Petersen Helle Vendel, Foged Signe, Nørholm Vibeke
Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark.
J Clin Nurs. 2019 May;28(9-10):1999-2008. doi: 10.1111/jocn.14805. Epub 2019 Feb 19.
To explore how the hospital and home care nurses talk about and experience cross-sectoral collaboration related to the transitional care of frail older patients.
Effective communication and collaboration between nurses involved in care transition are crucial for a safe patient handover. Organisational systems to support cross-sectoral collaboration have been developed but do not always promote the intended dialogue and precise and useful exchange of information. Other factors may also be of importance to an effective and constructive cross-sectoral nurse collaboration.
A qualitative design using thematic analysis.
Data were extracted from 24 focus group interviews conducted with registered nurses from eight hospital wards and six municipalities and a total of 165 hr of observations conducted in three hospital wards and three municipalities. The study was reported according to the COREQ guidelines.
The perception of nursing and care differed across sectors. The nurses expressed having shared goals for the patients-however, these goals derived from different values, the perception of nursing and approach to the patients. The lack of knowledge of each other's working conditions created assumptions and preconceptions, which affected communication and collaboration related to planning and executing care transition negatively.
The nurses perceived the hospital and home care as" two worlds". The collaboration between the nurses was characterised by insufficient communication and preconceptions rather than concrete knowledge and different cultures and professional identities. It can be questioned whether cross-sectoral collaboration between nurses should be characterised as interprofessional rather than intraprofessional collaboration as the features of the nurses' collaboration.
Organisational and political systems should recognise that nurses in different sectors are taking care of various aspects of nursing when planning on policies to support cross-sectoral collaboration. More possibilities for nurses across sectors to meet should be made available.
探讨医院和家庭护理护士如何谈论及体验与体弱老年患者过渡护理相关的跨部门协作。
参与护理过渡的护士之间进行有效的沟通与协作对于安全的患者交接至关重要。已建立了支持跨部门协作的组织系统，但并不总能促进预期的对话以及精确且有用的信息交流。其他因素对于有效且建设性的跨部门护士协作可能也很重要。
采用主题分析的质性设计。
数据提取自对来自八个医院病房和六个市政当局的注册护士进行的24次焦点小组访谈，以及在三个医院病房和三个市政当局进行的总共165小时的观察。该研究按照COREQ指南进行报告。
不同部门对护理和照料的认知存在差异。护士们表示对患者有共同的目标——然而，这些目标源自不同的价值观、护理认知和对待患者的方式。对彼此工作条件缺乏了解产生了假设和先入之见，对与规划和执行护理过渡相关的沟通与协作产生了负面影响。
护士们将医院和家庭护理视为“两个世界”。护士之间的协作特点是沟通不足和先入之见，而非具体的知识以及不同的文化和专业身份。鉴于护士协作的特点，护士之间的跨部门协作是否应被视为跨专业而非专业内协作值得质疑。
组织和政治系统在制定支持跨部门协作的政策时应认识到，不同部门的护士负责护理的各个方面。应提供更多机会让不同部门的护士相互交流。
