Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study.

AIM: To explore the collaboration experiences of junior physicians and nurses in the general ward setting. BACKGROUND: Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. METHODS: Nineteen junior physicians and nurses were interviewed in 2012 and 2013. Interviews were transcribed and analysed using thematic analysis. RESULTS: Junior physicians and nurses acknowledged the importance of working collaboratively to achieve better patient care, but they are struggling to cope due to heavy clinical workload, organisational constraints and differing power relationships. Nurses have to take on more responsibilities in the decision-making process of patients' care to foster effective interprofessional collaboration. CONCLUSION: The study calls for educational and organisational strategies to improve interprofessional collaboration between junior physicians and nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should ensure that ward nurses are given a designated time to participate in ward rounds with physicians and have access to a communication tool that assists them in contributing proactively in the decision-making process of patient care.

Nurses' self-confidence and attitudes in using the Glasgow Coma Scale: a primary study.

AIMS: The aim of this study was to examine nurses' self-confidence and attitudes towards the Glasgow Coma Scale (GCS). BACKGROUND: The GCS measures the depth and duration of impaired consciousness. However, there is an increasing evidence that problems are encountered in completing some aspects of the GCS. DESIGN: This descriptive correlational study recruited 114 Registered Nurses (RNs) in one acute care hospital in Singapore. METHODS: A set of questionnaires were given to the participants. The questionnaire had three parts, which collected data on demographics, attitudes and self-confidence. RESULTS: Data analysis showed the type of clinical discipline (B=0.19), seniority in nursing (Staff Grade) (B=0.28) and higher attitude scores towards the GCS (B=0.41) were significant factors determining a nurse's confidence in using the GCS. A longer length of time working in a Neuroscience setting (B=0.21) and higher self-confidence scores (B=0.41) were significant factors determining a nurse's attitude towards the GCS. CONCLUSION: To ensure patient safety, the GCS has to be performed accurately. This study has shown there are differences in attitudes and self-confidence in using the GCS between nurses of different demographics, and that there are a variety of factors influencing their attitudes and confidence. RELEVANCE TO CLINICAL PRACTICE: Mentoring and educational interventions are suggested in order to reduce safety risks resulting from lower proficiency in using the GCS.