Burgess Judith, Sawchenko Linda
Health Services, University of Victoria, Victoria, BC, Canada.
Nurs Leadersh (Tor Ont). 2011 Jun;24(2):99-112. doi: 10.12927/cjnl.2011.22468.
A study was undertaken with nurse practitioners (NPs) in 2008-2009 to examine post-legislation role development in British Columbia. The authors used a participatory action research approach to engage NPs in social investigation, education and action, and to explore, from the participants' perspective, how collaboration advances NP role integration in primary healthcare. A particular discovery of the study was the Interior Health Authority Community of Practice (CoP) established in collaboration with health leaders and NPs. The purpose of this paper is to report on the CoP and the five characteristics describing this collaborative CoP model, including sanctioned social structure, knowledge exchange network, practice discovery and innovation, generating meaning and value, and power sharing for strategic improvement. The CoP helped NPs to build collegial and collaborative relationships, enhance practice learning and competence, extend and apply new knowledge, enrich professional identities, and shape health organizational policy and politics. Because healthcare research about CoPs is limited, principles of a collaborative CoP model are offered for broader healthcare use. The authors conclude that a collaborative CoP model addresses the internal interests and needs of participating members while attending to the external concerns of the organization, and thus contributes to healthcare improvement.
2008年至2009年对执业护士（NP）开展了一项研究，以考察不列颠哥伦比亚省立法后的角色发展情况。作者采用参与式行动研究方法，让执业护士参与社会调查、教育和行动，并从参与者的角度探索合作如何促进初级医疗保健中执业护士角色的整合。该研究的一个特别发现是与卫生领域领导者及执业护士合作建立的内陆卫生局实践社区（CoP）。本文旨在报告该实践社区以及描述这种合作性实践社区模式的五个特征，包括认可的社会结构、知识交流网络、实践发现与创新、产生意义和价值以及为战略改进而进行的权力共享。实践社区帮助执业护士建立同行关系和合作关系，增强实践学习和能力，扩展并应用新知识，丰富职业身份，并塑造卫生组织的政策和政治格局。由于关于实践社区的医疗保健研究有限，现提供合作性实践社区模式的原则以供更广泛的医疗保健领域使用。作者得出结论，合作性实践社区模式在关注组织外部问题的同时，满足了参与成员的内部利益和需求，从而有助于改善医疗保健。
