Attitudes and beliefs for effective pediatric nurse practitioner and physician collaboration

Hallas, Donna; Butz, Arlene; Gitterman, Benjamin A.

doi:10.1016/j.pedhc.2003.09.009

Cited by 19 publications

(53 citation statements)

References 9 publications

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“…For MPs and NPs themselves this also included that NPs were competent in realising their limits and seeking assistance when needed [17,63,69]. While having complementary skills and similar goals was seen as an asset to collaboration [61,70,71], ideological differences in the practice style could cause difficulties in establishing a collaborative relationship [19,60,64,70]. …”

Section: Resultsmentioning

confidence: 99%

“…Developing a good collaborative relationship took time and improved once the NPs and MPs got to know each other, which also helped to establish trust among the health professionals [63,70,71]. A period of 3–6 months was observed to be sufficient to establish a collaborative relationship [58,63,70].…”

Section: Resultsmentioning

confidence: 99%

“…Most considered themselves liable for the care provided by the NP [19,58,60,61,63-65]. An equal amount of findings identified effective communication [70,71,73] as crucial to collaboration. In addition to face-to-face communication, two studies identified the use of technologies such as messaging systems as beneficial for regular communication [19,58].…”

Section: Resultsmentioning

confidence: 99%

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Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

et al. 2013

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BackgroundThis integrative review synthesises research studies that have investigated the perceptions of nurse practitioners and medical practitioners working in primary health care. The aggregation of evidence on barriers and facilitators to working collaboratively and experiences about the processes of collaboration is of value to understand success factors and factors that impede collaborative working relationships.MethodsAn integrative review, which used systematic review processes, was undertaken to summarise qualitative and quantitative studies published between 1990 and 2012. Databases searched were the Cochrane Library, the Joanna Briggs Institute Library, PubMed, Medline, CINAHL, Informit and ProQuest. Studies that met the inclusion criteria were assessed for quality. Study findings were extracted relating to a) barriers and facilitators to collaborative working and b) views and experiences about the process of collaboration. The findings were narratively synthesised, supported by tabulation.Results27 studies conducted in seven different countries met the inclusion criteria. Content analysis identified a number of barriers and facilitators of collaboration between nurse practitioners and medical practitioners. By means of data comparison five themes were developed in relation to perceptions and understanding of collaboration. Nurse practitioners and medical practitioners have differing views on the essentials of collaboration and on supervision and autonomous nurse practitioner practice. Medical practitioners who have a working experience with NPs express more positive attitudes towards collaboration. Both professional groups report concerns and negative experiences with collaborative practice but also value certain advantages of collaboration.ConclusionsThe review shows that working in collaboration is a slow progression. Exposure to working together helps to overcome professional hurdles, dispel concerns and provide clarity around roles and the meaning of collaboration of NPs and MPs. Guidelines on liability and better funding strategies are necessary to facilitate collaborative practice whether barriers lie in individual behaviours or in broader policies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

et al. 2013

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“…31 This shared philosophy includes approaches to care management. Variability of approaches challenges nurse practitioner-physician comanagement.…”

Section: Shared Philosophy Of Carementioning

confidence: 99%

Nurse Practitioner–Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain

Norful

Jacq

Carlino³

et al. 2018

Ann Fam Med

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PURPOSE Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement. METHODSWe conducted a literature search using the following key words: comanagement; primary care; nurse practitioner OR advanced practice nurse. From 156 studies, we extracted information about nurse practitioner-physician comanagement antecedents, attributes, and consequences. A systematic review of the findings helped determine effects of nurse practitioner-physician comanagement on patient care. Then, we performed 26 interviews with nurse practitioners and physicians to obtain their perspectives on nurse practitioner-physician comanagement. Results were compiled to create our conceptual nurse practitioner-physician comanagement model. RESULTSOur model of nurse practitioner-physician comanagement has 3 elements: effective communication; mutual respect and trust; and clinical alignment/ shared philosophy of care. Interviews indicated that successful comanagement can alleviate individual workload, prevent burnout, improve patient care quality, and lead to increased patient access to care. Legal and organizational barriers, however, inhibit the ability of nurse practitioners to practice autonomously or with equal care management resources as primary care physicians.CONCLUSIONS Future research should focus on developing instruments to measure and further assess nurse practitioner-physician comanagement in the primary care practice setting. Ann Fam Med 2018;16:250-256. https://doi.org/10.1370/afm.2230. INTRODUCTIONW ith imminent staffing shortages in the health care profession and an increase in the volume of patients seeking primary care services, patient loads are increasing rapidly, thus making it difficult for a single primary care professional to manage all patient care needs effectively and efficiently.1-4 Therefore, policy makers are calling for new primary care delivery models to meet the increased demands for care, especially due to patients with multiple comorbidities requiring more complex primary care visits. Different models of care delivery have been proposed, including team-based care, yet these models often have variability in task allocation and professional roles.5 Identifying innovative models of care delivery is increasingly important to meet these demands in primary care.One proposed care delivery model includes having more than 1 primary care professional comanaging the same patient and sharing the workload responsibilities or care management tasks. Researchers have explored comanagement of patients by 2 physicians in primary care, 6 and by a physician and a nonphysician ...

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“…But over time, the two have the opportunity to observe one another's professional behaviour as they work side by side. Eventually, if they have seen evidence of the other's clinical competence, they will begin to develop a trusting relationship (for more on competence and trust, see Hallas, Butz & Gitterman, 2004). Our informant suggested that collaboration between a healthcare practitioner and an interpreter would likely follow the same path.…”

Section: Relationship Buildingmentioning

confidence: 99%

Is Fidelity Ethical?

Clifford

2006

ttr

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This article explores the conduit model so often promoted in community interpreting and its connection with ethical behaviour. The author begins by exploring the origin of the model and the pathways through which it came to be applied in community interpreting. He then considers the model against the backdrop of competing ethical approaches and questions why it continues to be promoted in the face of mounting evidence of its shortcomings. Finally, he presents new information derived from interviews with stakeholders in the healthcare sector. The author argues that this information indicates practitioners may be willing to work with interpreters who take on a wider role, and he concludes by underlining the need to recognize the complexity in the work interpreters do.

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Attitudes and beliefs for effective pediatric nurse practitioner and physician collaboration

Cited by 19 publications

References 9 publications

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

Nurse Practitioner–Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain

Is Fidelity Ethical?

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