Category: Collaboration

In the light of modern developments, changes in patient expectation, and the advancements in healthcare sector, there is need to optimize the benefits that accrue in the aftermath of implementing inter-professional collaboration. In effect, inter-professional collaboration facilitates improved healthcare and ensures that patients receive the highest standards of medical attention. Improvement in quality takes effect because of the collaboration that nursing practitioners and other physicians advance as they administer healthcare to patients and concerned families.

When the practitioners in a medical facility employ and fully implement inter-professional collaboration, the quality and nature of services delivered augments (Sullivan, Kiovsky, Mason, Hill, & Dukes, 2015; Bridges, Davidson, Odegard, Maki, & Tomkowiak, 2011). Therefore, it is practical that nursing practitioners and other stakeholders in medical facilities implement the type of collaboration so that they stay in line with the demands that modern advancements and patients present. Imperatively, when practitioners fail to practice the type of collaboration, patients may not receive the best services and as such, the reputation of the facility diminishes.

In the medical facility where I work, I have witnessed and experienced the implementation of inter-professional collaboration. The collaboration takes place among nursing practitioners and physicians from different disciplines, who work together to achieve a common goal, which is improved quality of healthcare. During my time in the facility, I have seen nursing practitioners and physicians share ideas and work in a productive manner towards ensuring that patients and concerned relations receive the best services.

The collaboration has also improved the position and reputation of the facility and as such, patients throng the facility to receive medical attention. It is momentous to allude that without collaboration among practitioners working in different disciplines, exchange of crucial ideas that augment service quality would not have transpired. In the words of Martin, Ummenhofer, Manser, and Spirig (2010), inter-professional collaboration is one of the best models of healthcare delivery that propels the quality of service and increases instances of patient satisfaction. As such, when practitioners in the medical facility where I practice implement inter-professional collaboration, I not only acquire the requisite skills that are crucial in service delivery, but I also enjoy my practice in the facility.

References

Bridges, D., Davidson, R., Odegard, P., Maki, I., & Tomkowiak, J. (2011).Interprofessional collaboration: Three best practice models of interprofessional education. Medical education online, 16(1), 1-20.

Martin, J., Ummenhofer, W., Manser, T., & Spirig, R. (2010). Interprofessional collaboration among nurses and physicians: Making a difference in patient outcome. Swiss Med Wkly, 140 (1), 1-10.

Sullivan, M., Kiovsky, R., Mason, D., Hill, C., & Dukes, C. (2015). Interprofessional collaboration and education. The American Journal of Nursing, 115(3), 47-54.

Introduction

It is worth noting that at present, effective communication and collaboration are the key competencies required from all healthcare professionals. Such skills imply the ability to interact effectively with patients, their families, and other professionals in order to achieve the best patient results. The purpose of this paper is to explore the issues faced by nurse practitioners (NPs) in collaboration with other stakeholders and to discuss ways to avoid miscommunication.

Collaboration in Primary Care

It is important that with the help of efficient collaboration, the nurse will be able to assess risks and to use the most appropriate methods to ensure high levels of safety and quality of care. For instance, an effective partnership with families of patients and other specialists will allow providing a holistic approach towards care and working as part of the interprofessional team (Brooten, Youngblut, Hannan, & Guido-Sasnz, 2012). To ensure the cooperation with other specialists is successful, it is necessary to learn effective communicational strategies and to instruct other members of the professional team, if necessary. In addition, it is significant to participate actively in discussions, conferences, and other forms of continuous professional development (Sullivan, Kiovsky, Mason, Hill, & Dukes, 2015). Moreover, each NP should demonstrate effective communication with diverse people in accordance with the current situation (Milton, 2013). Also, the formation of collaborative relationships requires the provision of counseling to the patient and his or her family for the preservation and promotion of health. In general, the work in primary care requires cooperation with other specialists, implementation of diagnostics, treatment, and patient care in collaboration with the client’s family, and efficient communication with various social groups.

Challenges

One of the challenges I have faced in the student nurse practitioner role in my practicum was the ineffective collaboration with the medical practitioner. In the course of work, it was revealed that we had differing perceptions of NP’s autonomy as my colleague considered that nurses in this role require no supervision. Another difficulty faced in the practicum was the collaboration with the patient’s family (Milton, 2013). The family regarded NPs as 24-hour healthcare assistants and were reluctant to provide the additional care to the patient required from them. In the first case, the challenge was overcome through exposure to working together with the medical practitioner. The possible miscommunication was avoided with the help of the supervisor who instructed the practitioner on how to supervise student NPs. In this case, the issue was in the individual behavior rather than any other broader context (Clarke & Hassmiller, 2013). However, in the second case, the patient’s family teaching was essential. For example, it was crucial to educate the family on the importance and usefulness of alternative therapy, which can be provided by the family solely and the collaboration barrier was eliminated.

Strategies and Conclusions

The main behavioral strategy to overcome the faced challenge was educating fellow healthcare specialists to avoid miscommunication. In particular, it was essential to raise the medical practitioner’s awareness of my scope of practice and to receive confirmation from the supervisor (Farrell, Payne, & Heye, 2015). In terms of the patient family, the main strategy also lied in communication (Sullivan et al., 2015). Thus, it can be concluded that effective communication is central to the success of the collaboration with the customers, their families, and other health care providers. However, most importantly, the joint work of all main stakeholders will ensure that effective collaboration for better patient outcomes can be achieved.

References

Brooten, D., Youngblut, J. M., Hannan, J., & Guido-Sasnz, F. (2012). The impact of interprofessional collaboration on the effectiveness, significance, and future of advanced practice registered nurses. Nursing Clinics North America, 47, 283-294.

Clarke, P. N., & Hassmiller, S. (2013). Nursing leadership: Interprofessional education and practice. Nursing Science Quarterly, 4, 316-318.

Farrell, K., Payne, C., & Heye, M. (2015). Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process. Journal of Professional Nursing, 31(1), 5-10.

Milton, C. L. (2013). Ethical issues surrounding interprofessional collaboration. Nursing Science Quarterly, 26, 316-318.

Sullivan, M., Kiovsky, R., Mason, D., Hill, C., & Dukes, C. (2015). Interprofessional collaboration and education. AJN, 115(3), 47–54.

Introduction

The new challenges that the healthcare system is facing today can only be addressed with a collaborative effort and by holding all stakeholders responsible for the outcomes. Accountability, advocacy, and collaboration are three fundamental concepts in today’s care management that prescribe health practitioners duties and responsibilities they should take up to aid the progress. The three phenomena are interrelated: reforming the healthcare system is impossible if every single person involved does not hold themselves accountable, advocate for patient’s rights, and contact other institutions to join the cause. This paper will explain the meaning of each concept in detail and discuss why they should be an indispensable part of the care management system.

Accountability

By definition, accountability in health care is a set of policies and guidelines that allow a governing body (government, health authority, healthcare board, or professional association) to mandate healthcare providers or organizations to reach specific goals. This approach implies that organizations must account for their achievements and be ready to report results to the authorities. Adopting accountability can help augment care management in several ways. First, governing bodies provide medical facilities with guidance and clearly outline what needs to be accomplished. For instance, if the goal is to decrease readmission rates, healthcare organizations can start educating patients on self-management. The need to control the outcomes may be a catalyst for a change and replacement of the reactive system – the one that merely responds to a crisis but does not necessarily pay attention to its causes.

The second advantage that accountability presents for care management is a chance to start an open dialogue between stakeholders. As Denis (2014) notes, the relationship between governing bodies and organizations does not have to be hierarchical. It is quite the opposite: unilateral top-down decisions rarely lead to consistent results. An accountability relationship can be based on two-way communication in which both parties discuss their “relative achievement and predefined goals (Denis, 2014)”. During this process, the very definition of goals and objectives can be altered. What is most important is disposing of a disconnect between policy-making bodies and medical facilities.

Advocacy

An open dialogue between governing bodies and health practitioners can result in introducing new, better policies that will heed all the moments dismissed by their predecessors. It can take the form of health advocacy – a key promotion activity that aims at eliminating barriers to medical services and ensuring equity of opportunity. In his article, Sklar (2016) discusses two main types of health advocacy – agency and activism. The first involves advocating for individual patients’ rights and assisting them in locating resources, medications, support groups, and professional consultations. Activism refers to advocacy that targets large groups of people and big-scale problems addressing, which usually requires governing bodies’ interference. Activists try to bring about incremental changes and impact significant social determinants. Both types of health advocacy render the care management system more sustainable. Health practitioners observe trends and tendencies as insiders and can provide relevant data to authorities who cannot always be there to tackle a problem without an initial request. Health advocacy in the form of agency makes each patient valuable and ensures that they can ask for help and be empowered in their decisions.

Collaboration

Collaboration is one way to overcome detachment and to put the expertise of every person or entity on a team to the best use. Morley and Cashell (2017) list the following characteristics of collaboration:

• It involves multiple individuals interacting and working together to meet common goals;
• Includes both social and practical (task-related) inputs;
• It is an active and ongoing partnership built on cooperation, negotiation, trust, respect, and understanding.

Care management can benefit from promoting collaboration in at least two ways. First, when professionals with diverse backgrounds unite their forces, they can analyze a situation from different angles and perspectives. Morley and Cashell (2017) report that collaboration has a positive impact on patient safety in various contexts. The researchers observed a certain reduction in medical error rates when an interprofessional team worked on a case. The second benefit is bringing family and health practitioners together. Relatives know a patient best, can share valuable information with his or her consent, and help with the realization of a treatment plan.

Conclusion

Accountability, advocacy, and collaboration should be the three pillars of the modern care management system. As the world is becoming more global, it is no longer acceptable to let individuals, entities, and institutions involved in health care be disjointed and detached from each other. The first type of relationship that the healthcare system needs is that of accountability between governing bodies and medical organizations. Through an open dialogue, two parties need to establish realistic goals with clear deadlines and work together on meeting them. Communication between entities in the form of health advocacy can lead to positive changes for one patient at a time (agency) or health policies on a larger scale (activism). Lastly, as the medical field is growing interdisciplinary, the most challenging cases require the involvement of an interprofessional team that can use diverse skills and knowledge to come up with a solution.

References

Denis J. L. (2014). Accountability in healthcare organizations and systems. Healthcare policy, 10(SP), 8-11.

Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of Medical Imaging and Radiation Sciences, 48(2), 207-216.

Sklar, D. P. (2016). Why effective health advocacy Is so important today. Academic Medicine, 91(10), 1325-1328.

Introduction

The quality of interaction among patients and caregivers is largely based on specific principles of collaboration that allow both parties to benefit. Effective information sharing plays an essential role in the treatment process and is the indispensable element of any therapeutic course. In order to maintain a consistently high level of family-professional collaboration, it is necessary to adhere to the corresponding components of such interaction. As the key mechanisms of communication among healthcare professionals and patients, cultural responsiveness, conferences and meetings, and home visits will be considered. All of these elements of collaboration may stimulate the healing process and help both patients and medical employees to understand the degree of a particular health problem better.

Importance of the Components Chosen

Each of the components of family-professional collaboration has its own unique features, and due to these advantages, these principles’ role in the context of the interaction is essential. For instance, as Gargiulo and Kilgo remark, individual services delivered to patients through the practice of cultural responsiveness increase the effectiveness of treatment (138). This effect is achieved through a properly chosen communication strategy, eliminating any manifestations of bias, racism, and other unacceptable forms of behavior.

The relevance of conferences and meetings can be explained by the fact that valuable experience may be gained by sharing knowledge and personal observations. Therefore, in case medical specialists and patients spend time discussing the actual issues of prevention, the likelihood of increasing public awareness about specific methods of protecting health increases. Finally, home visits aimed at bringing physicians closer to family members may help build positive contact and, according to Gargiulo and Kilgo, enhance mutual trust (148). Therefore, all the three components considered can be used as the productive principles of establishing family-professional collaboration.

Using the Components of Collaboration to Foster Positive Interaction

In order to establish the effective process of interaction through the considered strategies of engaging families, it is necessary to offer patients information about the benefits of periodic data sharing. Also, as Gargiulo and Kilgo note, productive transitions are possible if both parties are interested in collaboration (147). In case one of the participants in the care process does not intend to contact, the time of treatment may increase.

Regarding my personal experience, a few months ago, I took part in an open conference where the representatives of the medical community and ordinary patients were present. All the members of the meeting were involved in the discussion, and many answers were received to topical questions. This form of interaction contributed to an orderly and organized collaboration aimed at improving the health indicators of the population.

Conclusion

Such components of family-professional collaboration as cultural responsiveness, conferences and meetings, and home visits contribute to positive interaction among healthcare employees and patients and help to avoid misunderstanding. The application of these principles in practice increases the awareness of people about how to prevent particular diseases. Based on personal experience, I can point out that meetings and conferences are valuable knowledge-sharing techniques maintaining mutual trust.

Work Cited

Gargiulo, Richard M., and Jennifer L. Kilgo. An Introduction to Young Children with Special Needs: Birth Through Age Eight. 4th ed., Cengage Learning, 2013.

Introduction

Although there has been a remarkable improvement in health care quality, health disparities, especially in chronic disease burden, continue to persist. Interventions to decrease these gaps need to occur at the local level. Community-based research projects can help identify and address the root causes of health disparities, especially in rural America. This paper examines the role of the Federal Collaboration on Health Disparities Research (FCHDR) and identifies the collaborative strategies for reducing these inequities, their implementation, and intervention development challenges.

Federal Collaboration on Health Disparities Research

Efforts by the FCHDR to improve health are evident in its integrated approach to the reduction of health disparities. It has mobilized scientists, federal officials, and state and local stakeholders to establish the built environment workgroup to identify socioeconomic variables linked to poor health outcomes among racial/ethnic minorities (Hutch et al., 2011). Examples of such determinants identified by FCHDR are community factors (housing and food access) and family/individual components (dietary intake).

It has also worked collaboratively with various entities to develop “policies, tools, and practices” for reducing health inequities (Hutch et al., 2011, p. 592). Examples include the Livable Communities Initiative and the Brownfields Cleanup that create pedestrian-friendly communities to improve air quality. Other community-focused strategies include faith-based and school-based provider-led educational programs (Walton-Moss et al., 2014). FCHDR has also worked collaboratively with partners to disseminate evidence-based research addressing issues causing health disparities. An example of such studies is the Irvine-Minnesota inventory.

Strategies in Community and/or Clinical Practice

I have observed the use of community-based participatory research to empower individuals and address health disparities. The strategy entails collaboration among local medical centers, schools, churches, and community organizers, among others, in health education, capacity building, dissemination of findings, and policy enforcement. For example, recently, a public health department of a university started a smoking cessation project using a media intervention. The researchers used local television and radio channels to mobilize support for the program and tackle health inequalities related to behavioral factors (Hutch et al., 2011). Thus, social action can be used to modify risky behaviors in the community, including smoking and dietary habits.

In clinical practice, I have observed clinician-led (community health workers or CHWs) diabetic education to promote four behaviors healthy eating, exercise, awareness, and self-care (Centers for Disease Control and Prevention, 2016). As Betancourt, Duong, and Bondaryk (2012), culturally tailored training on diabetes self-care that is implemented with at-risk minority populations by CHWs has been shown to be effective. This approach can help decrease health disparities in low-resource rural populations with a high chronic disease morbidity and mortality (Warshaw, 2017). It empowers communities to exercise control of their health.

Implementing these Strategies

Successful implementation of community-based participatory research, educational interventions, policies, and practices, among other strategies, would require adequate community engagement from their inception. The aim is to empower populations to lead such initiatives. It would also involve framing health disparities as a matter of social justice to mobilize support and gain buy-in from the community. Leveraging local assets is critical in implementing these strategies.

The Triad of Rural Health Disparities

Diverse economic, cultural, and geographical factors specific to a rural community present a challenge to clinician-led efforts to eliminate health disparities (Thomas, DiClemente, & Snell, 2014). In my view, healthcare practitioners cannot develop broader interventions to reduce these inequities due to health determinants that are beyond their control. For example, wide variations in the socioeconomic status exist in communities in “income, wealth poverty, transportation infrastructure, and the distribution of healthcare resources” (Ricketts, 2011, p. 1). Addressing these root causes requires multi-stakeholder collaboration. Another challenge is developing culturally sensitive interventions. The cultural characteristics of low-resource communities may be wide and varied. Interventions considered respectful and practical must reflect the norms and beliefs of the population to gain acceptance.

Conclusion

To eliminate health disparities, the different determinants of health must be addressed. Empowering communities through community-based participatory research, education, and policy are some strategies for achieving this goal. They address the diverse economic, cultural, and geographical factors that cause wide variations in access, use, and quality of care.

References

Betancourt, J. R., Duong, J. V., & Bondaryk, M. R. (2012). Strategies to reduce diabetes disparities: An update. Current Diabetes Reports, 12(6), 762-768. Web.

Centers for Disease Control and Prevention. (2016). The national program to eliminate diabetes related disparities in vulnerable populations. Web.

Hutch, D. J., Bouye, K. E., Skillen, E., Lee, C., Whithead, L., & Rashid, J. R. (2011). Potential strategies to eliminate built environment disparities for disadvantaged and vulnerable communities. American Journal of Public Health, 101(4), 587-595. Web.

Ricketts, T. C. (2011). Geography and health disparity. Washington, D.C.: Woodrow Wilson International Center for Scholars.

Thomas, T. L., DiClemente, R., & Snell, S. (2014). Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities. Health Education Journal, 73(3), 285-294. Web.

Walton-Moss, B., Samuel, L., Nguyen, T. H., Commodore-Mensah, Y., Hayat, M. J., & Szanton, S. L. (2014). Community-based cardiovascular health interventions in vulnerable populations. The Journal of Cardiovascular Nursing, 29(4), 293-307. Web.

Warshaw, R. (2017). Health disparities affect millions in rural U.S. AAMCNews. Web.

The modern health care system faces diverse challenges that demand efficient responses to guarantee improved outcomes and promote the further development of care delivery. However, the complexity of problematic issues and the tendency towards their further sophistication introduce a critical need for the integration of different fields of knowledge to provide patients with an appropriate care and attain high level s of their satisfaction. That is why the current approach to functioning regarding the healthcare includes a collaborative work in teams to attain success and suggest a patient-centered, safe, and efficient care (Barr, Vania, Randall, & Mulvale, 2017). Thus, the primary goal of this paper is do discuss the concept of interprofessional collaboration and the way it is now being implemented to the healthcare sector. The work also aims at the investigation of contributions of such disciplines as healthcare informatics, nursing, and public health specialists functioning to the development of the concept and the way it could help to improve outcomes. Considering the fact that the desired environmental health outcome is the increased effectiveness of the sphere, improved quality of life, and health of the nation, the concept could help to attain the goal and enhance final results.

Three Disciplines

Nevertheless, interprofessional collaboration implies the close cooperation of related disciplines which means that there are several contributors to the further development of the practice. Thus, public health professionals could be considered one of the central contributors to the improved outcomes. First, they provide a wide array of significant services to patients who might need them (Goodwin, 2017). Second, they precondition enhanced outcomes by engaging in the treatment process and guaranteeing the delivery of appropriate care to all patients that might need it. In this regard, public health professionals foster cooperation between different disciplines within the interprofessional collaboration by guaranteeing careful investigation of diverse cases and diagnosing (Huq, Reay, & Chreim, 2016). Moreover, regarding the desired environmental health outcome which is the gradual increase of the quality of the health of the nation, their functioning becomes fundamental.

The second discipline related to the concept of interprofessional collaboration is nursing. In the current healthcare sector, it remains the fundamental area of knowledge focused on the care of individuals or diverse communities for these to recover or preserve their high quality of lives (Engel & Prentice, 2013). Their scope of practice is different from the authorities of other health workers and remains unique (Ewashen, McInnis-Perry, & Murphy, 2013). In fact, these specialists provide care in different settings to numerous patients collecting critical information and processing it to guarantee the enhanced outcomes. For this reason, nurses become one of the main actors who contribute to the further improvement of the interprofessional collaboration and achieving the goal of the enhanced state of the health of the nation and peoples quality of lives.

The third important discipline related to the concept is the healthcare informatics. The fact is that the modern society could be characterized as a digitalized one. It means that technologies are an integral part of our society. They contribute to the improved outcomes and increased efficiency of different processes. For this reason, it becomes critical to implement knowledge from this sphere into the field of healthcare to attain improved results. Today, healthcare informatics uses health information technology (HIT) to improve health outcomes through the combination of high quality, efficiency, and innovative practices (Prentice, Engel, & Taplay, 2015). In this regard, this discipline provides public health professionals and nurses with new approaches to assist patients in their recovery. It is one of the fundamental activities regarding the need to face challenges and solve problems most efficiently to contribute to the better quality of peoples lives.

Discussion

In general, the concept of interprofessional collaborative practice becomes one of the distinctive traits of the modern discourse within the healthcare. The gradual increase in the complexity of challenges caregivers face today demands an efficient response. However, a specialist is not able to remain informed in all spheres of knowledge. For this reason, an interprofessional education as the way to support a new vision on how to overcome the challenge mentioned above emerged (Engel & Prentice, 2013). It is aimed at the further development of the practice and training specialists for them to understand the need for collaboration and its nature. The fact is that interprofessional practice means not only working together, but also it presupposes a commitment to a new operational framework that should be created by joint efforts from specialists working in different fields (Schwartz & Conklin, 2014).

For this reason, discussing the idea, it is crucial to note its outstanding contribution to the further evolution of the public health system. Specialist working in the sphere admit the necessity to ensure a successful integration of innovative tools, resources, and technology to create the environment beneficial for the further development of the interprofessional collaboration and improved outcomes (Milton, 2013). In this regard, the use of the approach will obviously help to attain the enhanced efficiency of the healthcare sector by creating a new innovative setting that will help to align a system of patient-centered care that will consider the most important requirements and guarantee their satisfaction. Its contributions include better cooperation with patients, between caregivers, and different departments within a particular health unit.

Application

Nevertheless, revolving around the above-mentioned aspects of the concept and disciplines related to its successful implementation, the Donadebian Model could be chosen as an appropriate approach for the process. First, the appropriate structure includes the cooperation between public health specialists, nurses, and health informatics with the primary aim to guarantee a comprehensive investigation of every case and its meaningful details (Gregory & Austin, 2016). In such a way, every patient who might need a particular care should be assessed using a new approach that includes innovative practices suggested by the health informatics and collaboration between nurses and public health specialists. The given method will obviously contribute to the improved outcomes by guaranteeing the enhanced ability to satisfy all diverse needs and choose the most efficient treatment (Samuelson et al., 2012). Finally, evaluation of outcomes might help to prove the efficiency of the interprofessional practice and its positive impact on the quality of care delivery, final results, and patients satisfaction.

Conclusion

Altogether, the concept of interprofessional collaboration and practice becomes one of the fundamental aspects of the modern healthcare sector. It means that specialists should be ready to engage in a specific cooperation aiming at the creation of a completely new framework that will provide caregivers with an opportunity to manage an increased diversity of cases. The interprofessional collaboration includes the close participation of disciplines crucial for the further evolution of the healthcare sphere like nursing, healthcare informatics, and public health professionals. The combination of these three elements will create the basis for the further development and enhanced efficiency of the approach. However, the implementation of the concept demands the creation of a specific framework that provides beneficial conditions for health workers to engage in collaboration and attain success.

References

Barr, N., Vania, D., Randall, G., & Mulvale, G. (2017). Impact of information and communication technology on interprofessional collaboration for chronic disease management: a systematic review. Journal of Health Services Research & Policy, 22(4), 250-257. Web.

Goodwin, N. (2017). How important is information and communication technology in enabling interprofessional collaboration? Journal of Health Services Research & Policy, 22(4), 202-203. Web.

Gregory, P., & Austin, Z. (2016). Trust in interprofessional collaboration: Perspectives of pharmacists and physicians. Canadian Pharmacists Journal, 149(4), 236-245. Web.

Engel, J., & Prentice, D. (2013). The ethics of interprofessional collaboration. Nursing Ethics, 20(4), 426-435. Web.

Ewashen, C., McInnis-Perry, G., & Murphy, N. (2013). Interprofessional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325-335. Web.

Huq, J., Reay, R., & Chreim, S. (2016). Protecting the paradox of interprofessional collaboration. Organization Studies, 38(3), 513-538. Web.

Milton, C. (2013). Ethical issues surrounding interprofessional collaboration. Nursing Science Quarterly, 26(4), 316-138. Web.

Prentice, D., Engel, J., & Taplay, K. (2015). Interprofessional collaboration: The experience of nursing and medical students’ interprofessional education. Global Qualitative Nursing Research. Web.

Samuelson, M., Tedeschi, P., Aarendonk, D., de la Cuesta, C., & Groenwegen, P. (2012). Improving interprofessional collaboration in primary care: Position paper of the European Forum for Primary Care. Quality in Primary Care, 20(4), 303-312. Web.

Schwartz, R., & Conklin, J. (2014). Competing paradigms: Exploring dialogue to promote interprofessional collaboration and transformation. The Journal of Applied Behavioral Science, 51(4), 479-500. Web.

This paper will discuss a case study of Loretta, a 72-year-old Australian diagnosed with dementia, describing a woman’s clinical condition by using ICF terminology and structure and outlining the measures which need to be imposed for providing her with effective interventions and enhancing the professionalism of the involved exercise physician.

Description of a clinical condition

Body structures and functions

Loretta is a 72-year-old Australian citizen living in Melbourne who is diagnosed with dementia. The pathological neurofibrillary changes in her central nervous system caused the structural impairments and had a devastating impact upon her cognitive functions, including the impaired memory and semantic processes which in their turn affected Loretta’s communicative abilities. The conversational difficulties in Loretta were caused by the decline of the mental processes essential to the communicative functions, including the functions of recognition and usage of language signs. The impairments of declarative memory resulted in communication difficulties, repetitive questions, and word-finding problems.

Activities and participation

The impaired cognitive abilities in Loretta significantly reduced her skills of learning applying knowledge and communicating with others. The communicative difficulties limited Loretta’s participation in the community and social life and threatened her interpersonal interactions and relationships. It made Loretta passive and uninvolved in domestic and community life.

Environment and contextual factors

Loretta’s communication disability can be regarded as the outcome of her ineffective interaction with her environment. She lacked interpersonal support because her husband and children perceived her clinical cognition as the loss of self. Having problems communicating with large groups of people and strangers, Loretta isolated herself and rejected any contacts.

Intervention project

An effective treatment program for Loretta’s condition requires developing multi-component interventions with special emphasis put upon physical training, psychosocial and emotional support through educating the family caregivers and involving the community in the treatment of patients with dementia. This approach would allow considering the body structures along with the environmental factors for providing complex treatment for the patient diagnosed with dementia.

Taking into account the fact that elderly individuals with dementia are under the threat of decline in their physical functioning, it can be stated that the physical training component is significant for developing an effective intervention program for Loretta. The multi-component physical training interventions, including the exercises intended to enhance the patient’s endurance, strength and balance have proven to be effective for improving the participants’ physical functioning, regardless of the stage of disease (Blankevoort, van Heuvelen, Boersma, Luning, and Scherder, 2010, p. 393; Flicker, Liu-Ambrose, & Kramer, 2011, p. 466). Moreover, the best intervention outcomes can be received from the programs with the largest training volume.

Due to the significant impact of environmental factors upon the condition of patients diagnosed with dementia, their passivity and segregation from the rest of the community, educating their relatives and community members and encouraging them to provide the patients with psychosocial support is of paramount importance for receiving a positive outcome from the intervention program. Burton (2010) pointed out the importance of creating dementia-friendly neighborhoods instead of focusing on the internal environment of dementia care homes. Taking into account the fact that conversational difficulties caused by cognitive impairments traditionally result in the patient’s passivity, understanding, and support of the surrounding people are critical in terms of palliative care. Another influential factor is the people’s misconceptions concerning the patients with dementia, their communicative needs, and abilities. These stereotypes need to be overcome through educational measures.

Three characteristics of professionalism

The three characteristics of professionalism that are essential for conducting the above-discussed intervention program successfully include the skills of an exercise physiologist to develop an appropriate training program for every individual patient, inter-professional collaboration, and addressing exercise as medicine clearly understanding its role in a complex intervention program.

Recognizing the significant impact that physical exercises can have upon the patient’s condition, an exercise physiologist has to make the right prescription for each person (Boone, 2011). Thus, Loretta’s physical functioning at the moment when the prescription is made needs to be taken into consideration for developing an appropriate multi-component physical intervention project.

With the current tendencies of professionalization in the exercise physiology domain, exercise physiologists need to gain a clear understanding of their role in the overall system of modern healthcare services. It would allow them to convince the patients with dementia and their relatives of the importance of appropriate physical training for the palliative care of patients with dementia, Due to the fact that dementia interventions require a complex approach and a combination of measures, it can be stated that inter-professional collaboration is critical for developing effective projects. Thus, exercise physiologists should realize the importance of their role in developing the intervention programs without understating the importance of inter-professional collaboration with other specialists.

The role of another professional

As it has been stated above, the recognition of the role of other professionals is significant for improving the outcomes of the intervention projects. Thus, the role of social workers and nurses in the implementation of an effective intervention project is as important as the role of exercise physicians (Perry, Draskovic, Lucassen, Vernooij-Dassen, van Achterberg, & Olde Rickert, 2011; Stevens, Lancer, Smith, & McGee, 2009 ). In that regard, their successful teamwork, information exchange, and recognition of the fact that the interventions need to be multi-component are essential to the quality of the provided services. To develop a specific training program for Loretta, an exercise physician will need to consider the impact of other interventions to make the components complementary.

Two strategies for making the practice person-centered

Taking into account the fact that the conversational difficulties in individuals diagnosed with dementia predetermine their passivity and segregation from the community, the person-centered approach is the most appropriate strategy for creating more comfortable conditions for individuals with dementia. The two strategies of person-centered care include looking at the world from the point of view of a patient diagnosed with dementia and creating a positive social environment for them.

There is evidence that person-centered strategies have a positive impact on the intervention outcomes (Kontos, Mitchell, & Baloon, 2010; Robinson, Bamford, Briel, Spencer, & Whitty, 2010). Empathy is critical for effective care for Loretta and other patients diagnosed with dementia. Looking at the surrounding world and community through the patients’ eyes would enhance understanding of the underlying problems and processes. Regarding the strategy aimed at creating a positive social environment, it should be noted that the community involvement and recognition of the problem of dementia in elderly people is critical for arriving at an appropriate resolution.

Two strategies for professional development

The two strategies which can be implemented for the professional development of an exercise physician include an evidence-based approach to professional practice and enhancing one’s knowledge in the related disciplines. Implementing the results of the recent research in professional practice can be beneficial for improving the outcomes and increasing one’s professional level. As to the importance of acquiring knowledge on the related professional domains, it would allow enhancing the effectiveness of the teamwork and improving the patients’ outcomes from the complex interventions in general.

Conclusion

In general, it can be concluded that interventions for Loretta diagnosed with dementia should comprise several components, including those of physical training educational and social work, and effective inter-professional work is required for improving the patient’s outcomes.

References

Blankevoort, C., van Heuvelen, M., Boersma, F., Luning, H., and Scherder, E. (2010). Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with Dementia. Dementia and Geriatric Cognitive Disorders, 30(5), 392-402.

Boone, T. (2011). Contemporary exercise physiology: The big picture. Professionalization of Exercises Physiology Online, 14(3), 1-17. Web.

Burton, E. (2010). Designing dementia-friendly neighborhoods: Helping people with dementia to get out and about. Journal of Integrated Care, 18(6), 11-18.

Flicker, L., Liu-Ambrose, T. & Kramer, A. (2011). Why so negative about preventing cognitive decline and dementia? The jury has already come to the verdict for physical activity and smoking cessation. British Journal of Sports Medicine, 45(6), 465-467.

Kontos, P., Mitchell, G., & Baloon. B. (2010). Using drama to improve person-centered dementia care. International Journal of Older People Nursing, 5(2), 159-168.

Perry, M., Draskovic, I., Lucassen, P., Vernooij-Dassen, M., van Achterberg, T & Olde Rickert, M. (2011). Effects of educational interventions on primary dementia care: A systematic review. International Journal of Geriatric Psychiatry, 26(1), 1-11.

Robinson, L., Bamford, C., Briel, R., Spencer, J., & Whitty, P. (2010). Improving patient-centered care for people with dementia in medical encounters: An educational intervention for old age psychiatrists. International Psychogeriatrics, 22(1), 129-138.

Stevens, A., Lancer, K., Smith, E., & McGee, R. (2009). Engaging communities in evidence-based interventions for dementia caregivers. Family & Community Health, 32(1), S83-S92.

Analytical Summary

The domain of healthcare has witnessed dramatic changes, especially about new information related to enhanced approaches and practices for better patient outcomes. To access and use this information for enhanced patient outcomes, healthcare providers need good interprofessional communication (IPC) and collaboration for effective coordination of patient care (Reeves et al., 2008). A growing body of research has been found asserting the importance of interprofessional education (IPE) in the domain of healthcare (Buring et al., 2009). IPE outlines the use of interactive learning methods such as seminars, discussions, workshops, and e-learning to effectively exchange information related to patient healthcare for better results. I have taken into account the patient’s history and their past experiences by interviewing them and having discussions with their families where possible. The summary integrates the important skills necessary for interprofessional practice and improving patient care.

Week 1 – Gastroenterology on a 60-year-old woman complaining of adnominal pain

The patient was diagnosed with emphysema, candidiasis Albicans, respiratory infection, knowledge deficit, and prone to anxiety to acute hospitalization. In the care plan for medical treatment for emphysema, I recommended steroid inhalation, bronchodilators, smoking cessation, and obtaining a baseline ABG. I gauged the patient’s knowledge of the illness and her approach to it. I explained the importance of compliance with medication when managing the disease process to the patient. I also felt the patient needed to be referred to social services or case management to find an alternative means for covering her medication.

Patient health care is a complex task, necessitating health care professionals and social workers to work together for better health outcomes among patients (Reeves et al., 2008). Enhancing patient healthcare outcomes necessitates interprofessional collaboration (IPC) and interprofessional education (IPE) (Reeves 2009). Research and literature suggest that IPE helps in the development of knowledge-based attitudes, attributes, and skills among healthcare professionals which enhance collaborative practice (Reeves, 2009). Reeves (2009) asserts that collaborative practices among healthcare professionals will produce positive healthcare outcomes due to the enhanced quality of patient care.

I considered two options – Referring the patient to a healthcare provider and referring to social services. Referring the patient to the healthcare provider helped her improve her adherence to completing medicinal regimes, probably due to a lapse of insurance coverage for her medication. Referral to social services will help her find an alternative means for covering her medication. Referring the patient to a social worker enhanced my IPE through interactive learning methods such as seminars, problem-based learning discussions, and other exchange-based learning methods.

The patient stated that she visits her primary care provider (PCP) 3-4 times annually but is unable to spend more time with her. Research confirms that communication barriers put patients at the risk for poor health outcomes through the providence of below-average health care treatments (Ratanawongsa et al., 2012). Since the patient stated that she can do much more to maintain her health and her PCP is busy, I put together several options to help her improve her health and increase her health knowledge. My research highlighted several options I could use to help the patient and achieve the best healthcare outcomes. These options are:

The Self-management Support Program

This allows the patient to individually assess herself through collaborative goal-setting, enhancement of self-care skills by providing access to healthcare-based resources (Ratanawongsa et al., 2012). The self-management support program showed promise of enhanced healthcare outcomes in the patient since she seemed motivated to improve her health. I began to research the available literature to find similar programs for the patient. However, during my research from journals and databases, I found that despite the demand for self-management programs, providing self-management support to patients requires high availability of resources, training and re-training staff members, huge investments in information technology, and designing specifically tailored programs to suit the diverse needs of patients (Fiscella & Geiger, 2006).

Patient-facing health information technology (HIT)

The HIT showed to be a promising program that suited my patient’s needs. I decided to use this program to help increase access of patients to self-management support (Schillinger et al., 2008). The program employs the use of the telephone to provide surveillance, education, and support to patients also termed automated telephone self-management (ATSM) (Schillinger et al., 2008). I found that the ATSM can be an excellent approach for my patient since it showed promise to promote collaborative goal setting by way of behavioral action plans which help patients accomplish short-term goals in self-management (U.S. Department of Health and Human Services, 2010). Research indicates that the employment of the ATSM strategy showed marked improvements in patients’ self-management behavior (Handley et al., 2008; Schillinger et al., 2008). I am confident of better outcomes in my patient’s health through the use of the ATSM.

Week 2 – Pulmonology patient

The patient was diagnosed with Emphysema, candidiasis Albicans, a respiratory infection. The patient showed a deficiency of knowledge and demonstrated anxiety to acute hospitalization. In my medical care plan, I proposed treatment including steroid inhalations bronchodilators, and smoking cessation. Obtaining a baseline ABG was also recommended. The patient demonstrated adherence to continual and complete medication, possibly due to a lapse of insurance coverage. I recommended referral to case management or social services to find alternative means for covering her medical expenses. Since the patient needed treatment for emphysema, I referred her to a pulmonologist.

The patient needed help from more than one health care professional. I used the interprofessional collaboration approach (IPC) which involves the active partnership between two health care professionals to effectively solve patient problems (Reeves, 2009). I provided her with information through various mediums such as verbal explanations, discussion, demonstration, and pictures to help her understand her health issue and foster optimal health outcomes by facilitating understanding. I referred her to a social worker so that we could work together to achieve optimal outcomes in interprofessional care in my patient (IPC) (Reeves, 2009).

Week 3 – Genitourinary Clinical Case Study

In week 3 patient of the Genitourinary Clinical Case Study, I obtained the patient’s history to determine his concerns and level of understanding of his illness. I found that he had no experience with cancer. Prostate cancer in males requires serious treatment involving severe side effects such as urinary incontinence and erectile dysfunction (Northouse et al., 2007). I confirmed if he knew his diagnosis and determined to see what his support systems were and how he would cope with stress. He was living with a spouse who I realized could be a primary caregiver to my patient. The spouse, as the primary caregiver can undergo much stress due to the complexity of the situation and the intimate nature of the disease (Northouse et al., 2007).

When providing education about the nature of the disease and the associated problems, I considered several aspects of the illness. The patient is living with his spouse who could be affected by the disease. Research confirms that the symptoms of prostate cancer can negatively affect the quality of life of patients as well as their spouses (Northouse et al., 2007). Studies indicate that psychosocial intervention can enhance the quality of life of cancer patients (Marcus et al., 2010). In keeping with my research findings, I suggested a family-based intervention plan which would help the patient as well his family cope with the stress of the disease.

The recommendation was based on the positive results of a study conducted with cancer patients to determine the efficacy of professional telephone counselors in psychosocial oncology to reduce stress related to the disease (Marcus et al., 2010). The intervention would help my patient’s spouse cope with the stress as primary caregiver (Northouse et al., 2007). I suggested they take an intervention program from an expert in oncology psychology. In the telephonic intervention program, a psychosocial oncologist would provide accurate information to the patient and the spouse and be responsive to their concerns (Northouse et al., 2007). Consultation sessions to patients as well as their spouses would offer systematically structured programs of care to help them cope with the effects of cancer (Northouse et al., 2007).

Week 4 – Cardiology Clinical Case

In week 4 of the Cardiology Clinical Case study of the patient, I recommended referral to a cardiologist. He complained of acute chest pain. Additionally, the patient reported smoking one packet of cigarettes daily. It was important to educate the patient about the harmful effects of smoking, considering his weak health condition. I informed him that the chemicals found in tobacco damage the vessels of the heart and cause atherosclerosis (Thrasher, 2012). The patient revealed that he did not have any exercise program; so I educated him about the importance of physical activity in reducing stress and blood pressure (Weekly News, 2013).

Patient history revealed that he was taking an unhealthy diet of pasta and fast foods. The patient lacked education on the importance of a healthy and low-fat diet for managing weight and symptoms of heart disease. With a BMI of 31.6 as compared to a normal BMI of 25 (Kee, 2013), the patient needed an education program to maintain weight and prevent further serious heart problems. The patient is diabetic and has a family history of diabetes, necessitating the need to be educated about the importance of maintaining blood sugar levels.

Nurses play an important role in providing education to patients (Stromberg, 2005). Nurses can begin to provide education to patients in hospitals or primary care as soon as the patient has been diagnosed (Stromberg, 2005). Stromberg (2005) explains the importance of repeated education due to a large amount of information to be given to patients. As such, I used different occasions to educate the patient about the importance of diet and exercise in taking care of his health.

I gave educational materials such as books, booklets, and links to web pages along with verbal education. I asked the patient to subscribe to newsletters so that he could access information on heart diseases, medications, and recommendations related to them. I understood that the patient is a knowledge deficit and needs an understanding of his health problem. I also considered telemonitoring as an effective educational intervention and enrolled the patient in one such program (Louis et al., 2003).

After accessing his understanding, I developed a therapeutic plan with him to increase his compliance with dietary measures and exercise regimes in his lifestyle. I asked him to maintain a logbook to record his diet and exercise regime.

Since the patient is dealing with a bedridden spouse, I engaged him in a community-based support group program that will help him release his emotions and reduce his levels of stress. Research affirms the importance of relieving stress and emotions as an essential therapy (Stress & Coping, 2010). I considered this important since the patient seemed lonely and was not in contact with friends, family members, or neighbors. Support groups will help the patient to adapt to his health conditions by gaining and receiving emotional support from peers in the group (Stress & Coping, 2010).

Week 5 – Musscoskeletal clinical case study

The patient, a 40-year-old Asian American male roofer complained of intense pain in the back and numbness in the toes. Stress and depression were visible as the patient worried about the inability to work in the future. The patient is divorced and considered to be a failure in marriage. He does not smoke but consumes alcohol on weekends and has a history of substance abuse, marijuana. He has bad dietary habits and eats his meals at fast-food restaurants.

He is a heavy consumer of caffeine and beverages. He has no exercise program and lacks knowledge about exercise. He expresses a desire to lose weight with the help of dieting but has no clue of how to go about it. He resides in a suburban community where he can access resources but lacks knowledge of these resources. His lab results show a mild degeneration of the lumbar vertebrae due to the high-intensity labor work he is engaged in. The MRI reveals a moderate disc bulge at L5: S1.

The patient needed to be informed about the importance of diet and exercise. He believed that his intensive work is sufficient exercise for his body. Keeping in mind the severity of his pain, I researched the database for therapies that would work for him and help control the degeneration of his vertebrae. I found that a variety of yoga programs have been developed and implemented in clinical and community settings for patients with musculoskeletal pain and degeneration (Reid et al., 2008).

The specific techniques used for breathing, stretching, and relaxation help in building strength and flexibility when practiced regularly (Reid et al., 2008). I suggested the patient enroll in a yoga program delivered by a qualified professional to reduce the pain as research indicated (Kolasinski et al., 2005). I found substantial literature on the use of yoga as an effective therapy program for the management of pain and stress is ever-expanding (Williams et al., 2005; Sherman et al., 2005).

My research for the patients provided me with the latest interventions, techniques, and therapeutic approaches to educating patients about their health conditions with the goal of better health outcomes. As a nurse, I would be able to intelligently use my available resources with the aid of my research. Knowing that resources can sometimes be few, research and investigation conducted by scholars would help me to utilize the available resources to the best potential and achieve the best possible goals of enhanced health outcomes in patients.

Instructional Worksheet – An Overview

Assessing the needs of the patient is an essential learning need. This includes understanding what the patient knows, what they need to learn, and their level of learning, understanding, and coping in the given situation. Some questions the nurse can get an overview of the patient are:

What is your average day like?
How long have you been ill?
What are your hobbies?
How do you spend your spare time?
What work do you do?
What are your primary concerns related to health?

Instructional Worksheet

References

Buring, S. M, Bhushan, A., Broeseker, A., Conway, S., Duncan-Hewitt, W., Hansen, L., & Westberg, S. 2009. Interprofessional Education: Definitions, student competencies, and guidelines for implementation. Am J Pharm Educ, 73(4), 59.

Fiscella, K., & Geiger, H. J., 2006. Health information technology and quality improvement for community health centers. Health Aff (Millwood), 25(2):405-412.

Handley, M. A., Shumway, M. & Schillinger, D. 2008. Cost-effectiveness of automated telephone self-management support with nurse care management among patients with diabetes. Ann Fam Med, 6(6):512-518.

Kolasinski S. L., Garfinkel, M., Tsai, A. G., et al. 2005. Iyengar yoga for treating symptoms of osteoarthritis of the knees: A pilot study. J Altern Complement Med, 11:689–93.

Louis A., Turner T., Gretton M., Baksh A. & Cleland J. 2003. A systematic review of telemonitoring for the management of heart failure. Eur. J. Heart Fail, 5:583-590

Marcus, A. C., Garrett, K. M., Cella, D., Wenzel, L., Brady, M. J., Fairclough, D., & Flynn, P. J. 2010. Can telephone counseling post-treatment improve psychosocial outcomes among early-stage breast cancer survivors? Psycho-Oncology, 19, 923–932. Web.

Northouse L. L., et al. 2007. Randomized Clinical Trial of a Family Intervention for Prostate Cancer Patients and Their Spouses.Cancer. Web.

Ratanawongsa, N., Handley, M. A., Quan, J., et al. 2012. Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support SMARTSteps) in a Medicaid managed care plan: study protocol. BMC Health Serv Res, 12:22.

Reid, M.C., et al. 2008. Self-management strategies to reduce pain and improve function among older adults in community settings: A review of the evidence. Pain Medicine, 9(4), 409-424.

Reeves, S. 2009. An Overview of Continuing Interprofessional Education. Journal of Continuing Education in the Health Professions. Vol. 29, No. 3, pp. 142-46.

Reeves, S., Zwarenstein, M., Goldman, J., Barr, H., Freeth, D., Hammick, M., Koppel, I. 2008. Interprofessional education: effects on professional practice and health care outcomes.Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD002213. Web.

Schillinger, D., Hammer, H., Wang, F., Palacios, J., McLean, I., Tang, A., Youmans, S. & Handley, M., 2008. Seeing in 3-D: examining the reach of diabetes self-management support strategies in a public health care system. Health Educ Behav, 35(5):664-682.

Sherman, K. J., Cherkin, D. C., Erro, J., Miglioretti, D. L. & Deyo, R. A. 2005. Comparing yoga, exercise, and a self-care book for chronic low back pain. Ann Intern Med; 143:849–56.

Stress and Coping. (2001). Encyclopedia of Women and Gender: Sex Similarities and Differences and the Impact of Society on Gender. Web.

Thrasher, J. 2012. Heart disease; pictures effective in warning against cigarette smoking. Heart Disease Weekly, 575. Web.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. 2010. National Action Plan to Improve Health Literacy. Washington D.C.: U.S. Department of Health and Human Services.

Williams KA, Petronis J, Smith D, et al. 2005. Effect of Iyengar yoga therapy for chronic low back pain. Pain; 115:107–17.

Collaboration and trust in nursing can make a drastic shift in patient care. Based on the concept of holistic nursing, a person is deemed to be in close connection with the environment. Treatment of the patient depends not only on the actions of the nurse but also on the usefulness of care. Holistic medicine means that a person can be cured solely by being in harmony between their personality, their body, consciousness, and reality (Thornton, 2019). The nurse acts as a guide to such a worldview, where, having united the disparate aspects of one’s personality, a person actually begins to heal. This is why collaboration and trust are particularly important in the nursing process for helping the patient feel worthwhile and self-sufficient.

The patient’s trust in the nurse is irreplaceable as a fundamental aspect of the treatment. Patients must cooperate with the doctor who works with them; otherwise, there is no psychological factor in the healing process, which is more important than the physical ones for avoiding adverse outcomes. The ability to negotiate, listen, and be heard must be communicated to the patient, and the results directly depend on the behavior of the nurse. It should be added that Florence Nightingale, considered the godmother of modern nursing, developed theoretical calculations in her diaries about the equality of people and the need for protecting their rights (Selanders & Crane, 2012). Indeed, the respect for people puts them high as independent human units. This provision, alongside a genuine desire to help, inevitably leads to the emergence of a positive spiritual healing effect. In addition, this concept is applied in my professional practice at the stage of diagnosing people for their collaboration with specialists, and in McAuley’s time, it could be used for promoting the restorative environment. Thus, inviting a patient to cooperate in a trusting manner is a condition for their successful treatment.

References

Selanders, L., & Crane, P. (2012). The voice of Florence Nightingale on advocacy.The Online Journal of Issues in Nursing, 17(1). Web.

Thornton, L. (2019). A brief history and overview of holistic nursing. Integrative Medicine: A Clinician’s Journal, 18(4), 32-33. Web.

Introduction

Nurses, physicians, administrators, and other healthcare professionals primarily work together in any organization. While they pursue the same goal of providing care, they have different duties and levels of autonomy. This variety in the professions can lead to conflicts or create an uncollaborative environment (Manias, 2018). As a result, many issues can occur, influencing patients and health care providers. The following interview with a registered nurse considers the problem of medication errors and possible theories that can aid an interprofessional collaboration intervention.

Interview Summary

The interviewee, a registered nurse, works at a medical intensive care unit of a small hospital. She does not have much prior experience, and she started this job less than a year ago. While the interviewee states that she still feels as though she is learning, she admits that her current coworkers do not communicate and prefer to use documents that are available through the hospital’s system. As a result, she has noticed that it is very easy for nurses and other health care professionals to make medication errors. Sometimes, a patient is prescribed conflicting medications, or a dose needs several corrections.

The interviewee considers these problems preventable and comments on how nurses and physicians do not communicate these problems openly. Instead, they usually talk in small groups and do not share the information systematically. The nurse comments that she often feels left out of these conversations as a relatively new employee, and physicians or other nurses do not take any steps to help integrate her into the processes.

Identified Issue

From the interview, it becomes apparent that medication errors are the top concern for this particular unit. This is a common problem that arises from nurses’ and physicians’ lack of communication and collaboration (Manias, 2018). As the professionals do not exchange information or offer advice to each other, they rely on limited data and their own understanding of each patient’s health. The outcome to this problem can include missed or incorrect doses administered to patients, incompatible or conflicting medications being prescribed, wrong drugs being used, and much more. Medication errors are considered preventable because they depend on healthcare professionals’ expertise and their use of available information (Manias, 2018). Therefore, interdisciplinary collaboration is vital in solving this problem, as it fosters communication and encourages knowledge sharing.

Change Theory

A change theory in the discussed case is needed to prepare health care professionals for a change and give them the tools to implement it. One of the most recognized theories is Lewin’s change model, and it includes three major steps – unfreezing, changing, and refreezing (Udod & Wagner, 2018). The first part, unfreezing, refers to the process of showing professionals why the change is necessary. Nurses and physicians do not engage in open conversations in the present unit. They are locked in a pattern of relying on themselves rather than on a team of professionals with shared knowledge and understating. Lewin proposes that one should “unfreeze” this old way of behavior and identify why professionals behave in this way (Udod & Wagner, 2018). Next, change is the intervention implementation process, where the proposed program is introduced and completed. Finally, the freezing stage is necessary to ensure that the intervention becomes the new habit in the unit.

Leadership Strategy

As the presented issue requires collaborative action, collective and transformational leadership styles can be proposed. Collective leadership relies on information sharing, group action, dispersed authority and duties (Nieuwboer et al., 2019). It depends on social interactions, which could help bring health care professionals in the unit together to create a stronger team. On the other hand, transformational leadership requires one or a small group of leaders that motivate others to achieve better results (Nieuwboer et al., 2019). Here, a charismatic person with a positive and active attitude is necessary to foster communication between other team members. Although both leadership strategies can lead to positive results, the appeal of collective leadership is its focus on relationships and shared responsibility. In the case of medication errors, this style may be more appropriate for encouraging all professionals to participate in the intervention.

Collaboration Approach

Many collaboration approaches have been reviewed in health care research to combat the high rate of medication errors. Manias et al. (2020) present an interprofessional team that includes a nurse, a physician, and a pharmacist as one of the effective collaborative efforts to reduce this problem. According to the available studies, such partnerships significantly decrease the rate of prescription errors and the use of inappropriate medications (Manias et al., 2020). Therefore, if a pharmacist monitors the team containing a nurse and a physician, all participants can improve their understanding of each patient’s needs as well as their professional expertise. Moreover, this strategy can also improve communication between professionals in the unit and inspire them to share their knowledge.

Conclusion

Medication errors are a common preventable problem in healthcare organizations. Poor communication and the lack of collaboration are at the root of this issue. Thus, a change is necessary to improve nurse-nurse and nurse-physician interactions and positively influence patient outcomes. Lewin’s change model can assist in designing the intervention because it is based on three simple steps. The collective leadership style is beneficial in the discussed case as it introduces the idea of shared decision-making and responsibility. One of the approaches proposed by research is pharmacist integration, where nurses, physicians, and pharmacists work together to reduce the rate of medication errors.

References

Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: An integrative review. Expert Opinion on Drug Safety, 17(3), 259-275. Web.

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11, 1-29. Web.

Nieuwboer, M. S., van der Sande, R., van der Marck, M. A., Olde Rikkert, M. G., & Perry, M. (2019). Clinical leadership and integrated primary care: A systematic literature review. European Journal of General Practice, 25(1), 7-18. Web.

Udod, S., & Wagner, J. (2018). Common change theories and application to different nursing situations. In J. Wagner (Ed.), Leadership and influencing change in nursing (pp. 228-253). University of Regina.