COLLABORATION, ISSUES IN NURSING AND MODELS
Download as PPTX, PDF0 likes3,185 views
This document discusses various models and issues related to collaboration within and outside of nursing. It begins by defining collaboration and explaining its importance for addressing complex health issues. Several models of collaboration are described, including the clinical school of nursing model from 1995, the dedicated education unit clinical teaching model from 1999, and the research joint appointment model from 2000. The document also covers collaborative issues that can arise within nursing between different roles, and outside nursing with other healthcare professionals. Overall, the document provides an overview of the meaning, need for, and approaches to collaboration in nursing.
COLLABORATION, ISSUES IN NURSING AND MODELS
- 1. COLLABORATION ISSUES AND MODELS WITHIN AND OUTSIDE NURSING Ms ARIFA T N FIRST YEAR M.Sc NURSING, MIMS CON
- 2. INTRODUCTION Nursing Profession is faced with lot of complex health issues due to Technological and medical achievements, Increased Elderly Population ,Increased Patients with chronic illness. The complexity of collaboration and the skills required to facilitate the process are formidable. Much of the literature on collaboration describes what it should look like as an outcome, but little is written describing how to approach the developmental process of collaboration.
- 3. COLLABORATION Derived from a latin word collaborare, ‘to labor together’ To collaborate is to ‘work jointly with others or together’ In olden days nurses was seen as providing assistance to the physician. The term Handmaiden is used to describe this role
- 4. MEANING The roots of the word collaboration, namely co-, and laborare, combine in Latin to mean “work together.” That means the interaction among two or more individuals, which can encompass a variety of actions such as communication, information sharing, coordination, cooperation, problem solving, and negotiation Teamwork and collaboration are often used synonymously. The description of collaboration as a dynamic process resulting from developmental group stages as an outcome, producing a synthesis of different perspectives
- 5. MEANING The collaborative process involves a synthesis of different perspectives to better understand complex problems An effective collaboration is characterized by building and sustaining “win-win-win” relationships.
- 6. DEFINITIONS “Colaborative care ‘as partnership relationship between doctors, nurses and other health care providers with patients and their families’ (Virginia Henderson) Collaboration is ‘Nurses and physicians cooperatively working together, sharing responsibility for solving problems and making decisions to formulate and carry out plans for patient care’ (-Baggs and schmitt,1988)
- 7. DEFINITIONS Collaboration is the most formal inter organizational relationship involving shared authority and responsibility for planning, implementation, and evaluation of a joint effort (Horde, 1986) collaboration as '... a mutually beneficial and well-defined relationship entered into by two or more organizations to achieve common goals. (Mattessich, Murray and Monsey (2001) A concentrated effort of individuals and groups to attain a goal.
- 8. OBJECTIVES Provide client-directed and client-centered care using a multidisciplinary, integrated, participative framework Enhance continuity across continum of care Improve client and family satisfaction with care Provide quality, cost effective, research based care Promote mutual respect, communication Develop interdependent
- 9. NEED FOR COLLABORATION Increasing gap between nursing education and nursing service. Graduate nurses often lack practical skills despite their significant knowledge of nursing process and theory. Clearly, a partnership between nursing educators and hospital nursing personnel is essential to meet this challenge To combine theoretical knowledge with sufficient technical training
- 10. CHARACTERISTIC OF COLLABORATION Joint venture Co operative endeavor Willing participation Shared planning and decision making Team approach Contribution of expertise Shared responsibility Non hierarchal relationship Shared power (based on knowledge and expertise)
- 11. ELEMENTS OF COLLABORATION Communication Mutual respect and trust Decision making
- 12. PRINCIPLES OF COLLABORATION A STATE OF ART A stands for Assets, attitudes and values that each potential partner brings Accountability to each other Agreements to be mutual and documented Acknowledgement of each others contributions Achievements -monitored
- 13. PRINCIPLES OF COLLABORATION A STATE OF ART R stands for Reciprocal benefits Respect for each partners Responsibilities –well defined and agreed upon T stands for Time and timing Tact and talent Trust
- 15. TYPES OF COLLABORATION Interdisciplinary collaboration- it is the term used to indicate the combining of two or more disciplines, professions, departments, or the like, usually in regard to practice ,research, education and theory. Multidisciplinary collaboration- refers to independent work and decision making, such as when disciplines work side-by-side on a problem
- 16. TYPES OF COLLABORATION Transdisciplinary collaboration- efforts involve multiple disciplines sharing together their knowledge and skills across traditional disciplinary boundaries in accomplishing tasks or goals. Transdisciplinary efforts effects reflects a process by which individuals work together to develop a shared conceptual framework that integrates and extends discipline specific theories, concepts, and methods to address a common Problems
- 17. TYPES OF COLLABORATION Interprofessional collaboration- has been described as involving “ interaction of two or more disciplines involving professionals who work together , with intention, mutual respect and commitments for the sake of a more adequate response to a human problem
- 18. COMPETENCIES REQUIRED FOR NURSE AS A COLLABORATOR Communication skills Mutual respect and trust Giving and receiving feedbacks Decision making Conflict management
- 21. TYPES OF RELATIONSHIP AMONG HEALTH PROFESSIONALS Complementary relationship Symmetrical relationship Parallel relationship
- 22. Complementary relationship One person is dominant and the other is submissive Control is not divided equally between the two participants Relationships are stable and predictable also inhibit creativity and independent thinking
- 23. Symmetrical relationship Control is more evenly distributed between the two participants Free to express their opinions Power struggles occurs when participants compete to acquire or give up control
- 24. Parallel relationship Control moves back and forth between the two participants Participants take turns holding and giving control, depending on the circumstances, rather than competing for control Effective and flexible communication
- 25. COLLABORATIVE ISSUES WITHIN NURSING The nurse and the superintendent The nurse and the head nurse /Departmental Nurse The nurse and fellow nurse
- 26. COLLABORATIVE ISSUES WITHIN NURSING Collaboration and the nursing shortage Mandatory over time Safety on job Work place bullying Lack of respect Regulatory barrier
- 27. COLLABORATIVE ISSUES OUTSIDE NURSING Nurse and the physician Nurse and the client Nurse and the health care professionals Nurse and pharmacist Nurse and nutritionist Nurse and the professional nursing organizations
- 28. COLLABORATIVE ISSUES OUTSIDE NURSING Disciplinary difference Meeting patient expectations Lack of respect Problems with nursing informatics Organizational barrier
- 30. MODELS OF COLLABORATION Clinical school of nursing model (1995) Dedicated education unit clinical teaching models(1999) Research joint appointment model ( 2000) Practice research model (2001) Collaboration clinical education Epworth Dakin (CCEED) MODEL (2003). The collaborative learning unit (British Colombia) model 2005 The collaborative approach to nursing care (can care) model(2006)
- 31. Clinical school of nursing model (1995)
- 32. Clinical school of nursing model (1995) Encompasses the highest level of academic and clinical nursing research and education. This was the concept of visionary nurses from both La Trobe and The Alfred Clinical School of Nursing University. The development of the Clinical School offers benefits to both hospital and university. Opportunities for exchange of ideas with clinical nurses with increased opportunities for clinical nursing research.
- 33. Dedicated education unit (DEU) clinical teaching models (1999)
- 34. Dedicated education unit (DEU) clinical teaching model (1999) In this model a partnership of nurse executives, staff nurses and faculty transformed patient care units into environment of support for nursing students and staff nurses while continuing the critical work of providing quality care to acutely ill adults. Key features of DEU are: Uses existing resources Supports the professional development of nurses Allows for the clinical education of increased number of students.
- 35. Dedicated education unit (DEU) clinical teaching model (1999) Exclusive uses of the clinical unit by school of nursing. Use of staff nurses who want to teach as clinical instructor. Preparation of clinical instructor for their teaching role through collaborative staff and faculty development activities. Faculty role to work directly with staff as a coach, teaching/ learning resources to develop clinical reasoning skills, to identify clinical expectations of students , and evaluate student achievement
- 36. Research joint appointment model (2000) A Joint appointment has been defined by Lantz et al. (1994),as “ a formalized agreement between two institutions where an individual holds a position in each institution and carries out specific and defined responsibilities The goal of this approach is to use the implementation of research findings as a basis for improving critical thinking and clinical decision making of nurses.
- 37. Research joint appointment model (2000) In this arrangement the researcher is a faculty member at the educational institution with credibility in conducting research and with an interest in developing a research programme in the clinical setting. Outcomes identified by Donnelly ,Werfel, Wolfe (1994) for the educational institutions are that it becomes more in touch with the real world and more readily able to identify research questions that have the potential
- 39. Practice research model It is an innovative collaborative partnership agreement between Fremantle Hospital and Health Service and Curtin University of Technology in Perth, Western Australia The partnership engages academics in the clinical setting in two formalized collaborative appointments. This partnership not only enhances Communication between educational and health services, but fosters the development of nursing research and knowledge
- 40. Practice research model This model encouraged a close working relationship between registered nurses and academics, and has also facilitated strong links at the health service with the Nursing Research and Evaluation Unit, medical staff and other allied health professionals Key Concepts: Practice – driven research development Collegial Partnership Collaborative Partnership and Best Practice
- 41. Practice research model KEY ELEMENT Collaborative Partnership The collaborative partnership was formed by nursing health professionals, from the community health service and the university who recognized the need to bridge the theory- clinical practice gap and acknowledged the futility of continuing to work in isolation from each other. In practical terms, this involved a formal contractual arrangement between the organizations that led to the establishment of a Nurse Research Consultant (NRC) position
- 42. Role of Nurse Research Consultant ( NRC) in PRM Role of Nurse Research Consultant ( NRC) in PRM In the PRM, the role of the Nurse Research Consultant (NRC) was articulated as that of mentor and consultant on issues related to research, methodology publications and dissemination Although the PRM was specifically designed to enhance nursing research activity and the implementation of evidence-based community health nursing practice, the Model also encouraged the involvement of the multi- disciplinary team to work to achieve the aims of the partnership agreement
- 43. COLLABORATIVE CLINICAL EDUCATION EPWORTH DEAKIN (CCEED) MODEL (2003) In an effort to improve the quality of new graduate transition, Epworth Hospital and Dakin University ran a collaborative project (2003) funded by the National Safety and Quality Council to improve the support base for new graduates while managing the quality of patient care delivery The Collaborative Clinical Education Epworth Dakin (CCEED) model developed to facilitate clinical learning, promote clinical scholarship and build nurse workforce capability.
- 44. COLLABORATIVE CLINICAL EDUCATION EPWORTH DEAKIN (CCEED) MODEL (2003)
- 45. COLLABORATIVE CLINICAL EDUCATION EPWORTH DEAKIN (CCEED) MODEL (2003) Key findings of the 2005 CCEED program were Students learning objectives were met and satisfaction was high. Undergraduate clinical education was valued by preceptors and managers as a workforce investment strategy. Preceptors were enriched in their clinician role as a result of their participation in the program and reflection on the process. Preceptors managed multiple roles in order to meet demands of patient care and student learning.
- 46. The collaborative learning unit (British Colombia) model 2005 The collaborative learning unit model was based on the ‘dedicated education units’ concept develop, Successfully implemented and researched in Australia. The collaborative learning unit model of practice education for nursing is a clinical education alternative to preceptor ship. In the CLU model, students practice and learn on a nursing unit, each following an individual set rotation and choosing their learning assignment , according to their learning plans.
- 47. The collaborative learning unit (British Colombia) model 2005 Clinical nurses preparing to adopt the CLU model have described a positive learning environment as one where questions are expected . In CLU approach the students are not attached to the units as an ‘extra set of hands’ to augment the nursing workforce In this model , nursing faculty , clinical nurses and students work collaboratively to enhance learning opportunities as well as develop the professional knowledge base of nursing
- 48. The collaborative approach to nursing care(CAN- care) model(2006) The CAN-care model emerged as academic and practice leaders acknowledge the need to work together to promote the education , recruitment and retention of nurses at all stages of their career The goal was to design an educationally dense , practice based experience to socialize second degree students to the role of professional nurse A secondary goal was to enhance and support the professional and career development of unit based nurses
- 49. The collaborative approach to nursing care(CAN- care) model(2006) The essence of the CAN-care model is the relationship between the nurse learner (student) and nurse expert (unit based nurse ) , within the context of each nursing situation Through this model the student comes to know the organizational context of nursing practice, the multifaceted role of professional nurses, and assumes responsibility for coming to know the meaning nursing in each unique situation
- 50. NURSE AS A COLLABORATOR With nurse colleagues Shares personal expertise with other nurses and elicits the expertise of others to ensure quality client care. Develops a sense of trust and mutual respect with peers that recognize their
- 51. NURSE AS A COLLABORATOR With other health care professionals Share health care responsibilities in exploring options, setting goals, and making decision with clients and families Listens to each individuals views Participate in collaborative interdisciplinary research to increase knowledge of clinical problems or situation
- 52. NURSE AS A COLLABORATOR With professional nursing organizations Seeks opportunities to collaborate with and within professional organizations. Serves on committee in state and national nursing organizations or speciality groups Supports professional organizations in political action to create solutions for professional and health care concerns
- 53. NURSE AS A COLLABORATOR With legislation Collaborates with other health care providers and consumes on health care legislations to best serve the needs of the public
- 54. Nurse physician collaboration Nurse patient collaboration is the ideal form of implementing the role. Nurse and physician working together create a synergism that can result in a product that is greater than can be produced by the professional alone
- 57. Collaboration with assistive personnels Relationship between the registered nurse and unlicensed assistive personnel known as nurses aids and nursing assistants, affect the quality of care given to hospitalized patients Difference in beliefs values perception and priorities create conflict, poor team work and reduced job satisfaction and ultimately a negative impact on patient care
- 58. Collaboration with assistive personnels Team building sessions were developed with registered nurse and unlicenced personnel. The purpose was to identify and align work related relationship needs of both groups with needs of the nursing units. This is used to encourage collaboration between two groups.
- 59. Collaboration out side nursing
- 60. Collaboration and independent practice: ongoing issues for nursing Inter – professional collaboration and independent practice: why these issues are important during the twentieth century, the nursing profession has undergone immense change Nursing has progressed from an occupation to a fully licensed profession, with members that provide a broad range of services independently and in a variety of professional relationships with other providers This evolution has changed how nurses are educated, clinically prepared, and how they perceive their role.
- 61. Collaboration and independent practice: ongoing issues for nursing Starting With turn – of –the –century debates concerning the appropriateness of professional nursing practice, registered nurses began assessing not only their licensure status but their roles related to other professionals. In the early years of nursing profession, it was generally believed that the nurses served and cared for their patients by assisting physicians. However the perception of nursing often varied dramatically from its practice
- 62. Collaboration and independent practice: ongoing issues for nursing During wars and times of crises, nurses worked with beside physicians conducting surgical procedures, diagnosing care, and prescribing treatments and drugs The role of the public health nurse, as it developed earlier in this century, was often independent with nurses working with families of patients with tuberculosis or other highly contagious diseases and providing a broad range of interventions, both health and socially focused.
- 63. Collaboration and independent practice: ongoing issues for nursing Intrinsic to nursing is the collaborative process: nurses and physicians working together and independently assessing, diagnosing, and caring for consumers by preparing patients histories, conducting physical and psychosocial assessments, and reviewing and discussing their cases with other health professionals to determine the hanging health status of each client Nurses and physicians have understood the importance of this overlap in scopes, practice, and patient care , yet there is little literature and virtually no legislation that clearly provides a balanced accounting of the benefits of this working relationship.
- 64. Conclusion
- 65. Summary
- 66. REFERENCES 1. BRAV KAUR,RAWAT.H.C.TEXTBOOK OF ADVANCEDNURSING PRACTICE.NEWDELHI;JAYPEE BROTHERS MEDICAL PUBLISHERS ;2015. 2. SONISAMTA .TEXTBOOK OF ADVANCED NURSING PRACTICE.NEWDELHI;JAYPEE;2014. 3. BASHEER P,KHAN Y.A CONCISE TEXTBOOK OF ADVANCED NURSING PRACTICE.BANGALORE;EMMESS;2013. 4. D ELLEKUVANA BASKARA RAJ, NIMA BHASKAR. TEXT BOOK OF NURSING EDUCATION. 1ST EDITION. EMMESS PUBLISHERS. 5. ANN B HAMRIC, JUDITH A SPROSS. ADVANCED PRACTICE NURSING. 3RD EDITION. SAUNDERS PUBLISHERS.