Effects of interprofessional practice on nursing workload in hospitals: A systematic review

Abstract

ObjectiveTo synthesise scientific evidence on interprofessional practice in hospital care and the effects on nursing workload.MethodsSystematic mixed method review, registered in PROSPERO (CRD42021225627) and conducted in the following databases: CINAHL, Medline, Web of Science and Scopus, with no restrictions on the publication period of the studies. Primary studies were recruited on nurses' interprofessional practice (actions and interactions with other professional categories) in hospitals and the effects on one or more dimensions of nursing workload (quantitative, qualitative, physical, cognitive, emotional, time and variation). Scientific articles available in open access, in English, Spanish or Portuguese, were included. The searches were carried out in January 2021. The studies were evaluated by pairs of independent researchers to verify methodological quality, through the Mixed Method Appraisal Tool, and data extraction. To summarise the studies, thematic analysis was adopted.ResultsA total of 1774 publications were assessed for eligibility and 17 studies were included. Of these, two were mixed methods, four were qualitative, and 11 were quantitative, published between 2011 and 2020. The main scenarios investigated were Intensive Care Units and/or Inpatient Units. During data analysis, three thematic categories emerged: Interprofessional practice in coping with emotional overload; Time dedicated by nurses to professional communication; and Working conditions and patient care. The third category consisted of three subthemes: Conflict and flexibility in the context of practice; Working conditions and interprofessional practice; and Effects on patient care.ConclusionsThe evidence points to the emotional overload of nurses in the face of uncooperative practices. Interprofessional actions, especially communicative ones, demand nurses' time and impact the care provided. The results contribute to political decisions and health work management.

The workforce crisis in healthcare: Moving the debate to bridge evidence and policy

“…41 Finally, the Special Issue investigates the capacity for HCWF recruitment and retention, accentuating organisational and professional levels. The articles reveal the benefits of interprofessional practice on nurses' workload in hospitals, 42 the impact of changes in nursing roles on retention drawing on findings from the Netherlands, 43 needs and benefits of implementation of coaching programmes in countries of the European Union, 44 and investigation in leadership competences in medical education in countries in the Pan American Health Organisation region. 45…”

“…Benefits of effective governance include inclusive work arrangements and investment in HCW training/education, such as 'interprofessional work' and 'communication', 42 'coaching programs', 44 'leadership competences', 43,45 and broader commitment to diversity, equality and inclusion. 30,40 The research presented in this Special Issue also illustrates the importance of global knowledge exchange.…”