Nursing assistants matters—An ethnographic study of knowledge sharing in interprofessional practice

Abstract

Interprofessional collaboration involves some kind of knowledge sharing, which is essential and will be important in the future in regard to the opportunities and challenges in practices for delivering safe and effective health care. Nursing assistants are seldom mentioned as a group of health care workers that contribute to interprofessional collaboration in health care practice. The aim of this ethnographic study was to explore how the nursing assistants' knowledge can be shared in a team on a spinal cord injury rehabilitation ward. Using a sociomaterial perspective on practice, we captured different aspects of interprofessional collaboration in health care. The findings reveal how knowledge was shared between professionals, depending on different kinds of practice architecture. These specific cultural-discursive, material-economic, and social-political arrangements enabled possibilities through which nursing assistants' knowledge informed other practices, and others' knowledge informed the practice of nursing assistants. By studying what health care professionals actually do and say in practice, we found that the nursing assistants could make a valuable contribution of knowledge to the team.

Relationship between nurses' perceptions of nursing assistant roles and information‐sharing behaviors: A cross‐sectional study

“…A previous study on interprofessionalhjn collaboration that included NAs reported that some nurses perceived NAs as supportive of them as well as their patients (Lancaster et al, 2015). Another qualitative study found that NAs tended not to participate in formal multidisciplinary meetings (Lindh Falk et al, 2017), suggesting that patient information shared by nurses and other staff members may not be shared with NAs. As nurses have the closest working relationships with NAs, it is important for nurses to express information to them.…”

“…Nakaoka, Mitani, Tomizawa, and Shibutani (2016) found that inadequate information‐sharing between nurses and NAs could lead to ineffective patient care. Nurses can access information about patients' diseases, care requirements, and medical decisions, whereas NAs can access valuable patient information through providing regular care (Kunimatsu, 2015; Potter & Grant, 2004), which can also be used to support nurses' work (Lindh Falk, Hult, Hammar, Hopwood, & Abrandt, 2017). As frontline care providers, NAs develop close relationships with patients, and often have information on contextual matters, such as patients' home lives and their feelings regarding hospitalization, which may differ from information obtained by nurses.…”

“…Including NAs among hospital staff members is recommended, particularly in Japan, as NAs communicate with and provide direct care to patients (Ogawa, 2010). Additionally, previous research has indicated that NAs are important partners with nurses in Japanese hospitals (Kudo et al, 2011; Kudo et al, 2016); however, some nurses do not always trust NAs' competency levels (Huber, Blegen, & McCloskey, 1994), nor do they necessarily recognize NAs as a part of the nursing team (Lindh Falk et al, 2017). Consequently, nurses may not collaborate with NAs, limiting information‐sharing and highlighting the necessity of understanding other professionals' roles in facilitating appropriate information‐sharing in the workplace (Yamamoto, Okumiya, & Yamamoto, 2015).…”

Nursing practice in stroke rehabilitation: Perspectives from multi‐disciplinary healthcare professionals

“…Stakeholders and policy‐makers might need to consider the effective strategies of encouraging nurses and highlighting the value of implementing stroke‐rehabilitation care (Kitson, ). Moreover, nursing practice has cultural characteristics, varying in different contexts (Lindh Falk, Hult, Hammar, Hopwood, & Abrandt Dahlgren, ; Tsujimura et al, ). Consideration of these facilitators in the specific cultural context might be necessary to develop effective strategies.…”

The Transition to “Patienthood,” the Contribution of the Nursing Assistant: A Grounded Theory Study

“…The labeling concept suggests those with power are able to construct a reality that has the potential to disadvantage those with less power. It could be proposed that the assistant dialogue has such power, potentially hidden ( 40 ), with limited interprofessional inclusion ( 41 ) which in turn may impact upon patient safety ( 42 ). Earlier work has however described the RNs’ awareness of these labels and the effort required to manage them so as not to subject the patient to inequity of care and treatment ( 43 ).…”