Interprofessional Care and Teamwork in the ICU

Donovan, Anne L.; Aldrich, Janet; Gross, Allison; Barchas, Denise; Thornton, Kevin C.; Schell-Chaple, Hildy; Gropper, Michael A.; Lipshutz, Angela

doi:10.1097/ccm.0000000000003067

Cited by 219 publications

(145 citation statements)

References 150 publications

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“…Nesse sentido, melhorias têm sido observadas quando práticas colaborativas envolvem o farmacêutico clínico, não só na analgesia, mas na efetividade e segurança da farmacoterapia, quando esses profissionais estão inseridos na equipe multiprofissional (9)(10)(11) . A contribuição multiprofissional, como, por exemplo, com o profissional de enfermagem, é de grande relevância uma vez que a atividade desse profissional envolve o cuidado direto ao paciente, sendo esses os mais indicados para auxiliar na identificação da inefetividade da farmacoterapia, como presença de dor, reações adversas, erros de administração e outros (5) .…”

Section: Introductionunclassified

Avaliação do acompanhamento farmacoterapêutico de idosos hospitalizados em uso de analgésicos opioides

Santos

Souza

Malta

et al. 2020

R. Enferm. Cent. O. Min.

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Objetivos: Identificar resultados do acompanhamento farmacoterapêutico de idosos hospitalizados em uso de analgésicos opioides. Métodos: Realizou-se um estudo descritivo e retrospectivo, integrado a um Programa de Residência Multiprofissional em Saúde do Idoso. Os critérios para encaminhamento ao serviço foram estar em uso de opioides e/ou com queixa de dor. Após captação dos pacientes, realizou-se análise da farmacoterapia e, mediante necessidade, intervenções foram efetuadas. Resultados: No total, foram analisados dados referentes ao acompanhamento de 53 pacientes, com média de idade de 73 anos (desvio-padrão + 14,8). Identificaram-se 85 evoluções farmacêuticas, sendo 36 com registro de uso de opioides. Tramadol, codeína, morfina e metadona foram os opioides utilizados no grupo estudado. As principais reações adversas registradas foram constipação, náusea e vômito. Foram realizadas 26 intervenções direcionadas a esses medicamentos. Conclusão: Quando devidamente monitorados, os riscos provenientes do uso de opioides, sejam eles reais ou potenciais, são passíveis de detecção em tempo hábil, permitindo a execução de ações que previnam, amenizem ou eliminem desfechos negativos. A busca por qualificação e a cooperação entre profissionais pode auxiliar o desenvolvimento de habilidades que forneçam aos pacientes uma melhor experiência ao longo dos serviços de acompanhamento.

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Section: Introductionunclassified

Avaliação do acompanhamento farmacoterapêutico de idosos hospitalizados em uso de analgésicos opioides

Santos

Souza

Malta

et al. 2020

R. Enferm. Cent. O. Min.

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“…The ICU team consists first and foremost of nurses and physicians from the ICU, but the extended team includes health professionals from different disciplines such as physicians from other specialties, physiotherapists, social workers and chaplains (Bjurling-Sjöberg, Wadensten, Pöder, Jansson, & Nordgren, 2017;Donovan et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Information concerning ICU patients’ families in the handover—The clinicians’ «game of whispers»: A qualitative study

Nygaard

Haugdahl

Brinchmann

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To explore how information concerning ICU patients´ families is included in the ICU clinicians’ daily handover. Background Handover refers to the transfer of information and care responsibility between clinicians. An effective and precise handover are of great importance to ensure quality of care. Although improvements in handovers have received increasing attention in recent decades, little is known about how information about ICU patients’ family members is included in handovers. Design A qualitative study using Charmaz’ constructivist grounded theory approach. Methods Data were gathered through participant observation, focus groups, dyadic and individual interviews of physicians and nurses from four ICUs in different Norwegian hospitals. The data consist of 270 observation hours, seven focus groups, three dyadic interviews and two individual interviews. Field notes and transcribed interview data were analysed using constructivist grounded theory approach. COREQ checklist was applied as reporting guideline for this study. Findings “A game of whispers” emerged as the core category, representing missing information about the patient's family during the handover. Together with three subcategories: “documentation dilemmas,” “being updated” and “talking together,” the core category explains how transfer of family‐related information between clinicians is continually processed and resolved. Conclusions This study indicates challenges related to appropriate and high‐quality handover concerning ICU patients´ families. Oral handovers are essential in terms of clinicians’ need to elaborate on written information and update each other. However, oral transmission involves a high risk of information loss during the handover. Written documentation about the family seems to be inadequate and poorly structured. Relevance to clinical practice The study findings suggest a need for increased awareness in practice and research of the importance of transferring appropriate and reliable information about patients’ families between ICU clinicians. User‐friendly handover tools and patient records that include information on patients’ family members should be developed.

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“…Beyond positioning interprofessional collaboration to address pertinent patient safety and healthcare manpower issues, the importance of interprofessional collaboration is further compounded and essential for safe patient care delivery in the intensive care units (ICUs), where patient conditions remain largely complex and volatile (Donovan et al, ). Such patient care in these specialized settings require salient synchronization of efforts among key clinical stakeholder such as nurses, physicians, and respiratory therapists.…”

Section: Introductionmentioning

confidence: 99%

Interprofessional collaboration during medical emergencies among doctors, nurses, and respiratory therapists in the intensive care unit: A phenomenological study protocol

Lin

Chan

2019

Journal of Advanced Nursing

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Aim:The aim of this study was to explore the lived experiences of interprofessional collaboration among nurses, doctors, and respiratory therapists during medical emergencies in the intensive care unit. Design: Descriptive phenomenological study.Method: Participants will be recruited through purposive sampling with maximum variation across the ICUs in a tertiary hospital in Singapore. Guided by data saturation, data collection will include individual semi-structured interviews with ICU nurses, physicians, and respiratory therapist who have attended to medical emergencies such as cardiopulmonary arrest or difficult airway management in the ICUs. Interviews will be audio recorded, transcribed verbatim, and analysed via Colaizzi's descriptive phenomenology method.Discussion: Whilst interprofessional collaboration remains a major interest among nursing research, there is a paucity of evidence surrounding interprofessional collaboration in the specific context of medical emergencies in the ICUs. This is especially crucial as the failure of interprofessional collaboration during medical emergencies can be catastrophic to patient safety. Hence, this study will adopt a qualitative approach to contribute to the evidence base surrounding this lesser known phenomenon. The findings generated from this study will inform future team training initiatives, advance nursing leadership initiatives, and identify barriers and facilitators towards fostering greater interprofessional collaboration during medical emergencies. Impact:The evidence gained from this study contributes to the limited knowledge base of interprofessional collaboration during medical emergencies. Findings will have vast impact on nursing and interprofessional programs such as crisis leadership and management. The findings could also inform practice frameworks during medical emergencies to support interprofessional collaboration and optimize patient care.

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Interprofessional Care and Teamwork in the ICU

Abstract: A robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs.

Cited by 219 publications

References 150 publications

Avaliação do acompanhamento farmacoterapêutico de idosos hospitalizados em uso de analgésicos opioides

Avaliação do acompanhamento farmacoterapêutico de idosos hospitalizados em uso de analgésicos opioides

Information concerning ICU patients’ families in the handover—The clinicians’ «game of whispers»: A qualitative study

Interprofessional collaboration during medical emergencies among doctors, nurses, and respiratory therapists in the intensive care unit: A phenomenological study protocol

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