Nurs490 discussion week 5
Complete your Week 5 discussion prompt.
During this week’s textbook reading, we took a look at the dynamics of working in interprofessional teams. Reflect back on your experiences working with interprofessional teams. Is there a particular situation in which you should have spoken up for your patient, but did not? Explain. What kept you from speaking up?
Reference: This is our university book
PROFESSIONAL NURSING CONCEPTS
Competencies for Quality Leadership
Anita Finkelman, MSN, RN
This chapter focuses on working in teams—both nursing teams and interprofessional teams. Throughout this content, when the term team is used, it applies to both interprofessional teams and nursing staff teams. Nurses are members of interprofessional teams and also members of nursing teams (nursing teams include nursing staff such as registered nurses (RNs), licensed practical/vocational nurses, and unlicensed assistive personnel (UAP).
This is a critical competency for every nurse. The content includes an explanation of the healthcare professions core competency, teams and teamwork, and critical components of effective teams: communication, collaboration, and coordination. Incivility is a problem that many healthcare organizations and staff are experiencing, and this behavior leads to ineffective teamwork. In addition, delegation is a part of the daily work for every nurse and is part of planning care and teamwork or how a team functions. Teams must cope with change and learn to make effective change decisions. Conflict and conflict resolution are issues that all teams face. Power and empowerment are also discussed in this chapter as they relate to staff and teams.
Through its assessment of the U.S. healthcare system, the IOM (2001) described the healthcare system as a system “in need of fundamental change. Many patients, doctors, nurses and healthcare leaders are concerned that the care delivered is not, essentially, the care we should receive. The frustration levels of both patients and clinicians have probably never been higher. Yet the problems remain. Healthcare today harms too frequently and routinely fails to deliver its potential benefits” (p. 1). This description continues to be relevant today. Technology, new drugs, and many other care advances can improve health and health care, but something is wrong with the care delivery models. This set of problems is what drove the need to it identify the five healthcare professions core competencies. This chapter examines the core competency that most directly addresses the need for changes in the care delivery models: Work in interprofessional teams. Figure 10-1 highlights the key elements for this competency.
The Core Competency: Work in Interprofessional Teams
The first of the healthcare professions core competencies is “provide patient-centered care.” This chapter covers the second core competency, “work in interprofessional teams.” The competency is described as: “cooperate, collaborate, communicate, and integrate care in teams to ensure that care is continuous and reliable” (IOM, 2003, p. 4). As a reminder, these core competencies were developed for all healthcare professions, not just nursing; however, this chapter focuses on nurses who are members of interprofessional teams and also members of nursing teams.
One has to ask why there is such emphasis on this core competency. After all, it makes sense that teams are important—why would anyone question this? The critical issue is whether healthcare professionals are prepared to participate effectively in teams, particularly interprofessional teams, but the conclusion is they are not. Healthcare professional education takes place in isolation; each healthcare profession provides its own education, with limited reference to other healthcare professionals. The result is that nursing, medicine, pharmacy, and allied health students (for example, physical therapists, occupational therapists, and so on) have limited, if any, contact with one another in their educational programs. As a consequence, they have limited knowledge of roles of the other professions and the ways in which they must collaborate and coordinate care to provide patient-centered care. This is a serious problem because when healthcare professionals graduate and meet licensure requirements, they are expected to work together.
In 2009, the Interprofessional Education Collaborative (IPEC) was formed to address the need for competencies that were not profession-specific (IPEC, 2011). The collaborative emphasizes that all healthcare organizations need to develop effective interprofessional teamwork and maintain these efforts. In 2016, IPEC published an update of its work (IPEC, 2016). Since 2009, recognizing the importance of interprofessional teams more education accreditors for different healthcare professions are including the IPEC competencies in their accreditation requirements. The American Association of Colleges of Nursing (AACN) is a founding member of IPEC and supports its approaches in AACN accreditation. Endorsement of IPEC content, standards, model, and so on from many healthcare professional accreditation bodies ensures greater integration in healthcare profession education and inclusion in professional literature, including textbooks and other professional literature to share with students. The 2016 update of the 2011 report on interprofessional competencies also included significant changes in health care, such as greater inclusion of quality improvement and references to changes related to the Affordable Care Act of 2010 (ACA), with greater emphasis on population health at the local, state, national, and global levels. Since 2011, there are more interprofessional education activities—for example, in 2011, 76% of schools of medicine offered these activities, and in 2014, 92% included these learning activities (IPEC, 2016).
IPEC also now offers a website to provide resources for faculty. Changes were made in the description of the core competencies: (1) The interprofessional collaborative domain is a domain in and of itself to assist in integrating population health competencies, and (2) there is emphasis on the Triple Aim (improve patient experience—quality and satisfaction, improve health of populations, and reduce costs). Additional content on the IPEC and its competencies is found in this text’s content on nursing education, for example, as described in an earlier figure, Figure 3-2. The 2016 IPEC update of the interprofessional collaborative practice core competency domains continue to support the World Health Organization (WHO) perspective on the need for and the impact of interprofessional education leading to effective interprofessional teams.
In addition, nurses need to know how to work on nursing teams whose focus is nursing care. In most cases, this, too, leads to isolation and limited recognition of the need for greater reaching out to other healthcare disciplines. Nurses tend to focus on the nursing care plan to the detriment of the total plan of care for the patient—a nursing care plan, as opposed to a patient-centered care plan. Nursing education reinforces this perspective by emphasizing the nursing care plan. This is not to say that the same scenario does not exist in other healthcare professions because it does. Nursing students need a broader view of health care along with the nursing perspective (Barnsteiner, Disch, Hall, Mayer, & Moore, 2007). Nurses also work together on teams related to service and healthcare delivery in general, such as committees and task forces. These teams require the same competencies as teams focused on patient care.
All healthcare providers should be focused on delivering patient-centered care—care that “alleviates vulnerability in all of its forms. That care should and must be delivered at the right time, at the right level, in the right place, and so on. If care were on a compass it would be true north and all other functions would stand in line to provide added value and service to that focus” (Hagenow, 2003, p. 204). Because one individual healthcare profession cannot do it all alone, interprofessional teams are best suited to achieve this patient-centered care.
Stop and Consider #1
All nurses should be competent in serving on interprofessional teams.