Teamwork in a coronary care unit: facilitating and hindering aspects

Abstract

Objective:To identify, within a multidisciplinary team, the facilitating and hindering aspects for teamwork in a coronary care unit. Method: A descriptive study, with qualitative and quantitative data, was carried out in the coronary care unit of a public hospital. The study population consisted of professionals working in the unit for at least one year. Those who were on leave or who were not located were excluded. The critical incident technique was used for data collection, by means of semi-structured interviews. For data analysis, content analysis and the critical incident technique were applied. Results: Participants were 45 professionals: 29 nursing professionals; 11 physicians; 4 physical therapists; and 1 psychologist. A total of 49 situations (77.6% with negative references); 385 behaviors (54.2% with positive references); and 182 consequences emerged (71.9% with negative references). Positive references facilitate teamwork, whereas negative references hinder it. A collaborative/communicative interprofessional relationship was evidenced as a facilitator; whereas poor collaboration among agents/inadequate management was a hindering aspect. Conclusion: Despite the prevalence of negative situations and consequences, the emphasis on positive behaviors reveals the efforts the agents make in order to overcome obstacles and carry out teamwork.

Estratégias para o desenvolvimento da sensibilidade moral: perspectiva dos enfermeiros de unidades de terapia intensiva

“…21 Therefore, effective communication requires a participatory and dialogical process is established in multidisciplinary teams, because the multidisciplinary work demands more than merely grouping different professionals in the same work environment; collaboration and effective communication is needed, with exchange of different types of knowledge and complementary actions. 22 Another strategy reported by nurses were meetings with the team in order to discuss actions and professional activities to promote participatory decisions, benefiting both patients and the health staff.…”

Barriers to Nursing Performance from the Perspective of Nurses Working in Intensive Care Units

“…Many studies showed that poor communication between nurse and physician were common and could act as an obstacle (14,16,21). A study showed that there were many negative situations in multidisciplinary teamwork in coronary care units that could hinder collaborative/communicative inter-professional relationship (23). The poor communication between nurse and physician increase the medication errors (21).…”

Teamwork in the Family Health Strategy: professionals’ perceptions

“…This leads to segmented and piecemeal work, which may compromise the patient's full care. [12][13] In this perspective, the context of health services is closer to that of team grouping, 11 since it does not promote articulated, integrated and dialogical labor.…”

“…This may be a reflection related to the influence of the Taylorist-Fordist fragmentation that stimulates and reinforces the rigidity in the division of tasks, which culminates with the distancing of the health team members, compromising integral care for the users. 12,14 In addition, it can be seen that the curricular structure of undergraduate courses in health does not promote interprofessional practice, since training still follows the highly specialized, technical and individualistic approach, which does not favor a shared performance. [15][16][17][18] To consolidate interprofessional teamwork, substantial elements are needed to qualify it as a powerful tool for coping with health work fragmentation.…”