执业护士在急性和长期护理中的互动：对纽结工作在支持跨专业协作中作用的探索。
Nurse practitioner interactions in acute and long-term care: an exploration of the role of knotworking in supporting interprofessional collaboration.
作者信息
Hurlock-Chorostecki Christina, van Soeren Mary, MacMillan Kathleen, Sidani Souraya, Donald Faith, Reeves Scott
机构信息
School of Nursing, Western University, London, ON Canada.
School of Nursing, Dalhousie University, Halifax, NS Canada.
出版信息
BMC Nurs. 2015 Oct 14;14:50. doi: 10.1186/s12912-015-0102-x. eCollection 2015.
BACKGROUND
Interprofessional care ensures high quality healthcare. Effective interprofessional collaboration is required to enable interprofessional care, although within the acute care hospital setting interprofessional collaboration is considered suboptimal. The integration of nurse practitioner roles into the acute and long-term care settings is influencing enhanced care. What remains unknown is how the nurse practitioner role enacts interprofessional collaboration or enables interprofessional care to promote high quality care. The study aim was to understand how nurse practitioners employed in acute and long-term care settings enable interprofessional collaboration and care.
METHOD
Nurse practitioner interactions with other healthcare professionals were observed throughout the work day. These interactions were explored within the context of "knotworking" to create an understanding of their social practices and processes supporting interprofessional collaboration. Healthcare professionals who worked with nurse practitioners were invited to share their perceptions of valued role attributes and impacts.
RESULTS
Twenty-four nurse practitioners employed at six hospitals participated. 384 hours of observation provided 1,284 observed interactions for analysis. Two types of observed interactions are comparable to knotworking. Rapid interactions resemble the traditional knotworking described in earlier studies, while brief interactions are a new form of knotworking with enhanced qualities that more consistently result in interprofessional care. Nurse practitioners were the most common initiators of brief interactions.
CONCLUSIONS
Brief interactions reveal new qualities of knotworking with more consistent interprofessional care results. A general process used by nurse practitioners, where they practice a combination of both traditional (rapid) knotworking and brief knotworking to enable interprofessional care within acute and long-term care settings, is revealed.
背景
跨专业护理可确保高质量的医疗保健。实现跨专业护理需要有效的跨专业协作，尽管在急性护理医院环境中，跨专业协作被认为并不理想。将执业护士角色融入急性和长期护理环境正在影响护理质量的提升。尚不清楚的是，执业护士角色如何开展跨专业协作或促进跨专业护理以提升护理质量。本研究旨在了解在急性和长期护理环境中工作的执业护士如何促进跨专业协作与护理。
方法
在工作日期间观察执业护士与其他医疗保健专业人员的互动。在“编织网络”的背景下探讨这些互动，以了解支持跨专业协作的社会实践和过程。邀请与执业护士共事的医疗保健专业人员分享他们对有价值的角色属性和影响的看法。
结果
六家医院的24名执业护士参与了研究。384小时的观察提供了1284次观察到的互动以供分析。观察到的两种互动类型与“编织网络”类似。快速互动类似于早期研究中描述的传统“编织网络”，而简短互动是一种新的“编织网络”形式，具有更高的质量，更能持续带来跨专业护理。执业护士是简短互动最常见的发起者。
结论
简短互动揭示了“编织网络”的新特性，能带来更一致的跨专业护理结果。揭示了执业护士使用的一个一般过程，即他们将传统（快速）“编织网络”和简短“编织网络”相结合，以在急性和长期护理环境中实现跨专业护理。
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