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Keywords = interprofessional/interdisciplinary team

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15 pages, 694 KB  
Article
Teamwork as an Interprofessional Competency for Collaborative Hospital Practice
by Laura Andrian Leal, Ivaneia Alves Pereira Sobrinho, Luan Gagossian Savóia, José Carlos Carvalho, Fabiana Faleiros and Silvia Helena Henriques
Nurs. Rep. 2026, 16(3), 82; https://doi.org/10.3390/nursrep16030082 - 26 Feb 2026
Viewed by 614
Abstract
Background/Objectives: This study aimed to analyze the perceptions and experiences of health professionals regarding teamwork as an interprofessional competency within the context of Intensive Care Units (ICUs) in a Brazilian public teaching hospital. Methods: This was a qualitative, exploratory study guided [...] Read more.
Background/Objectives: This study aimed to analyze the perceptions and experiences of health professionals regarding teamwork as an interprofessional competency within the context of Intensive Care Units (ICUs) in a Brazilian public teaching hospital. Methods: This was a qualitative, exploratory study guided by a constructivist–interpretative perspective. The scenario consisted of Intensive Care Units of a public teaching hospital, which is a reference for emergency care, located in Brazil. Sampling was intentional and involved 29 professionals, most of whom, 25 (86.20%), were females, including nurses, nursing technicians, physicians, physiotherapists, and others. In order to collect data, individual semi-structured face-to-face interviews were conducted in 2025, which were audio-recorded and fully transcribed. The criterion for determining the number of participants was theoretical saturation. Data analysis followed the steps of Braun and Clarke’s thematic analysis, conducted inductively, with peer validation and the use of illustrative quotations to ensure credibility. Results: Five main categories emerged: “Understanding teamwork as an interprofessional competency,” “Factors that facilitate interprofessional teamwork,” “Factors that hinder teamwork,” “Tools used in the ICU to develop interprofessional teamwork” and “Individual actions to develop interprofessional teamwork.” The analysis revealed a central tension: although professionals discursively value interprofessional teamwork, its practical implementation is constrained by organizational and hierarchical barriers. Communication was identified as a transversal axis, functioning at times as a facilitator and at other times as a barrier. Conclusions: This study demonstrates that interprofessionality in Brazilian ICUs cannot be sustained solely through individual initiatives, but requires structured institutional strategies, such as formal collaboration protocols, interprofessional education programs, and a revision of hospital organizational culture. Furthermore, although health professionals value interprofessional teamwork, their practice still faces significant barriers. These findings may support managers’ reflection on the need to implement in-service teaching and learning strategies that facilitate interprofessional teamwork, especially those in high-technology units, thus enhancing collaborative practice in health. Full article
(This article belongs to the Special Issue Nursing Management in Clinical Settings)
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14 pages, 243 KB  
Article
Building Safe Emergency Medical Teams with Emergency Crisis Resource Management (E-CRM): An Interprofessional Simulation-Based Study
by Juan Manuel Cánovas-Pallarés, Giulio Fenzi, Pablo Fernández-Molina, Lucía López-Ferrándiz, Salvador Espinosa-Ramírez and Vanessa Arizo-Luque
Healthcare 2025, 13(15), 1858; https://doi.org/10.3390/healthcare13151858 - 30 Jul 2025
Cited by 1 | Viewed by 3643
Abstract
Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and [...] Read more.
Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article
19 pages, 698 KB  
Article
Perceptions and Practices of Interdisciplinary Action in an Intra-Hospital Support Team for Palliative Care: A Qualitative Study
by Célio Cruz, Ana Querido and Vanda Varela Pedrosa
Healthcare 2025, 13(10), 1179; https://doi.org/10.3390/healthcare13101179 - 19 May 2025
Cited by 5 | Viewed by 4243
Abstract
Background: The quality of palliative care (PC) services is closely linked to the effectiveness of interdisciplinary collaboration. A coordinated approach among professionals from different fields fosters holistic, person-centered care, ensuring comprehensive support for patients with complex conditions and their families. In hospital settings, [...] Read more.
Background: The quality of palliative care (PC) services is closely linked to the effectiveness of interdisciplinary collaboration. A coordinated approach among professionals from different fields fosters holistic, person-centered care, ensuring comprehensive support for patients with complex conditions and their families. In hospital settings, In-Hospital Palliative Care Support Teams (EIHSCPs) play a key role in delivering specialized care, enhancing interdepartmental communication, training other healthcare professionals, and optimizing resources. Strong leadership by PC specialists, combined with effective team management, contributes to symptom relief, improved quality of life, and cost reduction. However, interdisciplinary collaboration presents challenges, including competing priorities, resource constraints, and communication barriers. Despite its recognized benefits, research on its implementation in PC, particularly in Portugal, remains scarce. Objective: This study explores the perspectives and practices of professionals within an EIHSCP, examining team dynamics, interprofessional collaboration, and key facilitators and barriers. Methods: Twelve semi-structured interviews were conducted with physicians, nurses, psychologists, and social workers from the EIHSCP in the Médio Tejo region. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results: The interview findings were organized into three themes: (1) Social Representations and Interdisciplinary Practice; (2) Competencies for Interdisciplinary Practice; and (3) Challenges in Interdisciplinary Practice. Participants consistently highlighted that interdisciplinary collaboration enhances communication between services and improves care quality. While teamwork is central, patient- and family-centered care remains the priority. Key competencies include empathy, ethics, active listening, and cultural sensitivity, alongside structural and procedural elements such as team meetings, integrated communication, and clear referral criteria. Continuous education and professional development are essential. Challenges primarily stem from limited human and material resources, staff workload and stress, communication gaps between hospital and community teams, and insufficient institutional recognition. Suggested improvements focus on investing in ongoing training, strengthening communication and inter-institutional collaboration, and revising the organizational model of PC within Portugal’s National Health Service. Conclusions: Interdisciplinary collaboration in PC is fundamental for holistic, patient-centered care but is hindered by structural and organizational barriers. Full article
(This article belongs to the Special Issue Quality Healthcare at the End of Life)
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14 pages, 894 KB  
Article
A Grounded Theory of Interdisciplinary Communication and Collaboration in the Outpatient Setting of the Hospital for Patients with Multiple Long-Term Conditions
by Emma A. Gans, Ursula W. de Ruijter, Agnes van der Heide, Suzanne A. van der Meijden, Frederiek van den Bos, Barbara C. van Munster and Janke F. de Groot
J. Pers. Med. 2024, 14(5), 533; https://doi.org/10.3390/jpm14050533 - 16 May 2024
Cited by 4 | Viewed by 5169
Abstract
Interdisciplinary communication and collaboration are crucial in the care of people with multiple long-term conditions (MLTCs) yet are often experienced as insufficient. Through the lens of complexity science, this study aims to explain how healthcare professionals (HCPs) adapt to emerging situations in the [...] Read more.
Interdisciplinary communication and collaboration are crucial in the care of people with multiple long-term conditions (MLTCs) yet are often experienced as insufficient. Through the lens of complexity science, this study aims to explain how healthcare professionals (HCPs) adapt to emerging situations in the care of patients with MLTC by examining interdisciplinary communication and collaboration in the outpatient hospital setting. We used the constant comparative method to analyze transcribed data from seven focus groups with twenty-one HCPs to generate a constructivist grounded theory of ‘interdisciplinary communication and collaboration in the outpatient setting of the hospital for patients with multiple long-term conditions’. Our theory elucidates the various pathways of communication and collaboration. Why, when, and how team members choose to collaborate influences if and to what degree tailored care is achieved. There is great variability and unpredictability to this process due to internalized rules, such as beliefs on the appropriateness to deviate from guidelines, and the presence of an interprofessional identity. We identified organizational structures that influence the dynamics of the care team such as the availability of time and financial compensation for collaboration. As we strive for tailored care for patients with MLTC, our theory provides promising avenues for future endeavors. Full article
(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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12 pages, 1323 KB  
Perspective
The Swiss Sleep House Bern—A New Approach to Sleep Medicine
by Simone B. Duss, Albrecht P. A. Vorster, Antoine Urech, Wolfgang J. Schmitt, Jonas Beck, Daniella Hilt, Oriella Gnarra, Julia van der Meer, Marina Tüzün, Thomas Berger, Carolin Schäfer, Anne-Kathrin Brill, Markus H. Schmidt, Kaspar A. Schindler and Claudio L. A. Bassetti
Clin. Transl. Neurosci. 2024, 8(1), 14; https://doi.org/10.3390/ctn8010014 - 19 Mar 2024
Cited by 2 | Viewed by 5597
Abstract
Sleep is essential for health, well-being, creativity, and productivity. Sleep loss and sleep–wake circadian disorders (SWCDs) affect at least one in three individuals but are underdiagnosed and undertreated for different reasons: First, the importance of sleep health and, second, the burden of sleep [...] Read more.
Sleep is essential for health, well-being, creativity, and productivity. Sleep loss and sleep–wake circadian disorders (SWCDs) affect at least one in three individuals but are underdiagnosed and undertreated for different reasons: First, the importance of sleep health and, second, the burden of sleep loss and SWCDs are underestimated. Third, education in sleep medicine is insufficient and health care-related sleep research is underdeveloped. Fourth, the validation and implementation of tele-sleep medicine approaches and novel devices to monitor SWCDs are still insufficient. Fifth, the reimbursement of sleep medicine in most countries is inadequate and the availability of specialized care is limited to a few centers. The Swiss Sleep House Bern (SSHB) was founded in 2022 to address these challenges and eventually promote better care for patients with SWCDs and improve sleep health for the broader population. The interdisciplinary and interprofessional team of the SSHB, which is integrated in the Bernese Interdisciplinary Sleep-Wake-Epilepsy Center, links sleep specialists with primary care providers to offer a rapid and accessible triage and first-level management of sleep complaints and SWCDs. The SSHB also promotes awareness and offers educational programs on sleep health and SWCDs, performs health care research, and fosters the implementation of new technologies, data science, and telemedicine into clinical routine. Full article
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10 pages, 591 KB  
Article
Helping Frontline Workers in Texas—A Framework for Resource Development
by Karima Lalani, Meredith O’Neal, Simone Lee Joannou, Bhanumathi Gopal and Tiffany Champagne-Langabeer
Int. J. Environ. Res. Public Health 2023, 20(20), 6935; https://doi.org/10.3390/ijerph20206935 - 17 Oct 2023
Cited by 4 | Viewed by 2838
Abstract
First responders disproportionately experience occupational stress when compared to the general population, and COVID-19 has exacerbated this stress. The nature of their duties as law enforcement officers, firefighters, and medics exposes them to repeated trauma, increasing their risk of developing a broad array [...] Read more.
First responders disproportionately experience occupational stress when compared to the general population, and COVID-19 has exacerbated this stress. The nature of their duties as law enforcement officers, firefighters, and medics exposes them to repeated trauma, increasing their risk of developing a broad array of mental health issues, including post-traumatic stress disorder (PTSD), substance use disorder (SUD), and compassion fatigue. This paper describes the need for resources for frontline workers and provides a framework for creating and implementing resources. A team of interdisciplinary subject matter experts developed two major resources. The first resource was a 24/7 helpline to support first responders and healthcare workers experiencing substance use or mental health concerns. The second resource was the First Responders Educational Campaign, which developed and delivered focused training modules on useful topics covering substance use and mental health concerns as they pertain to this workforce. Utilizing core interprofessional principles, content was sourced from multiple disciplines and contrasting perspectives to provide a comprehensive understanding of mental health and substance use issues. The curriculum was designed so that the content was interdisciplinary, interprofessional, and accessible to audiences across disciplines and professions. After engaging more than 1500 individuals, resources developed here have augmented mental health and substance use support resources available to the target population. Full article
(This article belongs to the Special Issue Mental Health Care during COVID-19 Pandemic)
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12 pages, 1716 KB  
Article
The Impact of Interprofessional Education on Health Profession Students’ Professional Identity
by Gioia J. Ciani, Gary Grimaldi, Maribel Macalintal and David Orner
Educ. Sci. 2023, 13(5), 494; https://doi.org/10.3390/educsci13050494 - 13 May 2023
Cited by 15 | Viewed by 5257
Abstract
Establishing interprofessional identity is critical in preparing health care teams to work in collaborative environments and enhance efficacy of patient care. Accreditation standards for health profession programs have been implemented to include interprofessional education (IPE), yet there remains obfuscation regarding occupational therapy’s (OT) [...] Read more.
Establishing interprofessional identity is critical in preparing health care teams to work in collaborative environments and enhance efficacy of patient care. Accreditation standards for health profession programs have been implemented to include interprofessional education (IPE), yet there remains obfuscation regarding occupational therapy’s (OT) professional identity. The purpose of this prospective pre-post test study was to assess an experiential IPE event for health profession students (n = 170 from ten health profession programs) to: (1) determine the effectiveness of role playing and team-based case discussions on students’ knowledge and perceptions toward each other’s professions, and (2) specifically assess the impact of the IPE event on students’ perceptions toward OT roles and responsibilities. Health profession students were asked to complete a survey prior to and at the conclusion of the IPE event, which included the validated Interdisciplinary Education Perception Scale (IEPS) and non-standardized closed and open-ended questions. Quantitative analysis of responses showed a significant improvement in interdisciplinary perceptions after the experience as evidenced by higher IEPS scores. Post-test open-ended responses confirmed this finding. Health profession programs were stratified, revealing positive significant differences regarding OT. These findings suggest role-playing and team-based case discussions for IPE can have a positive impact on students’ interprofessional perceptions and understanding of OT. Full article
(This article belongs to the Special Issue Health Professions Education & Integrated Learning)
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13 pages, 281 KB  
Article
From Identity to Ambugity: Exploring Interprofessional Collaboration Opportunities for Pharmacists in Rural and Remote Australia
by Selina Taylor, Alannah Franich, Sophie Jones and Beverley D. Glass
Pharmacy 2023, 11(2), 77; https://doi.org/10.3390/pharmacy11020077 - 20 Apr 2023
Viewed by 2822
Abstract
Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and [...] Read more.
Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and remote communities. This study aims to explore exercise physiologist and podiatrist perceptions of interprofessional practice opportunities with pharmacists. Role theory provided a framework for this qualitative study. Interviews were conducted, recorded, transcribed, and thematically analysed according to the constructs of role theory (role identity, role sufficiency, role overload, role conflict, and role ambiguity). The perceptions of participants varied, largely due to the lack of understanding of the role and scope of the practice of a pharmacist. Participants acknowledged and adopted a flexible approach to the way in which they delivered health services to meet the needs of the community. They also described a more “generalist” approach to care, owing to the high prevalence of disease and disease complexity, along with a lack of staffing and resources. The potential for increased interprofessional collaboration was supported and identified as a strategy to manage significant workloads and provide improved patient healthcare. The application of role theory to this qualitative study provides insight into perceptions of interprofessional practice that may inform future development of remote practice models of care. Full article
9 pages, 668 KB  
Systematic Review
A Qualitative Systematic Literature Review of the Role of U.S. Pharmacists in Prescribing Pre-Exposure Prophylaxis (PrEP)
by Alina Cernasev, Tyler C. Melton, Hilary Jasmin and Rachel E. Barenie
Pharmacy 2023, 11(1), 9; https://doi.org/10.3390/pharmacy11010009 - 5 Jan 2023
Cited by 8 | Viewed by 3647
Abstract
Pre-Exposure Prophylaxis (PrEP) is an effective treatment to combat the human immunodeficiency virus (HIV) endemic, but the uptake of PrEP has been low in the United States (U.S.). While individuals may access PrEP via obtaining a prescription from their prescriber and having it [...] Read more.
Pre-Exposure Prophylaxis (PrEP) is an effective treatment to combat the human immunodeficiency virus (HIV) endemic, but the uptake of PrEP has been low in the United States (U.S.). While individuals may access PrEP via obtaining a prescription from their prescriber and having it dispensed by their pharmacist, less cumbersome access points may exist. This systematic literature review evaluates qualitative literature to explore the role of pharmacists, pharmacy services, and interprofessional collaborations for persons seeking PrEP in the United States. Four electronic databases (PubMed, Scopus, CINAHL, and Embase) were searched in February 2022 and yielded 3841 results. After excluding duplicates, two researchers reviewed 2461 studies. These results were screened for inclusion and exclusion criteria and yielded 71 studies for full review. Out of these 71 studies, five studies met the pre-selected inclusion criteria. Of the five studies, four were qualitative studies, and one was a mixed-methods study. The studies examined different aspects of initiating PrEP and diverse outcomes, such as screening for PrEP, barriers to access PrEP, feasibility to access PrEP, accessibility via community pharmacy to PrEP, and interdisciplinary collaboration between members of the healthcare team to expand patient access to PrEP. A gap in the qualitative literature focusing on U.S. pharmacists’ roles in initiation and provision of PrEP for diverse populations may exist. While PrEP promotion and uptake are largely affected by convenience and accessibility, future interventions and strategies should include training pertaining to PrEP screening, stigma reduction, privacy considerations, and PrEP dispensing. Full article
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14 pages, 368 KB  
Article
The Significance of Cooperation in Interdisciplinary Health Care Teams as Perceived by Polish Medical Students
by Aleksandra Bendowska and Ewa Baum
Int. J. Environ. Res. Public Health 2023, 20(2), 954; https://doi.org/10.3390/ijerph20020954 - 5 Jan 2023
Cited by 96 | Viewed by 24861
Abstract
Teamwork, as the preferred method of cooperation in healthcare, became prevalent in the 1960s, and since then has been universally recognized as a measure to improve the quality of healthcare. Research indicates that medical care based on interdisciplinary cooperation is associated with increased [...] Read more.
Teamwork, as the preferred method of cooperation in healthcare, became prevalent in the 1960s, and since then has been universally recognized as a measure to improve the quality of healthcare. Research indicates that medical care based on interdisciplinary cooperation is associated with increased patient safety, lower hospitalization rates, and reduced rates of complications and medical errors. Furthermore, it enhances the coordination of care and improves patient access to medical services. This model of providing medical care also results in considerable benefits for medical professionals. These include greater job satisfaction and a reduced risk of professional burnout syndrome. Aim: The aim of the study was to explore the opinions of medical students with regard to cooperation in the interdisciplinary team, as well as the factors affecting the formation of opinions. Material and methods: The study was conducted using the Polish version of the questionnaire Attitudes Towards Interprofessional Health Care Teams. The study involved 1266 participants, including students of medicine (n = 308), midwifery (n = 348), nursing (n = 316) and physiotherapy (n = 294). Results: According to the opinions of the students participating in the study, the therapeutic process based on the interdisciplinary model improves the quality of medical care provided, increases patient safety, and improves communication between members of the therapeutic team. The factors affecting the assessment of cooperation in interdisciplinary medical care teams included the faculty and the year of studies, gender, as well as participation in the multidisciplinary courses. Conclusions: Students recognize the need for interdisciplinary medical teams. The training of future medical professionals should incorporate the elements of interprofessional education. This form of education allows students to develop both a professional identity and identification with their own profession, as well as encourages teamwork skills and shapes the attitude of openness towards representatives of other medical professions. However, in order to provide the students with the relevant knowledge, skills and competencies, it is essential to respect their diversity in terms of the faculty, as well as to account for the impact of gender and the year of studies which may affect their readiness to engage in teamwork. Full article
11 pages, 603 KB  
Article
Preventive Care and Outcomes of Interprofessional Medicare Annual Wellness Visits for Older Adults
by Camlyn Masuda, Lovedhi Aggarwal, Michele Lani Bray, Christabel K. Cheung, Bum Jung Kim, Aida Wen, Lauren Okamoto, Matthew Uechi, Yeonjung Jane Lee and Kamal Masaki
Int. J. Environ. Res. Public Health 2022, 19(24), 16752; https://doi.org/10.3390/ijerph192416752 - 13 Dec 2022
Cited by 7 | Viewed by 4896
Abstract
As we anticipate a growing population of older adults, we will see an increase in chronic conditions such as dementia and falls. To meet these public health needs, we must systematically provide screening, education, preventive care, and supportive care for older patients and [...] Read more.
As we anticipate a growing population of older adults, we will see an increase in chronic conditions such as dementia and falls. To meet these public health needs, we must systematically provide screening, education, preventive care, and supportive care for older patients and their caregivers in a primary care setting. This will require a workforce trained in providing for the complex medical and psychosocial needs of an older adult population in an interprofessional and collaborative fashion. By integrating geriatric screening tools into an interdisciplinary Annual Wellness Visit teaching clinic, we were able to successfully improve rates of geriatric screening for dementia, depression, falls, medication reconciliation and advance care planning. We also saw improvements in patient care and satisfaction and provided the opportunity for interprofessional collaboration and education for students in medicine, nursing, pharmacy and social work. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 508 KB  
Article
The Moderating Role of Team Conflict on Teams of Nursing Students
by Hsing-Yuan Liu
Int. J. Environ. Res. Public Health 2022, 19(7), 4152; https://doi.org/10.3390/ijerph19074152 - 31 Mar 2022
Cited by 5 | Viewed by 2904
Abstract
Inter-professional education has become a widespread trend in healthcare education around the world. This study examined whether conflict moderated the correlation between swift trust and creativity for nursing students on teams in inter-professional education courses in Taiwan. A cross-sectional survey study with comparative, [...] Read more.
Inter-professional education has become a widespread trend in healthcare education around the world. This study examined whether conflict moderated the correlation between swift trust and creativity for nursing students on teams in inter-professional education courses in Taiwan. A cross-sectional survey study with comparative, quantitative analysis was conducted to describe relationships between the studied variables. This study collected self-report data from 270 nursing students who attended interdisciplinary team-based capstone courses, and this study divided them into 54 teams. Each team consisted of five members. The study results showed cognition-based team swift trust had a positive correlation with team creativity. The negative association was revealed between relationship conflict and team creativity. Moderation models demonstrated that relationship conflict (95% C.I. [−0.70, −0.21]) negatively moderated the correlation between cognition-based swift trust and team creativity among nursing student teams. This research found that greater levels of cognition-based swift trust may enhance nursing students’ team creativity in inter-professional education courses. However, relationship conflicts may limit the positive outcomes of that association. Nursing educators should incorporate conflict management particularly aiming at relationship conflicts into their interdisciplinary nursing courses to support creative outcomes. Full article
(This article belongs to the Section Nursing)
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15 pages, 2226 KB  
Article
Interprofessional Collaboration between ICU Physicians, Staff Nurses, and Hospital Pharmacists Optimizes Antimicrobial Treatment and Improves Quality of Care and Economic Outcome
by Stephan Schmid, Sophie Schlosser, Karsten Gülow, Vlad Pavel, Martina Müller and Alexander Kratzer
Antibiotics 2022, 11(3), 381; https://doi.org/10.3390/antibiotics11030381 - 13 Mar 2022
Cited by 32 | Viewed by 8535
Abstract
(1) Background: Antibiotic resistance is a worldwide health threat. The WHO published a global strategic plan in 2001 to contain antimicrobial resistance. In the following year, a workshop identified crucial barriers to the implementation of the strategy, e.g., underdeveloped health infrastructures and the [...] Read more.
(1) Background: Antibiotic resistance is a worldwide health threat. The WHO published a global strategic plan in 2001 to contain antimicrobial resistance. In the following year, a workshop identified crucial barriers to the implementation of the strategy, e.g., underdeveloped health infrastructures and the scarcity of valid data as well as a lack of implementation of antibiotic stewardship (ABS) programs in medical curricula. Here, we show that interprofessional learning and education can contribute to the optimization of antibiotic use and preserving antibiotic effectiveness. We have initiated interprofessional rounds on a medical intensive care unit (MICU) with a focus on gastroenterology, hepatology, infectious diseases, endocrinology, and liver transplantation. We integrated ICU physicians, hospital pharmacists, nursing staff, and medical students as well as students of pharmacy to broaden the rather technical concept of ABS with an interprofessional approach to conceptualize awareness and behavioral change in antibiotic prescription and use. Methods: Clinical performance data and consumption figures for antibiotics were analyzed over a 10-year period from 2012 to 2021. The control period covered the years 2012–2014. The intervention period comprised the years 2015–2021, following the implementation of an interprofessional approach to ABS at a MICU of a German university hospital. Data from the hospital pharmacy, hospital administration, and hospital information system were included in the analyses. A specific electronic platform was developed for the optimization of documentation, interprofessional learning, education, and sustainability. The years 2020 and 2021 were analyzed independently due to the SARS-CoV-2 pandemic and the care of numerous COVID-19 patients at the MICU. Results: Implementation of an interprofessional ABS program resulted in the optimization of antibiotic management at the MICU. The suggestions of the hospital pharmacist for optimization can be divided into the following categories (i) indication for and selection of therapy (43.6%), (ii) optimization of dosing (27.6%), (iii) drug interactions (9.4%), (iv) side effects (4.1%), and (v) other pharmacokinetic, pharmacodynamic, and pharmacoeconomic topics (15.3%). These suggestions were discussed among the interprofessional team at the MICU; 86.1% were consequently implemented and the prescription of antibiotics was changed. In addition, further analysis of the intensive care German Diagnosis Related Groups (G-DRGs) showed that the case mix points increased significantly by 31.6% during the period under review. Accordingly, the severity of illness of the patients treated at the ICU as measured by the Simplified Acute Physiology Score (SAPS) II increased by 21.4% and the proportion of mechanically ventilated patients exceeded 50%. Antibiotic spending per case mix point was calculated. While spending was EUR 60.22 per case mix point in 2015, this was reduced by 42.9% to EUR 34.37 per case mix point by 2019, following the implementation of the interprofessional ABS program on the MICU. Through close interprofessional collaboration between physicians, hospital pharmacists, and staff nurses, the consumption of broad-spectrum antibiotics, e.g., carbapenems, was significantly reduced, thus improving patient care. In parallel, the case mix and case mix index increased. Thus, the responsible use of resources and high-performance medicine are not contradictory. In our view, close interprofessional and interdisciplinary collaboration between physicians, pharmacists, and nursing staff will be of outstanding importance in the future to prepare health care professionals for global health care to ensure that the effectiveness of our antibiotics is preserved. Full article
(This article belongs to the Special Issue Antimicrobial Agents Used in Intensive Care Unit)
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10 pages, 223 KB  
Article
An Innovative Approach for Improving Information Exchange between Palliative Care Providers in Slovenian Primary Health—A Qualitative Analysis of Testing a New Tool
by Erika Zelko, Jozica Ramsak Pajk and Nevenka Krčevski Škvarč
Healthcare 2022, 10(2), 216; https://doi.org/10.3390/healthcare10020216 - 22 Jan 2022
Cited by 4 | Viewed by 3867
Abstract
Background: Interprofessional collaboration is an important part of palliative care. Effective communication and information exchange is essential for a high quality of care. The aim of this study was to test the effectiveness of a new tool for exchanging information between professionals in [...] Read more.
Background: Interprofessional collaboration is an important part of palliative care. Effective communication and information exchange is essential for a high quality of care. The aim of this study was to test the effectiveness of a new tool for exchanging information between professionals in palliative care on primary healthcare level. Methods: With suggestions from the experts regarding palliative care needs in an interprofessional team from the Delphi study and community nurses from the field, we developed a paper version of the tool. The paper version was tested in a pilot phase, and subsequently, we conducted ten semi-structured interviews with the users of the new tool to test its feasibility and usability. The data were analyzed using qualitative content analysis, leading to improvement and development of the digital version of the new tool. Results: After completing the pilot phase of the research, we identified the following four categories: a systematic tool for more consistent treatment and better communication during the patient’s visit; training and empowerment; quality, safety and digitalization; these categories were later included in the final version of the digital communication tool. Conclusion: Effective palliative care requires a good exchange of information and communication between all care professionals who work with the patient. Effective communication contributes to making patients and their relatives feel safe in their home environment and allows patients to stay in their homes even as their disease progresses. The systematical new tool was assessed as useful to improve interdisciplinary cooperation and prepared in a digital version. Further research after the long-term use of the developed digital tool in everyday work might confirm its sustaining importance. Full article
(This article belongs to the Collection Healthcare Strategy and Community Care)
18 pages, 2639 KB  
Article
Existential Dimension and Spiritual Assistance in the “A. Gemelli” University Hospital in Rome: A Cross-Disciplinary and Sacramental Enhanced Dynamical Approach in Palliative Care
by Alessandro Mantini, Maria Adelaide Ricciotti, Eleonora Meloni, Anita Maria Tummolo, Sabrina Dispenza and Christian Barillaro
Religions 2022, 13(1), 53; https://doi.org/10.3390/rel13010053 - 6 Jan 2022
Cited by 3 | Viewed by 2919
Abstract
In the A. Gemelli university hospital in Rome, the presence of highly specialized inter-professional palliative care teams and spiritual assistants who are dedicated to their role in the service of inpatients is valuable to person-centered healthcare. Spiritual needs are commonly experienced by patients [...] Read more.
In the A. Gemelli university hospital in Rome, the presence of highly specialized inter-professional palliative care teams and spiritual assistants who are dedicated to their role in the service of inpatients is valuable to person-centered healthcare. Spiritual needs are commonly experienced by patients with sudden illness, chronic conditions, and life-limiting conditions, and, consequently, spiritual care is an intrinsic and essential component of palliative care. This paper focuses on the sacrament of the Anointing of the Sick to demonstrate the importance of spiritual care as an integral part of palliative care and highlights the need for all interdisciplinary team members to address spiritual issues in order to improve the holistic assistance to the patient. Over a 3-year period (October 2018–September 2021), data about the sacrament of the Anointing of the Sick administered by the hospitaller chaplaincy were collected. A total of 1541 anointings were administered, with an average of 514 anointings per year, excluding reductions related to the COVID-19 pandemic. In 98% of cases, the sacrament was requested by health personnel, and in 96% of cases, the same health personnel participated in the sacrament. These results demonstrate that, at the A. Gemelli polyclinic in Rome, the level of training that the care team has received in collaboration with the chaplains has generated a good generalized awareness of the importance of integrating the spiritual needs of patients and their families into their care, considering salvation as well as health, in a model of dynamic interprofessional integration. Full article
(This article belongs to the Special Issue Spirituality and Existential Issues in Health)
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