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重症监护病房跨专业协作推进中的挑战与最佳实践:护士视角

Challenges and best practices for moving forward in interprofessional collaboration in critical care units: nurses' perspectives.

作者信息

Ghattas Amina Hemida Salem, Abdou Hala Ahmed

机构信息

Critical Care & Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.

Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.

出版信息

BMC Nurs. 2025 Mar 25;24(1):317. doi: 10.1186/s12912-025-02860-0.

Abstract

BACKGROUND

The positive outcomes for critically ill patients rely on effective interprofessional collaboration (IPC), which depends on the collective expertise and skill of the critical care team (CCT) working cohesively and collaboratively to provide patients with high-quality, safe care.

AIMS

(1) To determine the challenges to interprofessional collaboration in critical care units as perceived by the diploma versus. baccalaureate nurses (2) To explore best practices suggested by nurses for improving IPC.

METHODS

A descriptive design using a four-point scale survey and two open-ended questions was employed to collect the data from 125 nurses in three critical care medicine units at a university hospital. Quantitative data were analyzed using t-tests, one-way ANOVA, and Pearson correlations, with 𝑝 < 0.05 considered statistically significant. Open-ended questions were analyzed by content analysis.

RESULTS

The results demonstrated a substantial difference between nurses who graduated from nursing faculties and hold baccalaureate degrees and nurses who graduated from nursing institutions and hold diploma degrees in agreement and satisfaction with the relations and collaboration with the physicians. Additionally, a significant correlation was seen between the level of nurses' education and the limited time caused by heavy workloads and the nurses' perspectives toward their relations with physicians. A content analysis of the nurses' texts revealed that five categories have emerged as nurses' suggestions to keep up the best practices for moving forward in the nurse-physician collaboration: changing the physician's attitude toward the nurses, improving communication skills, role clarification, interprofessional conflict resolution, and support and motivation.

CONCLUSIONS

On the one hand, nurses with baccalaureate degrees expressed lower satisfaction with IPC. On the other hand, five categories were suggested by the nurses as best practices for moving forward in their collaboration with the physicians, these include physician attitudes toward the nurses, communication tools and skills, nurses' roles clarification, interprofessional conflict resolution, and support and motivation. Implementation of the results of the current study will improve patient outcomes by preventing oversights, medication errors, and redundant interventions. In addition to creating relaxed working conditions, improving the morale of the healthcare team, job satisfaction, and decreased staff turnover.

摘要

背景

重症患者的积极治疗效果依赖于有效的跨专业协作(IPC),而这又取决于重症护理团队(CCT)的集体专业知识和技能,该团队需紧密且协作地工作,为患者提供高质量、安全的护理。

目的

(1)确定文凭护士与学士学位护士所感知到的重症监护病房跨专业协作面临的挑战;(2)探索护士提出的改善跨专业协作的最佳实践方法。

方法

采用描述性设计,运用四点量表调查和两个开放式问题,从一家大学医院三个重症医学科的125名护士中收集数据。定量数据采用t检验、单因素方差分析和Pearson相关性分析,p < 0.05被认为具有统计学意义。开放式问题通过内容分析进行分析。

结果

结果表明,毕业于护理学院并拥有学士学位的护士与毕业于护理机构并拥有文凭的护士在与医生的关系及协作的认同度和满意度上存在显著差异。此外,护士的教育水平与繁重工作量导致的时间限制以及护士对其与医生关系的看法之间存在显著相关性。对护士文本的内容分析显示,出现了五类作为护士对推进医护协作最佳实践的建议:改变医生对护士的态度、提高沟通技巧、明确角色、解决跨专业冲突以及支持与激励。

结论

一方面,拥有学士学位的护士对跨专业协作的满意度较低。另一方面,护士提出了五类作为与医生协作推进的最佳实践方法,这些包括医生对护士的态度、沟通工具和技巧、护士角色的明确、跨专业冲突的解决以及支持与激励。本研究结果的实施将通过防止疏忽、用药错误和重复干预来改善患者治疗效果。此外,还能营造轻松的工作环境,提高医疗团队的士气、工作满意度并减少人员流动。

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