Primary health care clinics as catalyst to community building and health among residents in low income housing units.

BACKGROUND: This paper focuses on the identified value of a community-based project (CBP), including residents' living within low income housing units and their reported experiences of receiving health and social services within two communities by nurse practitioners (NPs) and its impact on their communities. OBJECTIVE: To gain insight into the lived experience of residents in the housing units from a collaborative interprofessional care approach provided in a clinic situated within each housing unit, in integrating health and social services within the residents' own 'community' and its outcomes. DESIGN: A qualitative descriptive study to gain insight into the shared views of care informants. SETTINGS: Two low income housing units in xxxxxxxxxxxxxxxxxxxx. PARTICIPANTS: Twenty-two residents representing all genders who lived in the housing units. METHODS: A purposive sampling of willing residents participated in a focus group interview. Each group comprised from 4 to 6 persons. Two focus group interviews occurred in each of the two housing units. RESULTS: Their voices resulted in identification of two themes - clinic as a catalyst to creating a sense of community and clinic as assisting them in managing their overall health. Two subthemes were also identified within each theme. CONCLUSION: Findings provide insight into the value of CBP, that a strengths-based and interprofessional care approach can serve as a catalyst for an evolving community.

Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II): a multiphase study of validity and reliability amongst healthcare providers.

OBJECTIVE: To develop and validate an Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II). METHODS: A multiphase validation study was conducted. The first phase was the AITCS-II translation from English into Italian to develop the first version of I-AITCS II for practitioners. The second phase was the study of I-AITCS II face and content validity, and the third phase was a cross-sectional data collection to provide evidence of construct validity using the psychometrics testing and the reliability assessment through the internal consistency study. RESULTS: The agreement for the forward-translation among researchers was high. The face and content validity were satisfactory. The underlying constructs of I-AITCS II were partnership, cooperation and coordination. Internal consistency was good for both scale and domains level. There were significant differences related to partnership in the comparison between settings. CONCLUSIONS: I-AITCS II showed evidence of validity and reliability. It will be useful to gather data to address programs aimed to enhance interprofessional team collaboration within the Italian healthcare contexts, and it could be used for cross-national researches.

Collaborative Leadership, Part 1: The Nurse Leader's Role within Interprofessional Teams.

The purpose of this paper is to present a perspective advocating for a dual role of nurse leaders as both managers and advocates for nurses to demonstrate their disciplinary knowledge and practice. Further, the paper will demonstrate that nurse leaders have the capacity to influence integration of interprofessional collaborative practice with other health professionals within their leadership areas. Additionally, we present strategies to advocate for changing the meaning of nursing leadership in practice, and creating a shift from task orientation of nurses' care to one that is individualized and comprehensive. Finally, a plea will be made to return the coordinating role of the nurse to its rightful place within patient care.

Collaborative Leadership, Part 2: The Role of the Nurse Leader in Interprofessional Team-Based Practice - Shifting from Task- to Collaborative Patient-/Family-Focused Care.

This paper presents a discussion on the key role that nurses assume with their patients and also with other health providers. We will argue that a change is needed to provide "space" for nurses to re-engage with their patients and to return to their key coordinating role between their patients, their family members and other health providers in interprofessional patient and family-centred collaborative practice. Furthermore, we will discuss the important role of nurse leaders to present the nurses' unique role and importance to health system administrators and policy makers to improve health outcomes of patients and how their role can concomitantly reduce healthcare costs.

Assessment of Interprofessional Team Collaboration Scale (AITCS): development and testing of the instrument.

INTRODUCTION: Many health professionals believe they practice collaboratively. Providing insight into their actual level of collaboration requires a means to assess practice within health settings. This chapter reports on the development, testing, and refinement process for the Assessment of Interprofessional Team Collaboration Scale (AITCS). There is a paucity of literature and measurement tools addressing interprofessional collaborative team performance and the nature of effective teamwork processes and patient roles within collaborative teams. These gaps limit our knowledge about how health care teams form and function. Instruments are therefore needed to assess collaborative relationships. METHODS: The AITCS, with its 47 items within 4 subscales (partnership, cooperation, coordination, and shared decision making) and assessed on a 5-point Likert scale, was administered to a total of 125 practitioners from 7 health care teams practicing within a variety of settings, in 2 provinces in Canada. RESULTS: Principal components and factor analysis of data resulted in 37 items loading onto 3 factors, explaining 61.02% of the variance. The internal consistency estimates for reliability of each subscale ranged from 0.80 to 0.97, with an overall reliability of 0.98. Thus, the AITCS is a reliable and valid instrument. DISCUSSION: The psychometric analysis of this instrument supports its value in measuring collaboration within teams and when patients are included as team members. The AITCS can be applied to continuing professional education interventions to determine change over time. It has limitations to the Canadian context and within the settings where participants practiced. Further test and retest reliability and longitudinal study application is needed.

Persistent isolationist or collaborator? The nurse's role in interprofessional collaborative practice.

AIM: The present study explores current understanding about interprofessional collaborative client-centred practice and nursing's role in this form of care delivery. BACKGROUND: A profession-only focus on nursing practice has been challenged at professional, national governmental and World Health Organization levels stressing for more interprofessional patient-centred collaborative teamwork. EVALUATION: Moving to patient-centred collaborative practice is fraught with barriers. Enablers can result in building trust, power sharing and shared decision-making. Changing current workplace environments requires institutional commitments to support collaborative team development. KEY ISSUE(S): Nurses can become collaborative members of teams through: (1) re-socialize; (2) understanding and articulating nurses roles, knowledge and skills to others; (3) other health providers sharing the same to nurses; (4) identifying where shared roles, knowledge and skills exist; and (5) learning to work in collaborative teams. Nurses must address some fundamental issues about practice that negate collaboration and patient-centred care. CONCLUSIONS: All professionals, including nurses, must move away from a service-oriented delivery to a patient-centred collaborative approach to care. IMPLICATIONS FOR NURSING MANAGEMENT: The values within health organizations need to be underpinned by collaborative interprofessional patient-centred practice. To accomplish this goal, administrators and managers must support assessment of employees and visiting physicians as to their conformance with agency established expectations for such practice.

Integrated nursing access program: an approach to prepare aboriginal students for nursing careers.

The challenge to transfer the health care of Aboriginal peoples of Canada from non-Aboriginal to predominantly Aboriginal health professionals, requires preliminary innovative approaches in post-secondary education. Described in this paper, is the background, development and progress to date of the Integrated Nursing Access Program (INAP) for Aboriginal students, and its phenomenological approach to curriculum design. Traditional indigenous knowledge and methodologies are embedded in process learning and university-level program activities. Learning in this INAP Bachelor of Nursing program occurs over three years, during which time students complete high school requirements together with some first year nursing courses. The program is followed by three additional years of exclusive baccalaureate level nursing education. To date, students have successfully completed the first half of this program.

The interprofessional socialization and valuing scale: a tool for evaluating the shift toward collaborative care approaches in health care settings.

BACKGROUND: There is a need for tools by which to evaluate the beliefs, behaviors, and attitudes that underlie interprofessional socialization and collaborative practice in health care settings. METHOD: This paper introduces the Interprofessional Socialization and Valuing Scale (ISVS), a 24-item self-report measure based on concepts in the interprofessional literature concerning shifts in beliefs, behaviors, and attitudes that underlie interprofessional socialization. The ISVS was designed to measure the degree to which transformative learning takes place, as evidenced by changed assumptions and worldviews, enhanced knowledge and skills concerning interprofessional collaborative teamwork, and shifts in values and identities. The scales of the ISVS were determined using principal components analysis. RESULTS: The principal components analysis revealed three scales accounting for approximately 49% of the variance in responses: (a) Self-Perceived Ability to Work with Others, (b) Value in Working with Others, and (c) Comfort in Working with Others. These empirically derived scales showed good fit with the conceptual basis of the measure. CONCLUSION: The ISVS provides insight into the abilities, values, and beliefs underlying socio-cultural aspects of collaborative and authentic interprofessional care in the workplace, and can be used to evaluate the impact of interprofessional education efforts, in house team training, and workshops.

Career intentions of nursing students and new nurse graduates: a review of the literature.

This paper highlights findings from a literature search to examine the role of nursing education in preparing nurses to meet healthcare demands. The review focused on nursing students' perceptions of nursing and whether these views change during their nursing studies and impact workplace preferences. Nursing students often enter their program with preconceived ideas of where they want to work following graduation. Large urban hospitals were favored over community care because of the perceived opportunities for support. Of particular importance were the negative views relating to care of elderly patients. Unless attitudes are changed during their nursing studies, they may affect initial job selection. Implications for nursing education include provision of educational experiences that foster an optimistic career outlook in areas where there is a growing need for nursing services. More research is needed to determine how to enable appropriate learning experiences when there are limited resources and practice placements.