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探索重症监护病房中的跨专业协作。

Exploring interprofessional collaboration in the intensive care unit.

作者信息

Thethwayo Meluleki S, Camp Pat, van Staden Diane, Chetty Verusia, Maddocks Stacy

机构信息

Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Centre for Heart Lung Innovation, Faculty of Health Sciences, University of British Columbia, Vancouver, Canada.

出版信息

S Afr J Physiother. 2024 Nov 11;80(1):2098. doi: 10.4102/sajp.v80i1.2098. eCollection 2024.

Abstract

BACKGROUND

Critical care units require an interprofessional management approach to optimise patients' health. Clinical education and training delivered in remote healthcare settings are vital for fostering interprofessional collaboration (IPC) among health science students for future team functioning.

OBJECTIVES

Our study explored the IPC among clinicians in the intensive care unit (ICU) setting at two South African decentralised clinical training facilities to understand the existing collaborative practices that students are exposed to during their clinical training.

METHOD

A qualitative study design, utilising semi-structured interviews, was used to gather information on the experiences of 40 purposively selected participants working in the ICU settings at the two clinical sites. Data collected from the interviews were transcribed verbatim and thematically analysed.

RESULTS

Four major themes were identified from the data, namely, scope-of-practice dispute, teamwork disruption, organisational obstacles and future aspirations.

CONCLUSION

Participants believed that a lack of professional regard by medical doctors and an inadequate understanding of the role of other professionals impeded appropriate referral practice and collaborative team functioning. Under-exposure to interprofessional education (IPE) at an undergraduate level and the pervasive medical hierarchy were perceived as a primary attributable cause of this phenomenon. Moreover, the coronavirus disease 2019 (COVID-19) pandemic and persistent staff shortages purportedly obstructed potential opportunities to collaborate in multidisciplinary meetings. Participants believed that improving undergraduate IPE and compulsory multidisciplinary meetings to promote communication would improve team functioning in these clinical settings.

CLINICAL IMPLICATIONS

Undergraduate IPE is a feasible approach to improve collaborative care in ICUs to achieve better patient outcomes.

摘要

背景

重症监护病房需要跨专业管理方法来优化患者健康。在远程医疗环境中提供的临床教育和培训对于促进健康科学专业学生之间的跨专业协作(IPC)以实现未来团队运作至关重要。

目的

我们的研究探讨了南非两个分散式临床培训设施的重症监护病房(ICU)临床医生之间的IPC,以了解学生在临床培训期间所接触到的现有协作实践。

方法

采用定性研究设计,利用半结构化访谈收集了40名有目的地选择的在两个临床地点的ICU工作的参与者的经验信息。访谈收集的数据逐字转录并进行主题分析。

结果

从数据中确定了四个主要主题,即执业范围争议、团队合作中断、组织障碍和未来期望。

结论

参与者认为,医生缺乏专业尊重以及对其他专业人员角色的理解不足阻碍了适当的转诊实践和协作团队运作。本科阶段跨专业教育(IPE)接触不足和普遍存在的医学等级制度被视为这一现象的主要归因原因。此外,2019年冠状病毒病(COVID-19)大流行和持续的人员短缺据称阻碍了多学科会议中的潜在协作机会。参与者认为,改善本科IPE和强制性多学科会议以促进沟通将改善这些临床环境中的团队运作。

临床意义

本科IPE是改善ICU协作护理以实现更好患者结局的可行方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42aa/11622120/a23d77102d01/SAJP-80-2098-g001.jpg

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