Neonatal intensive care unit and emergency department nurses' descriptions of working together: building team relationships to improve safety.
ABSTRACT Teamwork is considered a critical factor in delivering high-quality, safe patient care although research on the evidence base of the effectiveness of teamwork and communication across disciplines is scarce. Health care providers have limited educational preparation for the communication and complex care coordination across disciplines required by today's complex patients. Complex work environments are affected by little understood human factors including the intricacies of human communication and behavior. To understand how nurses view teamwork, this secondary qualitative analysis examined nurses' perceptions of working in high-performance areas with interdisciplinary teams. Results from 4 focus groups of 18 nurses from a neonatal intensive care unit and emergency department trauma resuscitation teams, revealed 3 themes with descriptive meanings to help understand the complexities of teamwork. These findings illustrate the rewards and challenges for teams working together in the current health care environment. Continuing to investigate teamwork can add to our understanding of what nurses and health professionals need to know about teamwork to help develop evidence-based team training in prelicensure education and in practice settings.
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ABSTRACT: Interprofessional teamwork is considered as the key to improve the quality of patient management in critical settings such as trauma emergency departments, but it is not fully conceptualized in these areas to guide practice. The aim of this article is to explore interprofessional teamwork and its improvement strategies in trauma emergency departments. Participants of this qualitative study consisted of 11 nurses and 6 supervisors recruited from the emergency departments of a newly established trauma center using purposive sampling. Data were generated using two focus group and six in-depth individual interviews, and analyzed using qualitative content analysis. Interprofessional teamwork attributes and improvement strategies were emerged in three main themes related to team, context, and goal. These were categorized as the effective presence of team members, role definition in team framework, managerial and physical context, effective patient management, and overcoming competing goals. Interprofessional teamwork in trauma emergency departments is explained as interdependence of team, context, and goal; so, it may be improved by strengthening these themes. The findings also provide a basis to evaluate, teach, and do research on teamwork.Iranian journal of nursing and midwifery research 03/2013; 18(4):333-339.
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ABSTRACT: A carbon (C) and nitrogen (N) cycle-coupled model, CLASS-CTEMN+ was developed by incorporating soil and plant N cycling algorithms in the Canadian Land Surface Scheme (CLASS) and the Canadian Terrestrial Ecosystem Model (CTEM), used in the Canadian Global Climate Model. Key soil and plant N cycling processes incorporated in the model include biological fixation, mineralization, nitrification, denitrification, leaching and N controls on plant photosynthesis capacity. The model was used to analyse N controls on C and water exchanges in a 70-year-old temperate conifer forest in southern Ontario, Canada from 2003 to 2007. The simulated values of soil–plant N contents and fluxes – including N2O flux – were generally in good agreement with observations. When N controls on C and water cycling were included in the model, simulated daily gross ecosystem productivity (GEP), ecosystem respiration (Re), net ecosystem productivity (NEP) and evapotranspiration (ET) fluxes showed improved agreement with eddy covariance flux measurements. The five-year mean annual NEP predicted by the N-coupled model was 121gCm−2yr− for 2003–2007, compared to 273gCm−2yr−1, which was simulated by the model when N controls were switched off (non-N model). N-coupled model estimates compared well with the measured five-year mean (± standard deviation) annual NEP of 136±59gCm−2yr−1. Simulated annual mean ET over five-years was 384mmyr−1 for the N-coupled model, and 433mmyr−1 for non-N model, compared with the measured five-year mean annual value of 405±44mmyr−1. Model results confirmed that a proper representation of N controls on photosynthetic uptake and canopy conductance could result in more plausible simulations of observed C and water fluxes. The model results also suggested that N limitations in spring and early summer were generally more important in controlling NEP. Discrepancies between simulated and measured annual variations of C exchanges occurred in years that included extreme weather periods (e.g. low soil water content and warm spring/summer temperatures).Ecological Modelling 10/2011; 222(20):3743-3760. DOI:10.1016/j.ecolmodel.2011.09.008 · 2.33 Impact Factor
- Value in Health 11/2011; 14(7). DOI:10.1016/j.jval.2011.08.406 · 2.89 Impact Factor