Neonatal Intensive Care Unit and Emergency Department Nurses' Descriptions of Working Together: Building Team Relationships to Improve Safety
College of Nursing, Texas Woman's University, Houston, TX, USA.Critical care nursing clinics of North America (Impact Factor: 0.49). 06/2010; 22(2):253-60. DOI: 10.1016/j.ccell.2010.03.007
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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- "In another study, the nurses described working together as personal and professional attributes such as shared goal, mutual respect, working together for the patient›s sake, assisting each other during crises, heavy workload, developing and maintaining relationships, and concurrence which meant shared understanding of roles, abilities, and responsibilities, and feeling of frustration and uncertainty due to unclear leadership. Nurses in acute London hospitals in a survey reported overwork, lack of staff, space, equipment, and high levels of aggressive behavior as the barriers to delivering high-quality care. "
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.
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ABSTRACT: The purpose of this study was to assess the effects of an educational workshop on knowledge of and attitude toward therapeutic use of music and aesthetic experiences with music among first-line nurses. A one-group pre-test/post-test design was used. Forty-six first-line nurses, aged 21-56 years, were recruited from seven different hospitals. Questionnaires were used to assess the nurses' knowledge of and attitude toward therapeutic use of music and aesthetic experience with music before and after the workshop, and 3 months after the workshop. The workshop comprised three sessions; the nurses participated in 8h of instruction the first week and 4h, the second week covering analytical music appreciation, music staves comprehension, theory and practice of music therapy, and evidence-based music intervention. Educational workshop significantly improved knowledge of and attitudes toward therapeutic use of music and music aesthetic experiences (p<0.001). A sustained effect of the workshop was found at follow up 3-month after workshop. The mean change in scores for music aesthetic experiences between nurse with and without music backgrounds differed significantly (p=0.01). The workshop enhanced the knowledge of and attitude toward therapeutic use of music and aesthetic experiences with music among first-line nurses.
Article: Time Out for Patient Safety[Show abstract] [Hide abstract]
ABSTRACT: "Time out for patient safety" is a simple and effective tool to improve communication among caregivers based on the use of critical language that has been effective in the perioperative setting, airline industry, and military. In the emergency department it is non threatening and focuses attention on safe patient care. "Time out for patient safety" complements the use of other standardized communication techniques such as SBAR in clinical situations in which immediate intervention is mandatory for patient safety.This communication tool was presented to the multidisciplinary staff and has been embedded in the Emergency Department's simulation program for newly graduated nurses. The concept was well received by the group.Future research is needed to address outcomes for effectiveness.
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