings due to 'very low' evidence certainty and limited studies. More high-quality randomised controlled trials with longitudinal designs are needed.

The contribution of interprofessional education in developing competent undergraduate nursing students: integrative literature review

BACKGROUND

Effective interprofessional team collaboration is one of the necessary domains for successful interprofessional collaborative practices in healthcare (IPCP), which is crucial for the delivery of safe and quality healthcare services. Therefore, understanding the contribution of interprofessional education in nursing students is vital to improving collaboration practices in nursing students, in preparation for the dynamics that await after registration in practice amongst the interprofessional team. Thus, the aim of the study was to summarise the contribution of interprofessional education in nursing education in developing competent undergraduate nursing students.

DESIGN

The integrative literature review design as described by Whittemore and Knafl was adopted for the review. The review consists of five steps, namely, problem identification, literature search, data analysis, data interpretation, and the last step was data presentation. Three databases were searched for the articles, namely CINHAL, Scopus, and Science Direct. Articles were retrieved using Search terms such as "Competence," "Contribution,", "Development," "Interprofessional education" and "Undergraduate nursing students" retrieved Articles published between 2018 and 2022 were selected.

RESULTS

Three themes emerged from the review, namely the promotion of patient safety in nursing practice, the socialisation of nursing students in interprofessional collaboration, and the promotion of the development of professional identity.

CONCLUSION

This study is the first step in determining the contributions of early interprofessional education to nursing education. It could set the stage for further studies that examine strategies the undergraduate nursing curriculum can adopt and develop sound interprofessional competencies that promote patient safety and quality healthcare by nursing students.

IMPACT

The developers of the nursing curriculum and nursing educators can use the results in developing a curriculum that includes interprofessional education with the aim of improving the quality of teaching and learning that advances competent and safe nursing students.

Factor Structure and Construct Validity of a Hospital Survey on Patient Safety Culture Using Exploratory Factor Analysis

OBJECTIVE

Nurses' voluntary reporting of adverse events and errors is critical for improving patient safety. The operationalization and application of the concept, patient safety culture, warrant further study. The objectives are to explore the underlying factor structure, the correlational relationship, between items of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture and examine its construct validity.

METHODS

Exploratory factor analysis was conducted using secondary data from the instrument's database. Using pattern matching, factors obtained through exploratory factor analysis were compared with the 6-component Patient Safety Culture Theoretical Framework: degree of psychological safety, degree of organizational culture, quality of culture of safety, degree of high reliability organization, degree of deference to expertise, and extent of resilience.

RESULTS

6 exploratory factors, explaining 51% of the total variance, were communication lead/speak out/resilience, organizational culture and culture of safety-environment, psychological safety-security/protection, psychological safety-support/trust, patient safety, communication, and reporting for patient safety. All factors had moderate to very strong associations (range, 0.354-0.924). Overall, construct validity was good, but few exploratory factors matched the theoretical components of degree of deference to expertise and extent of resilience.

CONCLUSIONS

Factors essential to creating an environment of transparent, voluntary error reporting are proposed. Items are needed, specifically focusing on deference to expertise, the ability of the person with the most experience to speak up and lead, despite hierarchy or traditional roles, and resilience, which is coping and moving forward after adversity or mistakes. With future studies, a supplemental survey with these items may be proposed.

Nurses' perspective on team learning in interprofessional teams

AIM

The aim of this study is to find out what learning activities in interprofessional teams and what influencing factors for team learning activities in interprofessional teams can be described by nurses working in interprofessional teams.

DESIGN

We conducted a descriptive interview study.

METHODS

We used a semi-structured interview guideline and interviewed 10 nurses (N = 10) working in interprofessional teams. We analyzed our data using a qualitative content analysis.

RESULTS

Nurses describe team learning activities of knowledge sharing, team reflection, and storing and retrieving. Furthermore, our results show that team stability is important for interprofessional teams.

PATIENT OR PUBLIC CONTRIBUTION

Our results can be helpful for hospitals to improve organizational structures that help interprofessional teams to work together. Furthermore, vocational education and training for nurses should offer possibilities for nursing students to learn together with students of other fields.

Strategies to improving patient safety in hospitals

Introduction: Patient safety is the initial foundation of quality healthcare that shared responsibility between policymakers as well as healthcare delivery, especially nurses, who aim for improvement. Interventions in patient safety culture reduce safety incidents, thereby, lowering the disability rates and deaths due to side effects of healthcare delivery. Therefore, this research aims to provide an overview of strategies to improve patient safety culture, which involves nurses in hospital settings. Design and Methods: In this research, a Scoping review was carried out using online database searches at ProQuest, Ebsco, and Sciencedirect. The selected article was experimental research, using English, published between 2011-2021, and fulfilled the criteria for inclusion and exclusion set. Result: In the initial disbursement, 480 articles were obtained with 13 studies that meet the inclusion criteria. The articles obtained used quasi-experimental research methods (2 articles), pre-post intervention design (4 articles), intervention time series (2 articles), randomized controlled trial (1 article), prospective cohort intervention (1 article), repeated cross-sectional experimental research (1 article), Mix quasi-experimental method non-randomized design and qualitative (1 article), and control groups (4 articles). Based on the articles obtained, the strategies to increase the patient safety culture in hospitals can be categorized into 4, which include educational, simulation, team, and comprehensive programs. Conclusions: All interventions implemented possess a positive impact on patient safety culture.  

Comparison of Perceptions About Patient Safety Culture Between Physicians and Nurses in Public Hospitals in Vietnam

Introduction

Patient safety culture (PSC) is a vital component in ensuring high-quality and safe patient care. Assessment of physicians' and nurses' perceptions of existing hospital PSC is the first step to promoting PSC. This paper is aimed to assess physicians' and nurses' perceptions of PSC in 5 public general hospitals in Hanoi, Vietnam.

Methods

This cross-sectional study surveyed 410 physicians and 824 nurses utilizing the validated Hospital Survey on Patient Safety Culture in an online format.

Results

The composite positive physician's perception of PSC varied from 47.8 to 89.6% with the lowest composite score of patient safety for "staffing" (47.8%) and the highest composite score for "teamwork within units" (89.6%). The composite positive responses for perception among nurses varied from 51.3 to 94.2% with the lowest composite score of patient safety for "staffing" (51.3%) and the highest composite score for "teamwork within units" (94.2%).

Conclusion

The mean scores for "supervisor/manager expectations"; "staffing", "management support for patient safety", "teamwork across units", "handoffs and transitions" among nurses were significantly higher than that among physicians (p<0.05). About two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7%, respectively). The nurses reported significantly higher patient grades (every good and excellent) than physicians (75% vs 67.1%, p <0.001). Hospitals could develop and implement intervention programs to improve patient safety, including providing interventions on teamwork and communication, encouraging staff to notify incidents, and avoiding punitive responses.

Emerging Frontline Leaders' Voices in Response to COVID-19 Crisis

BACKGROUND

The COVID-19 pandemic has significantly affected healthcare institutions, introducing new challenges for nurse leaders and their colleagues. However, little is known about how the pandemic has specifically affected the lives of these leaders and what methods and strategies they are using to overcome pandemic-related challenges.

OBJECTIVES

The aim of this study was to examine the effect of the 2019 pandemic on emerging healthcare leaders and highlight methods and strategies they used to overcome pandemic-related challenges.

METHODS

The participants in this study represent a diverse group of interprofessional healthcare faculty enrolled in a transformational leadership course (Paths to Leadership) when the pandemic first appeared. Three months into the pandemic, the leadership cohort was invited to participate in this qualitative study, exploring four questions: Q1: How have you transformed your working styles in response to the pandemic? Q2: How have you adjusted your personal life in response to the pandemic? Q3: How have you used leadership skills learned from Paths to Leadership during the pandemic? Q4: What lessons have you learned from the pandemic? Participant narratives were analyzed by a team of nurse researchers using conventional qualitative content analysis.

RESULTS

Themes for Q1 (working styles) included shifted from face-to-face to telework, faced novel disease and decisions, worked more from home, and challenged to maintain contact with professional peers and team. Themes for Q2 (personal life) included accommodate adults working and children learning from home, looked for and found the positive, and continue to struggle. Themes for Q3 (leadership skills) included reflective practice, listening, holding, and reframing. Finally, themes for Q4 (pandemic lessons) included leadership, human connection, be prepared, taking care of ourselves, and connecting with nature.

DISCUSSION

The 2019 pandemic brought hardships and opportunities to faculty members enrolled in an interprofessional transformational leadership course. In conjunction with this course, the pandemic provided a unique opportunity for participants to apply newly acquired relationship building, positive organizational psychology, and reframing skills during a time of crisis. Nursing leaders, whose educational offerings may be immediately "put to the test," may find our lessons learned helpful as they develop strategies to cope with unanticipated future challenges.

Using the 'huddle' to enhance interprofessional teamwork among nursing students through a podcast: a qualitative and exploratory pilot study

Background

Interprofessional teamwork is crucial for fostering healthcare performance and for minimizing adverse events. The daily huddle is an important arena for interprofessional interaction and communication between nurses and physicians in hospitals.

Although prevalence strongly rooted in clinical practice, the huddle does not seem to be a prioritized area in nursing education programs. Taking part in a huddle is traditionally something nursing students learn in their clinical studies.

Therefore, there is need for learning tools that can provide nursing students with quality assured training that can improve their preparation for interprofessional teamwork and strengthen the link between the educational institution and the field of practice. In this study, we have developed and tested a podcast to increase nursing students’ competence in interprofessional teamwork when participating in huddles.

The aim of the pilot study was to explore nursing students’ experiences with utilizing a huddle-focused podcast as a learning tool during their clinical practice studies in the hospital.

Method

This qualitative and exploratory pilot study used focus group interviews.

Eleven third-year nursing students who had listened to the podcast during their practical studies at a medical hospital ward were included. The interviews were subjected to content analysis.

Result

The analysis identified four categories that resonated across all participants in the focus group interviews: 1. understanding one’s own role in the huddle; 2. being encouraged to speak up; 3. using the huddle as a flexible learning tool; and 4. being authentic but not always realistic.

Conclusion

Findings indicate that the huddle-focused podcast seems to be valuable for nursing students learning about interprofessional teamwork. The podcast seemed especially useful in helping the students to understand their own role and to speak up in the huddle meetings. The positive experiences with the flexibility of the podcast learning tool are promising for use in other educational settings.