Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors.

BACKGROUND: Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. OBJECTIVES: In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. DESIGN: The present study utilized a cross-sectional survey design following quantitative methods. METHODS: This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59 years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. ETHICAL CONSIDERATION: Research ethics approval was obtained from the researcher's university. RESULTS: Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). DISCUSSION: Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. CONCLUSION: Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.

The relationships of ethical climate, physician-nurse collaboration and psychological empowerment with critical care nurses' ethical conflict in China: A structural equation model.

AIMS: To explore the relationships of ethical climate, physician-nurse collaboration and psychological empowerment with ethical conflict in critical care nurses. BACKGROUND: Ethical conflict is a major ethical issue in nursing practice. Little research has been done on the associated factors from both organizational and personal perspectives, especially in China. METHODS: From October 2021 to March 2022, we collected the data from 342 critical care nurses in three tertiary general hospitals in China via questionnaires about four variables (ethical climate, physician-nurse collaboration, psychological empowerment and ethical conflict). Data were analysed using Spearman's correlation and a structural equation model through statistical product and service solutions (SPSS) and analysis of moment structure (AMOS). RESULTS: Critical care nurses' ethical conflict showed a negative correlation with ethical climate (r = -0.351), physician-nurse collaboration (r = -0.347) and psychological empowerment (r = -0.259) (all p < 0.001). Physician-nurse collaboration partially mediated the relationship between ethical climate and ethical conflict. Additionally, physician-nurse collaboration and psychological empowerment served as sequential mediators in the association. CONCLUSIONS: These findings suggested that negative ethical climate can lead to poor physician-nurse collaboration and ultimately ethical conflict. The intermediary role of psychological empowerment and physician-nurse collaboration was also identified. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should use the study as a fundamental basis to evaluate factors that can affect nurses' ethical conflict and develop effective strategies to mitigate this issue, which may help improve nurses' wellbeing and quality of patient care.

Nurse-nurse collaboration and performance among nurses in intensive care units.

BACKGROUND: An essential element for offering high-quality care in the intensive care units (ICUs) is the intraprofessional collaboration among nurses, which facilitates the exchange of knowledge and information and hence improves performance. More research is needed to understand the relationship between the nurse-nurse collaboration and job performance in the ICUs due to the multidimensionality of both concepts, the complexity of the ICU environment, and the lack of studies. AIM: To examine the relationship between nurse-nurse collaboration and self-perceived nurse performance among Jordanian nurses in ICUs. DESIGN: Descriptive, correlational cross-sectional design was used. METHODS: Data were collected through an online survey including the demographic questionnaire, the nurse-nurse collaboration scale, and six-dimensions scale for nursing performance. RESULTS: In total, 155 critical care nurses participated (response rate = 46.97%). Self-perceived job performance was significantly associated with gender (t = -3.189, P = .002), age (r = -0.301, P < .01), workplace (F = 28.20, P = .001), the type of ICU (F = 17.70, P = .001), and the number of assigned patients (r = 0.407, P < .01). Among all nurse-nurse collaboration subscales, only the conflict management subscale was an independent significant predictor of self-perceived nursing performance (t = 3.06, B = 3.066, P = .003). CONCLUSIONS: Effective conflict management is associated with better nurse performance, which could ultimately improve patient care in ICUs. RELEVANCE TO CLINICAL PRACTICE: Conflict resolution is an important dimension of optimal nurse-nurse collaboration and has an important effect on nursing performance. Nurses and nurse managers in ICUs need to attend workshops and training programs in conflict management.

[The prevalence and influence factors of work-related musculoskeletal disorders of dental nurse].

Objective: To investigate the prevalence and Influence factors of work-related musculoskeletal disorders (WMSDs) among dental nurses in tertiary stomatology hospitals. Methods: From June to July 2020, 1321 dental nurses from 18 tertiary stomatology hospitals in 18 provinces of China were enrolled as research subjects through a phased sampling method. The cross-sectional study was performed with validated instruments including the basic information questionnaire, Effort-Reward Imbalance Questionnaire, Nurse-Physician Collaboration Scale, and Chinese Musculoskeletal Questionnaire, so as to get the information about the social demography information, nursing-physician cooperation, work stress and the incidence of WMSDs. The influenang factors of WMSDs was analyzed. Results: The past prevalence, annual prevalence, and weekly prevalence of WMSDs were 80.8% (1067/1321) , 68.7% and 43.7% (575/1321) . 58.4% (771/1321) of nurses had WMSDs in three or more body parts. Neck (51.4%) , waist (42.2%) and shoulder (41.6%) were the top three body regions in the past year. The absenteeism rate due to musculoskeletal disorders ranged from 3.5% to 9.0%, waist (8.9%) and neck (8.0%) were the top two body regions. Working more than 40 hours per week (OR=1.74, P<0.001) and effect/reward>1 (OR=1.50, P=0.002) were risk factors of WMSDs (OR=1.74, 95% CI: 1.32~2.30; OR=1.50, 95%CI: 1.17~1.92, P<0.05) , while regular physical exercise every week (≥30 min per times) was the protective factor (OR=0.74, 95%CI: 0.56~0.97, P=0.030) . Conclusion: The prevalence rate of WMSDs of dental nurses in China was high, and most of the nurses suffered with many body parts. Thus, we should reduce controllable occupational stresso, ensuring adequate rest and strengthening physical exercise to reduce the incidence of WMSDs.

The Relationship Between Emotional Intelligence and Nurse-Nurse Collaboration.

PURPOSE: The purpose of this study was to examine the relationship between emotional intelligence and nurse-nurse collaboration among registered nurses in Jordan. DESIGN: This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan. METHODS: We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse-nurse communication. FINDINGS: A total of 311 questionnaires were returned (91% response rate). Nurses' emotional intelligence was positively and significantly correlated with the nurse-nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit. CONCLUSIONS: The present study demonstrated that nurse-nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse-nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system. CLINICAL RELEVANCE: Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.

The physician-nurse collaboration in truth disclosure: from nurses' perspective.

BACKGROUND: Collaboration between physicians and nurses is critical. However, a limited number of studies have provided insights into the status of physician-nurse collaboration in truth disclosure. METHODS: A cross-sectional survey was conducted using an electronic questionnaire among Chinese nurses who attended a provincial conference. The Nurse-Physician Collaboration Scale was administered to nurses to assess the collaboration in truth disclosure from their perspective. A multiple-choice question was asked to assess the perceived difficulties in truth disclosure. Descriptive statistics, univariate, and multiple stepwise regression analyses were performed to evaluate physician-nurse collaboration in truth disclosure. RESULTS: A total of 287 nurses completed the survey, and 279 of them reported that they had carried out truth disclosures among patients. The average score for physician-nurse collaboration in truth disclosure was 3.98 ± 0.72. The majority of nurses (73.1-81%) responded positively to different dimensions of collaboration in truth disclosure. The results of multiple stepwise regression analysis showed that seniority (B = - 0.111, 95% confidence interval [CI] = - 0.167-- 0.055, p < 0.001) and frequency of truth disclosure (B = 0.162, 95%CI = 0.076-0.249, p < 0.001) were the only two factors associated with collaboration in truth disclosure between physicians and nurses. The most common barrier perceived by nurses was fear of patients' negative emotions or their suicide attempts after truth telling. CONCLUSIONS: Most nurses responded positively to physician-nurse collaboration in truth disclosure. Various difficulties existed in the practice of truth-telling collaboration. Further studies are required to test the potential interventions to promote cooperation between nurses and physicians in truth disclosure.

The decline in attitudes toward physician-nurse collaboration from medical school to residency.

While interprofessional collaboration is a critical aspect of optimal patient care, practicing physicians often have sub-optimal attitudes regarding the importance of collaboration with their nursing colleagues. The impact of clinical training on medical students' and residents' attitudes toward physician-nurse collaboration has not been investigated. The primary goal of our study was to examine if learners at different stages in their medical training had more or less favorable attitudes regarding interprofessional collaboration (IPC). A secondary goal was to compare residents in procedural versus non-procedural specialties to determine if attitudes toward IPC varied by specialty type. Third-year medical students and residents at a large public university completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Student (n = 129) and resident (n = 292) scores were compared using Student's t-tests. Resident responses were further analyzed by specialty type. Students' perceptions of the physician-nurse relationship were significantly more favorable than the views of residents, particularly in the "Authority" and "Responsibility" domains. Residents in procedural specialties had less favorable attitudes toward physician-nurse collaboration than those in non-procedural specialties. Our findings highlight the importance of developing effective interventions for improving interprofessional collaboration during medical training.

Everyday ethical challenges of nurse-physician collaboration.

BACKGROUND: Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings. RESEARCH QUESTION/AIM: The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels of hospitals in Botswana (referral, district, and primary). ETHICAL CONSIDERATIONS: Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants' written informed consent was obtained. FINDINGS: Respondents' ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse-doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants' views about how their work experiences could be improved. DISCUSSION: Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom-and not a sufficient number of nursing staff. CONCLUSION: Collaboration between physicians and nurses is critical to optimizing patients' health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors.

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

Attitudes towards physician-nurse collaboration in a primary care team-based setting: Survey-based research conducted in the chronic care units of the Tuscany region of Italy.

Across the world, multidisciplinary teamwork has become an essential component in the care of patients with chronic conditions--the Chronic Care Units (CCUs) in the Italian region of Tuscany are no exception to this new era of collaboration. We sought to explore the attitudes towards collaboration of general practitioners (GPs) and nurses within the CCUs using the Jefferson Scale of Attitudes towards Physician-Nurse Collaboration (JSAPNC). The survey was sent electronically to 218 GPs and 46 nurses of 23 CCUs in two Local Health Authorities of Tuscany. A higher JSAPNC score is indicative of a more positive attitude towards physician-nurse collaboration. JSAPNC scores were calculated for both totals and by three factors: "shared education and collaboration," "caring versus curing," and "physician authority." A total of 133 healthcare professionals (94 GPs and 39 nurses) responded (response rate = 51.5%). Nurses reported significantly more positive attitudes towards collaboration than GPs (52.5 vs. 44.0, p < 0.01). This trend was also found in each of the three factors. This information adds to the scarce literature on nurse-physician collaboration in the primary care setting and highlights the need for considerable improvement given the rise of team-based outpatient care models.

Collaboration between hospital physicians and nurses: an integrated literature review.

BACKGROUND: Ineffective physician-nurse collaboration has been shown to cause work dissatisfaction among physicians and nurses and compromised the quality of patient care. AIM: The review sought to explore: (1) attitudes of physicians and nurses toward physician-nurse collaboration; (2) factors affecting physician-nurse collaboration; and (3) strategies to improve physician-nurse collaboration. METHODS: A literature search was conducted in the following databases: CINAHL, PubMed, Wiley Online Library and Scopus from year 2002 to 2012, to include papers that reported studies on physician-nurse collaboration in the hospital setting. FINDINGS: Seventeen papers were included in this review. Three of the reviewed articles were qualitative studies and the other 14 were quantitative studies. Three key themes emerged from this review: (1) attitudes towards physician-nurse collaboration, where physicians viewed physician-nurse collaboration as less important than nurses but rated the quality of collaboration higher than nurses; (2) factors affecting physician-nurse collaboration, including communication, respect and trust, unequal power, understanding professional roles, and task prioritizing; and (3) improvement strategies for physician-nurse collaboration, involving inter-professional education and interdisciplinary ward rounds. CONCLUSION: This review has highlighted important aspects of physician-nurse collaboration that could be addressed by future research studies. These include: developing a comprehensive instrument to assess collaboration in greater depth; conducting rigorous intervention studies to evaluate the effectiveness of improvement strategies for physician-nurse collaboration; and examining the role of senior physicians and nurses in facilitating collaboration among junior physicians and nurses. Other implications include inter-professional education to empower nurses in making clinical decisions and putting in place policies to resolve workplace issues.

Mediating effects of workgroup processes on the relationship between nurse turnover and nurse outcomes in hospitals.

Background: Nurse turnover is often considered to be an outcome, and few studies have investigated its consequences in nursing care. The underlying mechanism of the nurse turnover-nurse outcome relationship has not been empirically investigated. Therefore, this study examines workgroup processes and nurse outcomes as the consequences of nurse turnover and the mediating effect of workgroup processes on the nurse turnover-nurse outcomes relationship. Methods: A cross-sectional design was adopted to investigate the data collected from 264 staff nurses. Furthermore, six-month turnover rates, workgroup processes (nurse-nurse collaboration, team cohesion), and nurse outcomes (job satisfaction, intent to leave) were utilized in the multivariate regression models. Results: Overall, 53 (24.4%) nurses had worked in nursing units with a zero six-month turnover rate. The average mean six-month turnover rate was 15.5%. Nurse turnover adversely affected nurses' job satisfaction and several subscales of team cohesion including task cohesion and social cohesion. Team cohesion partially mediated the relationship between nurse turnover and job satisfaction. Conclusion: Nurse turnover decreased job satisfaction and team cohesion, and team cohesion partially mediated the nurse turnover-nurse outcomes relationship. These findings provide evidence supporting the significant adverse effects of nurse turnover and suggest the potential role of workgroup processes in explaining the underlying mechanism of the relationship between nurse turnover and nurse outcomes. Implications for nursing and health policy: Healthcare organizations must create a positive work environment to reduce nurse turnover. Further, states and countries should try to develop and establish nursing and health policies to prevent turnover.

Defining Physician-Nurse Efforts toward Collaboration as Perceived by Medical Students.

Collaboration between physicians and nurses is essential to healthcare delivery and is associated with high-quality patient care, greater patient satisfaction, and better health outcomes. Hence, it is imperative that doctors and nurses have a particular set of interprofessional collaboration skills. This descriptive cross-sectional study assessed how medical students in the pre-clinical and clinical years perceived attitudes toward collaboration between physicians and nurses in a hospital setting. The Jefferson Scale of Attitude toward Physician-nurse Collaboration (JSAPNC) was reverse-translated into Arabic for the current study. The results showed a total JSAPNC mean score of 46.55, lower than other medical students in other universities. In general, the results of the study showed no significant difference in the total JSAPNC score among medical students when analyzed according to age, clinical exposure, and year level, except in the two factors of JSAPNC: shared education and teamwork (p = 0.038) and caring as opposed to curing (p = 0.043). The findings of this study suggest the necessity of integrating interprofessional education (IPE) across the medical school curriculum because, as future physicians, medical students would be well equipped to treat their patients in partnership with their nursing colleagues.

Agreement of Nurses' and Physicians' Attitudes on Collaboration During the Covid-19 Pandemic Using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration.

Background: Collaboration between physicians and nurses has been shown to lead to better patient outcomes. However, studies have shown differing physicians' and nurses' responses to survey questions about physician-nurse collaboration. We surveyed physicians and nurses during the Covid-19 pandemic for their attitudes toward collaboration. Methods: In August 2021, during the Covid-19 pandemic, we surveyed physicians and nurses throughout an urban, academic teaching hospital over a consecutive twenty-day period using the validated Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Anonymous surveys were obtained from nurses and physicians on duty at the hospital. Demographic data from each survey included gender, age, profession of nurse or physician, degree, and specialization. Results: Four hundred and fifteen (415) unique paper surveys were collected from 308 nurses and 107 physicians over the twenty-day period. Five nurses and two physicians declined to complete the survey (1.6%). Using the Independent t-test of Means, total score and sub-scores were analyzed. Physicians and nurses scored the paper surveys in a similar manner. No statistically significant differences between the scores of physicians and nurses were found for any of the fifteen Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration questions, except for the youngest age group (20-29-year-old) having a significantly more positive response to doctors being the dominant authority on all health matters (p-value=0.011). Gender and nursing degree did not make a significant difference. Surgical Specialties (167), Medical Specialties (196), Intensive Care Unit (21), and the Emergency Department (43) survey responses did not differ significantly from each other. Conclusion: One and a half years into the Covid-19 pandemic, physicians and nurses at an urban, academic teaching hospital were in agreement with their responses on the validated Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Our data may reflect a catalytic and positive effect of the Covid-19 pandemic on physician and nurse attitudes toward collaboration.

Interdisciplinary knowledge gaps on intravenous fluid management in adult patients: Survey among physicians and nurses of a university hospital.

RATIONALE: Intravenous (IV) fluids are frequently involved in iatrogenic complications in hospitalized patients. Knowledge of IV fluids seems inadequate and is not covered sufficiently in standard medical education. METHODS: Two surveys were developed, based on the 2016 British National Institute for Health and Care Excellence guideline 'IV fluid therapy in adults in hospital', to provide insight on the learning needs and expectations of physicians and nurses. Each survey focused on profession-specific practice and consisted of three parts: demographics, knowledge questions and evaluation of current habits. Physicians and nurses practicing in a Belgian university hospital were invited to complete the survey electronically, respectively, in January and May 2018. RESULTS: A total of 103 physicians (19%) and 259 nurses (24%) participated. Although every indication for fluid therapy may require a specific fluid and electrolyte mixture, and hence, knowledge of their exact composition, most physicians and nurses did not know the composition of commonly prescribed solutions for IV infusion. Senior physicians did not score better than juniors did on questions concerning the daily needs of a nil-by-mouth patient. The availability of an IV fluid on the ward guides physicians to prescribe IV fluids (17%). Nurses (56%) feel they share responsibility in fluid management as they frequently intervene in urgent situations. More than half of participants (70% of physicians, 79% of nurses) indicated a need for additional information. CONCLUSIONS: A clear need for more structured information on IV fluids was identified. Both physicians and nurses struggle with fluid therapy. Continuing education on IV fluid management, emphasizing multidisciplinary collaboration, and monitoring evidence-based practice is essential to support the clinical decision process in daily practice.

The Application Effect of Doctor-Nurse Collaborative and Hierarchical Management Combined with Nursing Risk Management in Nursing Management of Patients with Postpartum Hemorrhage.

Background: To study the application effect of doctor-nurse collaborative and hierarchical management combined with nursing risk management in nursing management of patients with postpartum hemorrhage. Methods: Overall 200 patients with postpartum hemorrhage treated in Guangdong Second Provincial General Hospital (Guangzhou, China) from Mar 2018 to Mar 2019 were divided into the experimental group and the control group. The experimental group received the nursing model of doctor-nurse collaborative and hierarchical management combined with nursing risk management while the control group received nursing risk management to compare the satisfaction, medical record quality before and after nursing, incidence of nursing risk events and treatment effect between the two groups. Results: After nursing management, the bleeding volume in the experimental group was significantly less than that in the control group (P<0.05). The quality score of nursing records in the experimental group was higher than that in the control group (P<0.01). The occurrence of nursing risk events in the experimental group was significantly less than that in the control group (P<0.05). The overall nursing satisfaction of the experimental group was higher than that of the control group (P<0.01). The treatment effect of the experimental group was significantly better than that of the control group (P<0.01). Conclusion: Doctor-nurse collaborative and hierarchical management combined with nursing risk management had a significant effect in the nursing management of patients with postpartum hemorrhage, which is worthy of promotion and application.

The influence of physician-nurse collaboration on patient safety culture.

Background: Many factors in health care organizations affect patients' safety, such as; multi-professional teamwork and collaboration. Physician-Nurse collaboration is the most crucial inter-professional collaboration in the health care system. Because these professionals are the closest to the patient and make most decisions related to patients' conditions, Physician-Nurse collaboration affects patients' health condition consequences, length of stay in health care facilities, patients' mortality, and the existence of medical errors. Aim of the study: This study explores the relationship between physician-nurse collaboration and patient safety culture and compares patient safety culture levels between Jordanian hospitals from different sectors. In addition, examine differences in patient safety culture levels according to the position of health care providers (i.e., nurse managers, RN, and physicians). Methods: A descriptive, cross-sectional design using a self-administered questionnaire was used for the current study. Data were collected between February and May of 2019. Four different hospital settings in Jordan (University, not-for-profit, private and governmental hospitals) were selected. In addition, we recruited a convenience sample representing registered nurses, nurse managers, and physicians at the selected hospitals. Measurements: Three self-administered questionnaires were used to collect data for the current study: Demographic Data, Collaboration and Satisfaction About Care Decisions (CSACD), and Hospital Survey on Patient Safety Culture version 1.0 (HSOPS). Data analysis: Data were screened for errors in data entry, outliers, or missing values. Data were normally distributed without extreme outliers. This study used descriptive statistics, the Pearson product-moment correlation, one-way ANOVA, and the Chi-square tests were used in this study. The level of significance (alpha value) is set at 0.05. Results: showed that physician-nurse collaboration had a significant positive relationship with all patient safety culture levels (P < 0.01). In addition, the Pearson's product-moment correlation coefficient results indicated that all patient safety culture scores and subscales were positively and significantly correlated with physician-nurse collaboration (P < 0.01). Furthermore, the results of one-way ANOVA showed a statistically significant difference in the overall perception of patient safety culture according to the position of participants (P < 0.01). Moreover, Participants in Not-for-Profit Hospitals were more likely to report an 'excellent/very good' patient safety grade (P < 0.001) than in other hospitals. Conclusion: Physician-nurse collaboration positively impacts overall patient safety culture grades. Health care organization in Jordan has the potential to increase levels of patient safety cultures; however, to achieve this aim, there should be a stronger focus on building effective inter-professional collaboration and building a blame-free culture among healthcare providers, and these organizations should receive the needed support from health care leaders in the country. To help strengthen the health care system, raise patient safety culture levels, and improve quality.

[Survey of Nurse and Community Pharmacist Collaboration and Expectations of Nurses in Community Care Systems].

The purpose of this study was to clarify the current status of collaboration between nurses and community pharmacists as well as the requests and expectations that community pharmacists have of nurses in community-based comprehensive care systems. Questionnaires requiring open-ended responses were sent to 867 pharmacies throughout Fukushima prefecture (excluding four suspended pharmacies). We asked one pharmacist at each facility to answer the questions. We then analyzed the collected questionnaires using descriptive statistics, including the current status of nurse cooperation and the basic information about the pharmacies. Additionally, the open-ended descriptions of nurses' requests and expectations were analyzed quantitatively and qualitatively. The questionnaire collection rate was 32% (278 cases), and the breakdown of pharmacies that responded was 68.0% for facilities with 1 or 2 full-time pharmacists and 27.0% for facilities with 3 to 5 pharmacists. About 30% of respondents reported contact with the nursing profession at least once a week, while about 50% reported no contact at all or several times a year. The types of nurses collaborating with the pharmacies were clinic nurses (54.6%) and visiting nurses (43.4%). Some pharmacists had expected nurses to work cooperatively and rely on pharmacists. These results indicate that only about half of the pharmacists had opportunities to cooperate with nurses. For trust to be established between nurses and pharmacists, it is necessary for nurses to ask the pharmacists about medication and consult with them about patient medication management.

Evaluating the clinical dyad leadership model: a narrative review.

PURPOSE: Dyadic leadership models, in which two professionals jointly lead and share unit responsibilities, exemplifies a recent trend in health care. Nonetheless, much remains unknown about their benefits and drawbacks. In order to understand their potential impact, we conducted a review of literature evaluating dyad leadership models in health systems. DESIGN/METHODOLOGY/APPROACH: Our narrative review began with a search of PubMed, CINAHL, Web of Science and Scopus using key terms related to dyads and leadership. The search yielded 307 articles. We screened titles/abstracts according to these criteria: (1) focus on dyadic leadership model, i.e. physician-nurse or clinician-administrator, (2) set in health care environment and (3) peer-reviewed with an evaluative component of dyadic model. This yielded 22 articles for full evaluation, of which six were relevant for this review. FINDINGS: These six articles contribute an assessment of (1) teamwork and communication perceptions and their changes through dyad implementation, (2) dyad model functionality within the health system, (3) lessons learned from dyad model implementation and (4) dyad model adoption and model fidelity. RESEARCH LIMITATIONS/IMPLICATIONS: Research in this area remains nascent, and most articles focused on implementation over evaluation. It is possible that some articles were excluded due to our methodology, which excluded nonEnglish articles. PRACTICAL IMPLICATIONS: Findings provide guidance for health care organizations seeking to implement dyadic leadership models. Rigorous studies are needed to establish the impact of dyadic leadership models on quality and patient outcomes. ORIGINALITY/VALUE: This review consolidates evidence surrounding the implementation and evaluation of a leadership model gaining prominence in health care.

Standardizing nightly huddles with surgical residents and nurses to improve interdisciplinary communication and teamwork.

BACKGROUND: Clear and effective communication supports interdisciplinary teamwork and prevents adverse patient events. At our academic teaching hospital, poor communication between surgical residents and nurses was identified as a recurring problem, particularly on the inpatient general surgery night float rotation. METHODS: A standardized nightly huddle with surgical residents and nurses was developed and implemented as a resident-led quality improvement initiative on two acute care units. The huddle was evaluated with pre/post surveys of nurses and residents, as well as analysis of paging volume and rapid response events. RESULTS: Nightly huddles significantly improved nurses' perception of interdisciplinary teamwork and communication (p < 0.00005). With nightly huddles, significantly more nurses were able to identify and name the on-duty night float resident at the end of a 4-week rotation (p < 0.00005). Nurses perceived a positive impact on patient care and work environment. There were no changes in the number of nighttime pages or rapid responses. CONCLUSION: With night float rotations becoming a standard part of residency training, standardized huddles can enhance nighttime collaboration between residents and nurses.