Newcastle Business School, University of Newcastle, Newcastle, 2308 NSW, Australia.
Int J Nurs Stud. 2013 Apr;50(4):536-42. doi: 10.1016/j.ijnurstu.2012.11.008. Epub 2012 Dec 6.
In an effort to reduce tracheostomy-related complications, many acute care facilities have implemented specialist tracheostomy teams. Some studies, however, generate only mixed support for the connection between tracheostomy teams and patient outcomes. This suggests that the effect of collaborative teamwork in tracheostomy care is still not well understood.
The aim of this paper is to investigate the mechanisms through which an interprofessional team approach can improve the management of patients with a tracheostomy.
The achievement of this research objective requires the collection of rich empirical data, which indicates the use of a qualitative methodology. A case study approach provided an opportunity to collect a wealth of data on tracheostomy team activities and dynamics.
Data were collected on an interprofessional tracheostomy team in a large tertiary referral hospital in Australia. The team was composed of clinical nurse consultants, a physiotherapist, a speech pathologist, a dietician, a social worker and medical officers.
Data were collected through a focus group and one-to-one, semi-structured in-depth interviews, and thematic analysis was used to analyse experiences of tracheostomy team members.
Qualitative analysis resulted in two main themes: interprofessional protocol development and implementation; and interprofessional decision-making.
Our findings suggest that tracheostomy teams enhance consistency of care through the development and implementation of interprofessional protocol. In addition, such team allow more efficient and effective communication and decision-making consequent to the collocation of diverse professionals. These findings provide new insight into the role of tracheostomy teams in successfully implementing complex protocol and the explanatory mechanisms through which interprofessional teams may generate positive outcomes for tracheostomy patients.
为了降低气管切开术相关并发症的发生率，许多急症护理机构都设立了专科气管切开术团队。然而，一些研究对气管切开术团队与患者结局之间的关联仅提供了混合支持。这表明协作式团队工作在气管切开术护理中的作用仍未得到充分理解。
本文旨在探讨多专业团队方法如何改善气管切开患者的管理。
实现这一研究目标需要收集丰富的实证数据，这表明需要使用定性方法。案例研究方法提供了收集大量气管切开术团队活动和动态数据的机会。
在澳大利亚的一家大型三级转诊医院的跨专业气管切开术团队中收集了数据。该团队由临床护士顾问、物理治疗师、言语病理学家、营养师、社会工作者和医务人员组成。
通过焦点小组和一对一的半结构化深入访谈收集数据，并使用主题分析来分析气管切开术团队成员的经验。
定性分析产生了两个主要主题：跨专业协议的制定和实施；以及跨专业决策。
我们的发现表明，气管切开术团队通过制定和实施跨专业协议来提高护理的一致性。此外，由于不同专业人员的配置，这种团队允许更高效和有效的沟通和决策。这些发现为气管切开术团队在成功实施复杂协议以及跨专业团队如何通过解释机制为气管切开术患者带来积极结果方面提供了新的见解。
