NURS 8002 BLOG: HOW DO YOU PRACTICE INTRA- AND INTERDISCIPLINARY COLLABORATION IN PRACTICE?

NURS 8002 BLOG HOW DO YOU PRACTICE INTRA- AND INTERDISCIPLINARY COLLABORATION IN PRACTICE?

My experience with intradisciplinary collaboration in my practice is being part of the hospital’s nursing shared governance. The critical concepts of nursing shared governance are shared decision making between the bedside nurses and nurse leaders, which includes areas such as resources, nursing research/evidence-based practice projects, new equipment purchases, and staffing. This type of shared process allows for active engagement throughout the healthcare team to promote positive patient outcomes and creates a culture of positivity and inclusion, which benefits job satisfaction (McKnight, 2022). Being a part of the nursing shared governance in my practice, gives me the opportunity to work with different nurses from different specialties. One of the issues that we helped resolve was when it was brought to our attention that there was a rise in complaints of nurses not giving detailed report during shift change, which most times caused delay in care. We took a random survey of important information that needs to be passed on during every shift change report from about ninety percent of the nurses in the hospital, which allowed us to come up with a detailed universal report shift templates for all the nurses. Ninety days after the initiation of the project, we saw a decrease in the amount of complaint and saw an increase in nurses’ knowledge of their patients.

My experience with interdisciplinary collaboration in my practice is being part of the daily team rounds. Interdisciplinary rounding is a structured approach for integrating care provided by the staff nurse, hospitalist/attending physician, care manager and patient/family, creating a structure for more streamlined communication and planning (Reduce Hospital days and Dollars with Interdisciplinary Rounds, 2018). The key component in these rounds is communication, making sure that everyone involved in the patient’s care is on the same page. According to Busari et al (2017), the communication between nurses and physicians is a key factor for effective interprofessional collaboration and thus, for the assurance of the quality of care.

Being a part of shared governance, having similar experiences and being at the fore front of patient care, makes it easier for us to implement ideas that changes the hospital’s policies and processes for better patient outcomes. It also allows us to become engaged due the positive outcome that results when these changes are being made. However, trying to get nurses involved outside of their working hours becomes hard sometimes. With interdisciplinary rounds, it improves communication with all parties involved for quality patient care. Patient’s issues are resolved in a timely manner. This can however be time consuming as it requires frequent meetings for it to be effective.

Like Henry et al. (2018) case study design approach, the interdisciplinary team rounds, allow each team member to see problems through the eyes of another. Before the interdisciplinary rounds became the norm in my facility, there were constant drop in communication and even while reading the physicians notes, there were so many decisions being made regarding the patient care that I did not understand. After attending the rounds, these decisions were talked about in depth as it pertains to each person’s field. This allowed even for better communication with not just the team but also with the patient.

Reference

McKnight, H. (2022, September 19). Nursing Shared Governance. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK549862/#:~:text=Definition%2FIntroduction,new%20equipment%20purchases%2C%20and%20staffingLinks to an external site..

Reduce Hospital Days and Dollars with Interdisciplinary Rounds. (2018, December 19). Premier. https://premierinc.com/newsroom/blog/reduce-hospital-days-and-dollars-with-interdisciplinary-rounds#:~:text=Interdisciplinary%20rounding%20(IDR)%20is%20a,more%20streamlined%20communication%20and%20planningLinks to an external site..

Busari, J., Moll, F., & Duits, A. (2017). Understanding the impact of interprofessional collaboration on the quality of care: A case report from a small-scale resource limited health care environment. Journal of Multidisciplinary Healthcare, Volume 10(1), 227–234. NCBI. https://doi.org/10.2147/JMDH.S140042Links to an external site.

Henry, B., Male, B., Garner, C., & Guernon, A. (2018). Teaching and learning about interprofessional collaboration through student-designed case study and analysisLinks to an external site.Links to an external site.. International Journal of Teaching and Learning in Higher Education, 30(3), 560–570.

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thank you for your post! I enjoyed hearing about your thoughts on shared governance. As a nurse leader, I am part of the shared governance committee. Shared governance helps facilitate better communication between our bedside staff and our leadership. In my opinion, this is truly invaluable because it helps nurse leaders understand the resources that our bedside staff need to provide on time best practices. Through shared governance healthcare team members are allowed to actively engage to create a culture which promotes collaboration throughout a hospital (McKnight, 2022).

The impact that shared governance has on healthcare organizations are too numerous to count. Here at my organization, I know that it has helped improve communication, create better policy and procedures and has significantly improved patient outcomes. In my opinion, it’s the best way to give bedside nurses the ability to have a voice in the decision-making process. It is tough to get staff involved outside of working hours but when they realize that playing a role in shared governance increases, job satisfaction and belonging to a voice of change, nurses will fully understand why it is so beneficial to be involved (McKnight, 2022).

Reference:

You referred to the interdisciplinary team as a partnership among various healthcare professionals. This is a great way to describe the healthcare team in reference to patient care. A partnership forces accountability, mutual respect, defined expectations, and communications. According to Berry et.al (2021), for health care to reach its full potential as a service, trust must also include the notion of partnership, whereby patients see their clinicians as reliable, caring, shared decision-makers who provide ongoing “healing” in its broadest sense. As interdisciplinary rounding becomes part of the standards for improving patient care and outcomes, we realize the importance each discipline plays and how much we begin to rely on daily rounding. During patient discharge, we all know case management is the discipline that ensures many of the patient’s needs are met beyond discharge. As a nurse, I see the concern many of my patients have about care implemented beyond their hospital stay. I often have solace in knowing I can give them an adequate update about care for discharge. This is due to interdisciplinary teamwork and rounding. If I don’t have immediate answers, it is comforting knowing case management can be called in to visit a patient and address concerns they may have. Henry et al. (2018) study allowed participants to gain respect and appreciation for what each discipline brings to a team. The study also allowed professionals to see problem-solving from a different perspective. In retrospect, we use the Henry et al. (2018) study as a model daily.

As a supervisor, you mentioned pairing nurses with other healthcare providers to give them an opportunity to experience what each discipline does in their role. Prior to implementing this effort, you also mentioned thinking interdisciplinary rounding was an extra responsibility. The differences in the views and attitudes of healthcare professionals regarding the importance of collaboration indicate that there is a need for changes in formal education in the field of interprofessional collaboration (Sanc and Prason 2022). Not understanding roles leads to conflict and overstepping boundaries. We have a general idea of what each team member brings, but we don’t always know what goes on behind the scenes to see what is required to meet patient needs. Sometimes understanding and respecting what one brings means stepping into their position. Ultimately gaining more knowledge and respect as to what each discipline brings to the team.

References

Berry, L. L., Awdish, R. L. A., Letchuman, S., & Steffensen, K. D. (2021). Trust-Based Partnerships Are Essential — and Achievable — in Health Care Service. Mayo Clinic Proceedings, 96(7), 1896–1906. https://doi.org/10.1016/j.mayocp.2021.03.035

Henry, B., Male, B., Garner, C., & Guernon, A. (2018). Teaching and Learning about Interprofessional Collaboration Through Student-Designed Case Study and Analysis. International Journal of Teaching & Learning in Higher Education, 30(3), 560–570.

Sanc, P., & Prosen, M. (2022). Interprofessional collaboration in interdisciplinary healthcare teams: A quantitative descriptive study. Medpoklicno sodelovanje v interdisciplinarnih zdravstvenih timih: kvantitativna opisna raziskava Obzornik Zdravstvene Nege, 56(1), 9-21. https://doi.org/10.14528/snr.2022.56.1.3106

I think the idea to create templates so that shift report is more detailed was an amazing thing to do. I often saw a delay in care due to skimp shift reports. One idea my floor had was to bring the computer on wheels to each room during report at shift change. The nurse would open the patient’s chart and skim through it while the off-going nurse verbally gave a rundown on the patient. The delay in care was another reason report had to be given at the bedside. One question was, ” Does the implementation of BSR as compared to standard shift report at the nurses’ station increase patient safety and patient and nurse satisfaction? The practice of shift report at the bedside is not a new concept and is well documented in the literature” (McAllen et.al.,2018). This question allowed for a nursing script to be created so that there was satisfaction between the nurses and the patients.

McAllen, E.R., Stephens, K., Swanson-Biearman, B., Kerr, K., Whiteman, K (April 9, 2018) “Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2.

To develop the critical thinking abilities required for nursing practice, case study design is a great idea. This encourages collaboration among different disciplines and helps students understand more about what they do as well as expands their thinking and problem-solving abilities, which will help them once they graduate and enter the real world. According to an article quoted by the National League of Nursing (2016), there is a gap between the realities of practice and the use of teamwork skills to provide patient-centered care. This gap is between team training in educational programs and the actual practices of working in teams. Implementing these case study methods is beneficial when a nursing student needs to make a sincere commitment to studying and broadening their knowledge base.

Working as a team and understanding the dynamics of each specific professional discipline are made possible by collaboration with other professionals. This also enables students to observe firsthand how each discipline contributes to the implementation of better patient care. Building respect, stronger relationships, and improved health outcomes are facilitated by establishing a working relationship while comprehending each discipline’s role in patient care (Almendingen et al., 2021). The first stages of competency-based interprofessional education, according to Barr (1998), as referenced by Henry et al. (2018), involve understanding and respecting the roles of other professionals. For teamwork to be successful, this is a crucial component.

As an illustration, I previously cared for a patient who had several chronic conditions. Working together with the other specialists on the care team, we were able to create a comprehensive plan of care that satisfied all the patient’s needs. It was essential that we build a strong rapport with the patient and their family to deliver the best care. While working together, tension and disagreement might arise. There may be disagreements about care procedures and varying priorities among the team members. For instance, a doctor would prefer to focus on treating a patient’s medical condition, whereas a social worker could be more concerned in addressing the patient’s social concerns. To better meet the needs of patients, professional Collaboration is used to deliver what is required in a variety of ways. One way is by bringing people together to pool their knowledge from different disciplines to discuss and solve problems. According to Henry et al. (2018), viewing difficulties from the perspective of another person forces students to adapt their problem-solving techniques in new ways (Henry et al., 2018), This helps students receive the information they need to build on their fundamental knowledge and increases their comprehension of what goes into treating the patient.

Another good illustration was When I was a posted to surgical unit as a student nurse in Africa. I recall my first encounter with an interdisciplinary team. Once a week, the patient’s primary nurse, the doctor and referral partner (such as a cardiologist or internist), the social worker, dietician, and charge nurse would conduct grand rounds on the patients. After that, we would convene for a conference to discuss what the patient would need at that time and after discharge, and we would go over how we would make it all happen. To achieve the goals of a quicker recovery, shorter hospital stays, and enhanced care after release, collaboration was found to be crucial for averting unfavorable long-term outcomes.

Interprofessional collaboration in healthcare is a partnership of various health professionals to deliver high-quality treatment to patients, families, and carers. According to Ansa et al. (2020). Working as a team to solve difficult medical problems for one patient at a time is an efficient strategy.

Initially, twenty-five years ago, I considered those rounds to be only an additional responsibility for staff. When I was given the responsibility of supervisor, I was able to see more clearly how important each function was within that partnership and how it ultimately affected the patients. This demonstrates the necessity of case study design in nursing education to educate nurses for collaboration in the real world. Once in the workplace, I would advise pairing nurses up with an interdisciplinary team member once a week so they can have a more in-depth grasp of what each discipline entails and how it contributes to patient care. Finally, enlist the nurse and a team member to collaborate on finding solutions to problems and resolving patient care difficulties. By setting a goal for the patient and pairing a nurse with a team member once a week, it may be possible to provide the patient with treatment that is both more targeted and more collaboratively thought out.

References:

Ansa, B. E., Zechariah, S., Gates, A. M., Johnson, S. W., Heboyan, V., & De Leo, G.

(2020). Attitudes and behavior towards interprofessional collaboration among

healthcare Professionals in a large academic medical center. Healthcare, Vol 8, Iss

323, p 323 (2020). DOI: 10.3390/healthcare8030323

https://doaj.org/article/aca411b3c5614eb29109661d321f014eLinks to an external site.

Barr, H. (1998). Competent to collaborate: Towards a competency-based model for

Interprofessional education. Journal of Interprofessional Care, Vol 12(2), May,

Special Issue: Competent to practice. pp. 181-187. DOI:

http://dx.doi.org/10.3109/13561829809014104Links to an external site.

Henry, B., Male, B., Garner, C., & Guernon, A. (2018). Teaching and learning about interprofessional collaboration through student-designed case study and analysis Links to an external site.Links to an external site..

International Journal of Teaching and Learning in Higher Education, 30(3), 560–570.

Almendingen, K., Sparboe-Nilsen, B., Kvarme, L. G., Benth, J. S., & Saltyte Benth, J.

(2021).Core competenciesfor interprofessional collaborative practice: Journal of

Multidisciplinary Healthcare; Aug2021, Vol. 14, p2249-2260, 12p DOI:

10.2147/JMDH.S325086

National League for Nursing. (2016). Interprofessional collaboration in education and

practice. Nursing Education Perspectives. Jan 01, 2016, 37(1):58-58. DOI:

10.1097/01.NEP.0000476111. 94472.a6

NURS 8002 BLOG: HOW DO YOU PRACTICE INTRA- AND INTERDISCIPLINARY COLLABORATION IN PRACTICE?