Emergency nurses’ attitudes toward interprofessional collaboration and teamwork and their affecting factors: A cross-sectional study

Authors

1 Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of Statistics and Epidemiology, Faculty of Health Science, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: The emergency department (ED) is a multidisciplinary department and seriously needs interprofessional collaboration (IPC). Objectives: The purpose of this study was to examine the emergency nurses’ attitudes toward IPC and teamwork and their affecting factors. Methods: A cross-sectional study was conducted on 138 emergency nurses working in teaching hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, from January to April 2019. Data were collected using a three-part questionnaire including a demographic data sheet, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, and the Testing Team Attitude Questionnaire. The data were analyzed using descriptive statistics, Pearson’s correlation coefficient, analysis of variance, and multivariate regression analysis. Results: The majority of the study participants were female (68.1%), in the age range of 30–40 years old (44.2%), and had a working experience of 1–5 years in the ED (63.8%). The mean scores of nurses’ attitudes toward IPC and teamwork were 48.68 ± 5.14 and 96.15 ± 8.97, respectively. A direct and strong correlation was found between nurses’ attitudes toward IPC and teamwork (r = 0.594, P = 0.001). Regression analysis showed that, among all variables, only the participants’ employment status (compulsory governmental services, P < 0.031 and B = 2.356), overall work experience between 1 and 5 years (P < 0.001 and B = -3.769), and the attitude toward teamwork (P < 0.001 and B = 0.350) could significantly predict nurses’ attitude toward IPC. Conclusion: The attitudes of emergency nurses toward IPC and teamwork were at an optimal level. Nurses’ belief in IPC and especially belief in nurse–physician collaboration plays an important role in providing quality care and keeping patient safety in ED. Joint in-service workshops on the philosophy and principles of IPC and teamwork for nurses and physicians working in EDs can further strengthen the IPC.

Keywords


1. Nair DM, Fitzpatrick JJ, McNulty R, Click ER, Glembocki MM.
Frequency of nurse-physician collaborative behaviors in an acute
care hospital. J Interprof Care 2012;26:115-20.
2. Varjoshanin J, Hosseini M, Khankeh H, Ahmadi F. Competency
and cultural similarity: Underlying factors of an effective
interprofessional communication in the emergency ward:
A qualitative study. J Qual Res Health Sci 2014;3:292-303.
3. Farhadi A, Elahi N, Jalali R. Nurses’ and physicians’ experiences
of the pattern of their professional relationship with each other:
A phenomenological study. J Qual Res Health Sci 2017;6:201-13.
4. Di Prospero L, Bhimji-Hewitt S. Teaching collaboration:
Aretrospective look at incorporating teamwork into an interprofessional
curriculum. J Med Imaging Radiat Sci 2011;42:118-23.
5. Ranjbari P, Alimohammadzadeh Kh, Hosseini SM. The
relationship of physician-nurses interaction with patient safety
incidents in Amir-Al-Momenin Hospital in Tehran. Manage
Strateg Health Syst 2018;3:240-8.
6. Matziou V, Vlahioti E, Perdikaris P, Matziou T, Megapanou E,
Petsios K. Physician and nursing perceptions concerning
interprofessional communication and collaboration. J Interprof
Care 2014;28:526-33.
7. Azimi Lolaty H, Ashktorab T, Bagheri Nesami M,
Bagherzadeh Ladari R. Experience of professional communication
among nurses working in educational hospitals: A phenomenological
study. J Mazandaran Univ Med Sci 2011;21:108-25.
8. Kilner E, Sheppard LA. The role of teamwork and
communication in the emergency department: A systematic
review. Int Emerg Nurs 2010;18:127-37.
9. Hawkins RE, Lawson LE, Starr SR, Borkan J, Gonzalo JD.
Health Systems Science e-Book. 1st ed. Philadelphia: Elsevier;
2017.
10. Reeves S, Xyrichis A, Zwarenstein M. Teamwork, collaboration,
coordination, and networking: Why we need to distinguish
between different types of interprofessional practice. J Interprof
Care 2018;32:1-3.
11. Bochatay N. Discussing teamwork in health care: From
interprofessional collaboration to coordination and cooperation.
Health Info Libr J 2019;36:367-71.
12. Danna D, Bernard M, Schaubhut R, Mathews P. Experiences
of nurse leaders surviving Hurricane Katrina, New Orleans,
Louisiana, USA. Nurs Health Sci 2010;12:9-13.
13. Salas E, Dickinson TL, Converse SA, Tannenbaum SI.
Toward an understanding of team performance and training.
In: Swezey RW, Salas E, editors. Teams: Their Training and
Performance. Norwood: Ablex; 1992. p. 3-29.
14. Ribeiro EM, Pires D, Blank VL. Theoretical review of the work
process in health care used to analyze work in the Family Health
Program in Brazil. Cad Saude Publica 2004;20:438-46.
15. Masoomi R, Yamani N. A review on interprofessional
education in health professionals’ training. Iran J Med Educ
2012;11:1231-40.
16. Sterchi LS. Perceptions that affect physician-nurse collaboration
in the perioperative setting. AORN J 2007;86:45-57.
17. Le Roux L. Nurses' and physicians' attitudes toward physiciannurse collaboration in private hospital critical care units. A thesis
for the degree of Master of Science in Nursing. University of the
Witwatersrand, Johannesburg, 2014.
18. Snelgrove S, Hughes D. Interprofessional relations between
doctors and nurses: Perspectives from South Wales. J Adv Nurs
2000;31:661-7.
19. Cotter PT. Clinical Autonomy and Nurse/Physician Collaboration
in Emergency Nurses. DN Thesis, University College Cork; 2013.
20. Pakpour V, Hojat M, Salehi H, Rahmani A, Shahim A,
Mohammadi R. [Viewpoint of nurses on interprofessional
relationship between nurses and doctors]. Hayat 2014; 20:74-85.
21. Zeyghami Mohammadi S, Haghighi S. The association between
nurses’ communication skills and nurse-physician relationship
and collaboration in Alborz Hospital of Karaj in 2008. Med Sci J
2009;19:121-7.
22. Rostami H, Rahmani A, Ghahramanian A. The viewpoint of
nurses about professional relationship between nurses and
physicians. J Res Dev Nurs Midwifery 2010;7:63-71.
23. Jasemi M, Rahmani A, Aghakhani N, Hosseini F, Eghtedar S.
Nurses and physicians’ viewpoint toward interprofessional
collaboration. Iran J Nurs 2013;26:1-10.
24. Casacchia M, Bianchini V, Mazza M, Pollice R, Roncone R.
Acute stress reactions and associated factors in the help-seekers
after the L’Aquila earthquake. Psychopathology 2013;46:120-30.25. Shaghayeghfard B, Derakhshan Rad SA, Kamali Sarvestani F.
Attitude survey of physiatrist and rehabilitation professionals
towards team working process in the city of Shiraz. J Res
Rehabil Sci 2012;8:1319-27.
26. Hojat M, Nasca TJ, Cohen MJ, Fields SK, Rattner SL,
Griffiths M, et al. Attitudes toward physician-nurse collaboration:
A cross-cultural study of male and female physicians and
nurses in the United States and Mexico. Nurs Res 2001;50:
123-8.
27. Baker DP, Krokos K, Amodeo A. TeamSTEPPS Teamwork
Attitudes Questionnaire Manual. Washington, DC: American
Institute for Research; 2008.
28. Najafi M, Keshmiri F, Najafi M, Shirazi M. Assessment of
validity and reliability of team STEPPS teamwork attitudes
questionnaire (T-TAQ) in Iran. Payavard 2014;7:389-98.
29. Hekmat SN, Dehnavieh R, Rahimisadegh R, Kohpeima V,
Jahromi JK. Team attitude evaluation: An evaluation in hospital
committees. Mater Sociomed 2015;27:429-33.
30. Zakerimoghadam M, Ghiyasvandian S, Kazemnejad Leili A.
Nurse-physician collaboration: The attitudes of baccalaureate
nursing students at tehran university of medical sciences. Iran
Red Crescent Med J 2015;17:e23247.
31. Elsous A, Radwan M, Mohsen S. Nurses and physicians attitudes
toward nurse-physician collaboration: A survey from Gaza Strip,
Palestine. Nurs Res Pract 2017;2017:7406278.
32. Chaboyer WP, Patterson E. Australian hospital generalist and
critical care nurses’ perceptions of doctor-nurse collaboration.
Nurs Health Sci 2001;3:73-9.
33. Sayed K. Sleem W. Nurse-physician collaboration: A comparative
study of the attitudes of nurses and physicians at Mansoura
University Hospital. Life Sci J 2011;8:140-6.
34. Amsalu E, Boru B, Getahun F, Tulu B. Attitudes of nurses and
physicians towards nurse-physician collaboration in northwest
Ethiopia: A hospital based cross-sectional study. BMC Nurs
2014;13:37.
35. Karanikola MN, Albarran JW, Drigo E, Giannakopoulou M,
Kalafati M, Mpouzika M, et al. Moral distress, autonomy and
nurse-physician collaboration among intensive care unit nurses in
Italy. J Nurs Manag 2014;22:472-84.
36. Georgiou E, Papathanassoglou ED, Pavlakis A. Nurse‐
physiciancollaboration and associations with perceived autonomy
in Cypriot critical care nurses. Nurs Crit Care 2017;22:29-39.
37. Copnell B, Johnston L, Harrison D, Wilson A, Robson A,
Mulcahy C, et al. Doctors’ and nurses’ perceptions of
interdisciplinary collaboration in the NICU, and the impact
of a neonatal nurse practitioner model of practice. J Clin Nurs
2004;13:105-13.
38. Pasyar N, Sharif F, Rambod M. Nurses and physicians’
collaborative behaviors in intensive care units. Sadra Med Sci J
2017;5:239-49.
39. Barrere C, Ellis P. Changing attitudes among nurses and
physicians: A step toward collaboration. J Healthc Qual
2002;24:9-15.
40. Flin R, Yule S, McKenzie L, Paterson-Brown S, Maran N.
Attitudes to teamwork and safety in the operating theatre.
Surgeon 2006;4:145-51.
41. Mahmoodian F, Jafari S, Keshmiri M, Azimi A, Vosoughi M.
Nurses’ experiences about the challenges of nurse-physician
professional relationships, in 1390. Sadra Med Sci J
2014;2:31-42.
42. Santos JL, Lima MA, Pestana AL, Colomé IC, Erdmann AL.
Strategies used by nurses to promote teamwork in an emergency
room. Rev Gaucha Enferm 2016;37:e50178.
43. Vafadar Z, Vanaki Z, Ebadi A. Interprofessional education
a response to health system challenges. Iran J Med Educ
2014;14:148‑64