Aims: To explore emergency nurses' and physicians' experience of collaboration and collective decision-making when triaging older Emergency Department patients within the interprofessional team triage system.
Methods: Semi-structured interviews were conducted with seven nurses and five physicians. Transcripts were analysed via Interpretive Description between September 2016-May 2017.
Results: 'Negotiating collaboration' was developed as the main theme. Three subthemes influenced the negotiation process: Participants described divergent opinions on how an optimal triage system should work ('preferences for triage systems'); they had conflicting perceptions of each profession's role ('role perceptions'); and they expressed different coping strategies regarding 'perceived time pressure'. The compatibility of participants' views on these sub-themes determined whether the nurse and physician were able to successfully negotiate their collaboration. These themes became more evident when the team triaged older ED patients.
Conclusion: Improving interprofessional team triage requires working with the involved nurses' and physicians' values and beliefs. The strengths of both professions need to be considered and a flexible approach to collaboration established according to the patients' situations.
Impact: Emergency Department leaders need to consider nurses' and physicians' values and beliefs to promote interprofessional collaboration in team triage.
目的: 探讨急诊护士和医师在跨专业团队分诊系统中对急诊科老年患者进行分流时的协作和集体决策经验。 设计: 质化设计 方法: 对七名护士和五名内科医生进行了半结构式访谈。在2016年9月至2017年5月期间, 通过解释性说明对记录进行分析。 结果: 将‘协商合作’的发展作为主要主题。三个分主题影响了谈判进程: 参与者表达了关于最佳分流制度应如何运作的不同意见 (‘对分流制度的偏好’) ; 对每个职业角色的认知存在分歧(‘角色认知’) ; 在时间压力感知上, 表现出不同的应对策略。参与者对这些分主题观点的兼容性决定了护士和医师是否能够成功与其进行协商合作。当研究小组对老年ED患者进行分类时, 这些主题变得更加明显。 结论: 提高跨专业团队间的分诊需要与相关护士和医师具有相同价值观和信念。需要考虑两个专业的优势, 并根据患者的情况建立灵活的协作方法。 影响: 急诊科领导需要考虑护士和医师的价值观和信念, 以促进团队分诊中的跨专业协作。.
Keywords: emergency department; emergency medicine; emergency nursing; interpretive description; interprofessional; nurses; older adults; physicians; teamwork; triage.
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