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PubMed2002

Interprofessional relations: case studies of working relationships between Registered Nurses and general practitioners in rural Australia.

Interprofessional working relationships of nurses and doctors have been discussed in the literature but are less frequently the subject of research. A review of international research on nurse-doctor professional relationships conducted over 30 years (1966-99) shows that the relationship is of interest predominantly to nurses. From a series of interviews with nurses and doctors, as part of a case study of four rural health services, harmonious working relationships between nurses and doctors were examined. Further analysis reveals many aspects of nurse-doctor relationships that are traditional and common across many contexts. There are, however, some aspects that are specific to the rural nature of the working context and relate well to contemporary advances in nursing knowledge and confidence.

Attitude of Health Personnel↗
PubMedDate not supplied

Health reform, professional identity and occupational sub-cultures: the changing interprofessional relations between doctors and nurses.

Recent literature on health reform describes advantages of a collaborative approach to the management of health organizations. However, it is important for the managers of health organizations, including nurse managers, to understand that occupational groups adapt to organizational change and policy reform in different ways. These differences to change may have an effect on health reform initiatives, in particular, by potentially limiting the development of collaboration, team work and inter-professional practice. This paper presents fieldwork from a study on health reform and professional identities. Data from focus group discussions are used to discuss the dynamics of reform, the tensions between occupational subcultures and the organization, and changing relations within and between diverse occupational and professional groups. As opposed to much of the literature on professional identity, data for this research suggests that professional identities are changing under the strain of environmental changes to the health system, and associated cultural changes. Professions are not static. In addition, this research found that cultural differences are not limited to occupational groups of doctors, nurses and others, and include differentiation within the medical profession that is based upon specialization, generation, educational background, employment status and feelings of [non]association with the organization. These differences have resulted in cultural ambiguity of sustained and non-sustained fragmentation of occupational and professional groupings that, if not fully understood, are potentially complicating the implementation of change.

Attitude of Health Personnel↗
PubMedDate not supplied

[Child and adolescent psychiatry and child and adolescent welfare: general interprofessional relations--results of a study].

Child and adolescent Psychiatry on the one hand and Social Welfare Services and Child Protection on the other share common fields. The theoretical orientation of the Social Sciences differs from that of Psychiatric Medicine, producing a potential of conflict in areas of mutual operation. This report is based on an analysis of the transferrals from Child and adolescent psychiatric in-patient treatment to foster care. The results show that the children concerned mainly present with conduct disorder plus emotional problems and that the process of transferral is impaired by a number of factors which can be clearly named.

Adolescent↗
PubMed2006

Knowledge translation and interprofessional collaboration: Where the rubber of evidence-based care hits the road of teamwork.

Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in interprofessional relations. Interprofessional education and collaboration interventions aim to improve interprofessional relations, which may in turn facilitate the work of knowledge translation and thus evidence-based practice. We summarize systematic review work on the effects of interventions for interprofessional education and collaboration. The current evidence base contains mainly descriptive studies of these interventions. Knowledge is limited regarding the impact on care and outcomes and the extent to which the interventions increase the practice of evidence-based care. Rigorous multimethod research studies are needed to develop and strengthen the current evidence base in this field. We describe a Health Canada-funded randomized trial in which quantitative and qualitative data will be gathered in 20 general internal medicine units located at 5 Toronto, Ontario, teaching hospitals. The project examines the impact of interprofessional education and collaboration interventions on interprofessional relationships, health care processes (including evidence-based practice), and patient outcomes. Routes are suggested by which interprofessional education and collaboration interventions might affect knowledge translation and evidence-based practice.

Canada↗
PubMed2005

Can interprofessional education make a difference in the care of people with chronic disease?

In recent years, there has been an increasing policy focus on the role of interprofessional education in healthcare. However, the literature emphasizes process rather than outcomes, with little that specifically relates interprofessional educational interventions to the care of people with long-term conditions. This article questions what we know about interprofessional interventions in the care of people with chronic disease, examines the evidence for and potential of interprofessional education in changing practice, and makes suggestions for further research.

Chronic Disease↗
PubMedDate not supplied

Collaborative needs assessment and systems development in Alabama: Process and products.

This article describes the implementation of a collaborative project and its results, involving a department of maternal and child health (DMCH) in a school of public health and a state department of public health. The state received a federal grant to enhance systems development for women and children. Adequate information regarding the existing system of health care was lacking. The state contracted with the DMCH for assistance in designing and conducting a needs assessment, whose purpose was to (1) identify strengths and weaknesses in the state system of care, (2) provide baseline information for targeting resources and measuring change, and (3) initiate an on-going process of assessment and evaluation of need. The DMCH collected data about financial and nonfinancial barriers to care from state-level health agency and organization experts, county-level service personnel, and consumers. The contributions to understanding the needs of the state offered by the information garnered in the three surveys helped the state in setting immediate and long-range objectives. The presence of the school of public health and the focus of its particular DMCH on assisting state agencies provided an atmosphere in which the state could ask for assistance and the university could respond in a way that was useful and relevant to the state's needs. Medical Subject Headings (MeSH): assessment, health planning, health priorities, interprofessional relations, program planning, public health.

Alabama↗
PubMed1994

A comparative study of the attitudes of nursing and medical students to aspects of patient care and the nurse's role in organizing that care.

The purpose of this study was a comparative analysis of the attitudes of nursing and medical students toward some issues relating to patient care and the role of the nurse in organizing that care. The data were collected from 11 medical students and 19 undergraduate nursing students in their fourth or final year of study. Findings suggested that there was a statistically significant difference in the attitudes of both groups of students to the areas under investigation. Medical students were rather more cure-oriented than nursing students who showed a care orientation. Further, the nursing students had a more positive attitude towards the need for a nursing assessment than their medical colleagues. Finally there was a marked difference in the way in which each group perceived the nurse's role, the nursing students emphasizing its independent scope while the medical students were less convinced on this issue. The conclusions suggest that both nursing and medical students need to develop a mutual understanding and respect for each other's roles if interprofessional relations are to improve.

Attitude of Health Personnel↗
PubMed2001

Ethical issues and the importance of consensus for the intensive care team.

This paper draws upon an empirical study and combines moral philosophical insights and sociological analysis to shed light on the ethical issues in intensive care. It is argued that moral philosophical debate often leaves aside the social context in which ethical decisions are taken and carried through. In order to gain an understanding of how intensive care is accomplished and specifically how ethical issues are handled, the study focused primarily on nurses' accounts of and views on the practices which form the everyday work of intensive care. A qualitative approach was adopted involving theoretical sampling and the constant comparative method of analysis. The paper argues that the most difficult ethical issue in intensive care, namely the withholding or withdrawal of treatment, is an area in which nursing and medical perspectives are often at odds. However, when the social context of clinical practice is taken into account, this paper argues. there is common ground between the two professions. It was found that the period during which the decision to withdraw treatment is being made, the members of the intensive care team closest to the bedside, nursing and medical staff. become impatient for some resolution of the situation. The differences of opinion which arise over the decision to withdraw are not simply to do with the way in which the situation is experienced by each professional group, proximity to the patient had a part to play in shaping their views rather than, as it is sometimes presumed. a simple rift between medicine and nursing. The data suggest that intensive care has to be a team effort. Even though there is no legal requirement for nurses to agree with the ICU decisions, there seems to be a strong desire within the intensive care team that moral consensus should be achieved in the interests of good patient care. Intensive care relies on the integrity of the team and the unfailing functioning of teamwork. Consequently, achieving this, it seems, is more important than other temporary lapses in interprofessional relations and disagreements over treatment in individual cases. Consensus is important and its achievement is a central, day to day working arrangement for insuring the solidarity of the team.

Decision Making↗
PubMed1981

Interprofessional education in medical school.

The opinions of entering medical students regarding interprofessional education (IPE), and their reasons, are described in this article. More female than male students favour IPE, 49 as compared to 25%. Students who endorse IPE give different reasons for their position than students who oppose it. The former group refer to increased communication and respect among health professionals, increased knowledge about mutual roles and function, greater equality among members of the health team and improved patient care. The opposing group fear that IPE would lower the quality of education by increasing class size and slow the pace of instruction to accommodate students with limited scientific backgrounds. Students also protest against having to study irrelevant subjects and acquire irrelevant skills. The opposing group is concerned primarily with IPE's effect on medical students; the group in favour is concerned more with the effect on patients and interprofessional relations. It seems that opinions about IPE are part of a basic attitudinal structure that medical students bring with them when they enter medical school. The implications for IPE in medical school are discussed.

Attitude of Health Personnel↗
PubMed1984

Preparing students for the realities of contemporary pharmacy practice. American Association of Colleges of Pharmacy.

A report of the American Association of Colleges of Pharmacy Study Committee on the Preparation of Students for the Realities of Contemporary Pharmacy Practice is presented. The development of the committee and its charge are described. The report includes a description of the purpose and essential elements of contemporary pharmacy practice, and the barriers restricting their achievement that arise within the profession, society, and pharmacy education. Recommendations of the committee regarding curricular offerings, instructional strategies for developing problem-solving, communication, and self-learning skills, types of post-entry-level education and training programs, career counseling, student recruitment, pharmacy faculty, and intra- and interprofessional relations are discussed. The report calls for a combined effort on behalf of practitioners and educators to prepare graduates to enter practice in community, hospital, or long-term care pharmacy, and emphasizes the need to match these efforts to the dynamics of contemporary pharmacy practice.

Economics, Pharmaceutical↗