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跨专业合作在急诊科团队分诊中的挑战——一种阐释性描述。

The challenge of interprofessional collaboration in emergency department team triage - An interpretive description.

机构信息

Emergency Department, University Hospital Basel, Basel, Switzerland.

Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland.

出版信息

J Adv Nurs. 2021 Mar;77(3):1368-1378. doi: 10.1111/jan.14675. Epub 2020 Nov 27.

Abstract

AIMS

To explore emergency nurses' and physicians' experience of collaboration and collective decision-making when triaging older Emergency Department patients within the interprofessional team triage system.

DESIGN

Qualitative.

METHODS

Semi-structured interviews were conducted with seven nurses and five physicians. Transcripts were analysed via Interpretive Description between September 2016-May 2017.

RESULTS

'Negotiating collaboration' was developed as the main theme. Three subthemes influenced the negotiation process: Participants described divergent opinions on how an optimal triage system should work ('preferences for triage systems'); they had conflicting perceptions of each profession's role ('role perceptions'); and they expressed different coping strategies regarding 'perceived time pressure'. The compatibility of participants' views on these sub-themes determined whether the nurse and physician were able to successfully negotiate their collaboration. These themes became more evident when the team triaged older ED patients.

CONCLUSION

Improving interprofessional team triage requires working with the involved nurses' and physicians' values and beliefs. The strengths of both professions need to be considered and a flexible approach to collaboration established according to the patients' situations.

IMPACT

Emergency Department leaders need to consider nurses' and physicians' values and beliefs to promote interprofessional collaboration in team triage.

摘要

目的

探索在跨专业团队分诊系统中,急诊护士和医生在对老年急诊患者进行分诊时的合作和集体决策经验。

设计

定性研究。

方法

2016 年 9 月至 2017 年 5 月,对 7 名护士和 5 名医生进行了半结构化访谈。通过解释性描述对转录本进行了分析。

结果

“协商合作”是主要主题。三个子主题影响了协商过程:参与者对最佳分诊系统应如何运作的意见存在分歧(“对分诊系统的偏好”);他们对各自专业角色的看法存在冲突(“角色认知”);他们对“感知时间压力”表达了不同的应对策略。参与者对这些子主题的看法的兼容性决定了护士和医生是否能够成功协商他们的合作。当团队对老年 ED 患者进行分诊时,这些主题变得更加明显。

结论

改善跨专业团队分诊需要与相关护士和医生的价值观和信念合作。需要考虑到两个专业的优势,并根据患者的情况建立灵活的合作方式。

影响

急诊部门的领导需要考虑护士和医生的价值观和信念,以促进团队分诊中的跨专业合作。

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