The purpose of this study is to explore leadership and interprofessional team learning in well-established specialist teams in an academic health care organization. It also illuminates the data with more precise team leadership theories to help advance interprofessional health care practice. Employing an interactionist ethnographic approach, the study focuses on exploring team leaders’ role, their perceptions, meanings, and behaviours within the culture of two teams in the department of nephrology in an academic health care organization. Qualitative data derived from interviews, observations, and documents were gathered over a two-year period to obtain a comprehensive understanding of the workings of the teams. The research is also informed by the experiences of the researcher who had been a member of the department of nephrology under study. Data analysis involved an inductive thematic analysis of observations, reflections, and interview transcripts. The three broad themes of this dissertation reflect the characteristics and activities of leaders of team learning: first, situational team leadership, as a process, affects the social context of interprofessional team-learning relationships, interactions, and activities within the complex culture of an academic health care organization. Second, team learning embodies the collective praxis of its members. The members inform the role of leading learning through the social construction of meaning in dialogue and their reflective practices. Third, effective team leadership ensures the transfer of collective knowledge to students and trainees. Effective leaders also help team members deal with the challenge of learning how to work within a well-established, specialized health care team as community of practice. Such a team has special capabilities that enable interprofessional team learning. Hence, a leader who learns how to use team learning to create new and collective knowledge will be able to create a learning experience for students, trainees, and team members who are focused on interprofessional practice and care. This study offers a contribution to the interprofessional education literature in two ways. First, the study’s use of theoretical perspectives provides new ways of thinking about leaders and learning in interprofessional communities of practice. Second, the study provides a rare empirical in-depth account of, interprofessional team leadership within well-established specialized teams in an academic health care organization.

The purpose of this study is to explore leadership and interprofessional team learning in well-established specialist teams in an academic health care organization. It also illuminates the data with more precise team leadership theories to help advance interprofessional health care practice. Employing an interactionist ethnographic approach, the study focuses on exploring team leaders’ role, their perceptions, meanings, and behaviours within the culture of two teams in the department of nephrology in an academic health care organization. Qualitative data derived from interviews, observations, and documents were gathered over a two-year period to obtain a comprehensive understanding of the workings of the teams. The research is also informed by the experiences of the researcher who had been a member of the department of nephrology under study. Data analysis involved an inductive thematic analysis of observations, reflections, and interview transcripts. The three broad themes of this dissertation reflect the characteristics and activities of leaders of team learning: first, situational team leadership, as a process, affects the social context of interprofessional team-learning relationships, interactions, and activities within the complex culture of an academic health care organization. Second, team learning embodies the collective praxis of its members. The members inform the role of leading learning through the social construction of meaning in dialogue and their reflective practices. Third, effective team leadership ensures the transfer of collective knowledge to students and trainees. Effective leaders also help team members deal with the challenge of learning how to work within a well-established, specialized health care team as community of practice. Such a team has special capabilities that enable interprofessional team learning. Hence, a leader who learns how to use team learning to create new and collective knowledge will be able to create a learning experience for students, trainees, and team members who are focused on interprofessional practice and care. This study offers a contribution to the interprofessional education literature in two ways. First, the study’s use of theoretical perspectives provides new ways of thinking about leaders and learning in interprofessional communities of practice. Second, the study provides a rare empirical in-depth account of, interprofessional team leadership within well-established specialized teams in an academic health care organization.

The purpose of this DNP project was to determine the feasibility of implementing a nurse practitioner led interprofessional collaborative management model of caring for patients with complex medical conditions who are at high risk for ED and hospital readmission. The target of the feasibility study was an accountable care organization (ACO) in Idaho. The ACO assumes greater financial risk for providing care to a population that includes Medicare Advantage patients - dual insured Medicare/Medicaid patients. The care management teams are currently led by physicians. The members of the population that suffer most from multiple chronic conditions often encounter barriers to accessing high quality primary care, in particular when transitioning between different levels of care. Interprofessional collaborative team based care coordination can address medical and social issues that can affect a patient’s ability to achieve/maintain wellness. The literature suggests that nurse practitioners are ideally suited to lead those teams Approval was given by leadership in the ACO to accomplish a study to determine the feasibility of successfully implementing an innovative NP led interprofessional collaborative care management model: the AEIØOU Bundle of Care Practices. Principles of qualitative descriptive methodology, using content analysis, were applied to explore the responses provided at individual interviews by thirteen key stakeholders. The data collected were not intended to be generalized, but rather to evaluate the potential for implementation of a new model of interprofessional collaborative care within the ACO. Findings suggest that implementation of this model is feasible within the ACO. Common themes uncovered include: (a) change is challenging, (b) coordinated patient care aligns with organizational goals, (c) success requires cost analysis, a comprehensive business plan, buy-in from primary care physicians, and a pilot program, and (d) strong support among all participants for NP and RN home visits was notable.

As a result of rapid development in Emergency Medicine and Intensive Care the patients with brain damage have better chances of surviving than they had in the past. However the survivors need to deal with severe loss of function and consequences resulting from that. An excellent primary care for patients who suffer from strok is provided in Czech Republic, the rehabilitation on the other hand is insufficient. The main problem is an absence of continuity of care which leads to aneffective outcomes and increase of total costs of treatment The purpose of this diploma theses was to evaluate the possibilities of occupational therapist of interprofessional collaboration in community based rehabilitation - in client's home environment. There are several categories of brain damage including acquired brain injury, genetic brain disorders and brain damage acquired during labor. The goal was to detect basic deficient fields. Results of this thesis based on knowledge from foreign literature as well as own experiencis in the team. Results might be used as basis for designed guidelines to improve situation. One client with degenerative brain disorder and five with acquired brain injury which live in home environment were selected. Three months long therapy was provided to them, occupational therapist as case...

Skilled home health care (HH) is the largest and fastest growing long-term care setting in the United States. Patients in HH are served by an interprofessional team, and may have little direct contact with physicians, when discussing their progress, prognosis, and goals of care. Such conversations are part of primary palliative care communication. Evidence on primary palliative care communication training in the non-physician HH interprofessional team is lacking. The objectives of this study were to assess the feasibility, acceptability, and preliminary effectiveness of using a palliative care communication model known as COMFORT© to provide palliative care communication training to HH staff. A randomized controlled trial was conducted at a regional health system in the southeastern U.S. to test online training modules (n = 10) (Group 1) and online training modules plus face-to-face training (n = 8) (Group 2). Measures included training completion rates, staff acceptability ratings, comfort with palliative and end-of-life communication (C-COPE) and moral distress (MMD-HP). Results showed that COMFORT© training was feasible (92%), highly acceptable (>4 on a 6-point scale), and positively correlated with improved C-COPE scores (P = .037). There was no significant difference in moral distress scores pre- and post-intervention or in effectiveness between the groups. However, acceptability of COMFORT© was positively correlated with history of leaving or considering leaving a job due to moral distress ( χ 2 = 7.6, P = .02). Preliminary findings from this pilot study suggest that administration of COMFORT© training was feasible, and it was correlated with increased HH staff comfort with palliative care communication.

Sjölin, C. Träning för bättre samarbete. En litteraturstudie om simulering som verktyg för att förbättra teamarbetet i akuta situationer. Examensarbete i omvårdnad 15 högskolepoäng. Malmö högskola: Hälsa och samhälle. Institutionen för vårdvetenskap, 2014.Bakgrund: En Intensivvårdssjuksköterska ska kunna samarbeta i ett team kring den akut sjuka patienten och för att teamet ska fungera behöver inte bara tekniska färdigheter utan även icketekniska så som kommunikation, ledarskap och att ta sin roll i teamet utvecklas. Syftet med denna litteraturstudie var att undersöka hur simuleringsövningar påverkar teamarbetet i akuta situationer. Metod: Litteratur har sökts via Cinahl, Pubmed och the Cochrane librery, sökord som användes var bland annat intensive care, critical care, interprofessional, teamwork, inservice training och simulation. Resultatet visar att direkt efter simulering uppnås förbättringar inom kommunikation, rolluppfyllnad och självförtroendet förbättras, men några artiklar visar att om förbättringen ska befästas bör upprepade simuleringar ske.Nyckelord: Intensivvård, Interprofessionella team, litteraturstudie, simuleringsövning, Teamwork / Sjölin, C. Training for better teamwork. A literature review of simulation as a tool to improve teamwork in emergency situations. Degree project, 15 credit points. Malmö University: Health and society, Department of Nursing, 2014.Background: A Critical Care Nurse needs to collaborate in a team around the acute ill patient and for the team to function requires not only technical skills but also non-technical such as communication, leadership and to take the role as a team member. The Purpose of this study was to investigate how simulation training affect teamwork in emergency situations. Method: The literature has been reviewed using Cinahl, Pubmed and the Cochrane library. The search terms among others were intensive care, critical care, interprofessional teamwork, inservice training and simulation. The Result: Directly after simulation the results show improvements in communications, assuming a role and confidence. For sustainable results there is a need for repeated training. Keywords: Intensive care, Interprofessional team, Review, Simulationtraining, Teamwork

Bakgrund: Typ 1-diabetes en av de vanligaste, svåra kroniska sjukdomarna bland barn och ca 8000 barn i Sverige är drabbade. Vid insjuknande får barnen kontakt med tvärprofessionella diabetesteam, en kontakt de behåller till 18 årsdagen. Det finns flera fördelar med teamarbete och de tvärprofessionella teamen uppskattas av både personal, patienter och anhöriga. Teamets kompetens och sammansättning har en stor betydelse kring vården för familjerna. Motiv: Målet är att bidra med en ökad förståelse av det stöd tvärprofessionella team kan bidra med samt eventuellt finna förslag på utvecklings- och förbättringsarbete inom diabetesvården. Syfte: Syftet med studien är att belysa föräldrars upplevelse av stöd från tvärprofessionella diabetesteam. Metod: En kvalitativ intervjustudie. Resultat: Föräldrarnas erfarenheter av diabetesteamets stöd genomsyrades av positivitet, men visade även en viss brist på föräldrastöd. Intervjuernas resultat mynnade ut i 3 huvudkategorier; ”Stödjande relation”, ”Stöd i lidande” och ”Stöd i vardagen”. Konklusion: För att möta upp föräldrarnas behov av stöd krävs en förändring kring diabetesteamens arbete. En mer individanpassadomvårdad, där även föräldrars psykosociala behov inkluderas vilket gynnar hela familjen. / Background: Type 1-diabetes is one of the most common, severe chronic diseases among children and about 8000 children in Sweden are affected. When the children get sick, they get in touch with interprofessional diabetes team, a contact they keep until their 18th birthday. There are several benefits to teamwork and the interprofessional teams are appreciated by staff, patients, and relatives. The team’s competence and composition are of great importance in the care of the families. Motive: The goal is to contribute with an increased understanding of the support that interprofessional teams can contribute with and possibly find proposals for development and improvement work in diabetes care. Aim: The aim of the study is to find out parent’s experience of the support from the diabetes team.Methods: A qualitative interview study.Result: The parent´s experiences of the diabetes team´s support was permeated by positivity, but also showed a certain lack of parental support. The results of the interviews resulted in 3 main categories: “Supportive relationship”, “Support in suffering” and “Support in everyday life”.  Conclusion: To meet the parent´s need for support, a change in the work of the diabetes team is required. A more individualized care, where parent´s psychosocial needs are also including, which benefits the whole family. / <p>Presenationen genomfördes via zoom, anordnad av Instutionen för omvårdnad, Umeå Universitet</p>

Bakgrund: Sjuksköterskan ska kunna samverka i team där flera vårdprofessioner är delaktiga, så kallade interprofessionella team. För att kunna lära sig arbeta i ett interprofessionellt team kan interprofessionellt lärande vara till hjälp. En läraktivitet som används vid interprofessionellt lärande är simuleringar, där studenter från olika vårdutbildningar kan samlas i ett team och arbeta med ett iscensatt patientfall. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskestudenters upplevelser av interprofessionella simuleringar.  Metod: Litteraturstudien baserades på tolv vetenskapliga artiklar med kvalitativ ansats. Litteratursökningarna som låg till grund för arbetet gjordes i databaserna CINAHL och PubMed. De vetenskapliga artiklarna granskades enligt en granskningsmall för kvalitativa studier och innehållet analyserades. Resultat: I resultatet framkom tre teman om sjuksköterskestudenternas upplevelser: interprofessionella team, roller, och lärsituation. Alla tre teman hade två subteman, vilket resulterade i totalt sex subteman.  Slutsats: Flertalet sjuksköterskestudenter upplevde de interprofessionella simuleringarna som en positiv erfarenhet, som gav möjligheten att lära om teamarbete, kommunikation samt den egna rollen och andras roller i teamet. / Background: Nurses are required to be able to work within a team. Within healthcare these teams are oftentimes interprofessional, where a multitude of healthcare professions are working together. Learning how to work in interprofessional teams is aided by interprofessional education. One activity often used in interprofessional education are simulations, where students from different professions gather and work together on a staged patient case.  Aim: The aim of this study was to describe nursing students’ experiences of interprofessional simulations. Method: This literature study used twelve scientific articles with a qualitative study design. The included articles were found in two databases, CINAHL and PubMed. The scientific papers were reviewed using a template for reviewing qualitative articles and then the content was analyzed.  Results: Three themes related to nursing students’ experiences were found in the result, interprofessional teams, roles and learning situation. Each theme had two subthemes, resulting in a total of six subthemes.  Conclusion: The nursing students who participated in simulations within interprofessional education had mainly positive experiences. These experiences were summarized as improved communication skills, improved understanding of teamwork as well as an improved understanding of their own and other’s roles within the team.

Bakgrund Att förlösas med kejsarsnitt fortsätter att öka internationellt och något nationellt och är även förenligt med risker. Kejsarsnittsfrekvensen varierar stort i Sveriges olika län och tros delvis bero på att kriterier och rutiner för kejsarsnitt skiljer sig åt. Syfte Att beskriva hur operationssjuksköterskans roll i det interprofessionella teamet vid kejsarsnitt framställs i riktlinjer vid svenska sjukhus som utför kejsarsnitt Metod En totalundersökning av Sveriges sjukhus riktlinjer vid kejsarsnitt ledde till att en tvärsnittsstudie med kvantitativ deskriptiv design användes. Riktlinjerna färgkodades utifrån ett systemteoretiskt perspektiv och en granskningsmall gjordes för att enhetligt kunna beskriva hur operationssjuksköterskans roll framställs i respektive riktlinje. Ett reliabilitetstest på mallen gjordes och Cronbach’s alfa beräknades till 0,891. Resultat 29 av 41 av Sveriges sjukhus som utför kejsarsnitt är representerade i studien. Operationssjuksköterskans roll identifierades slutligen utifrån fyra strukturer; direkt omnämnd, indirekt omnämnd, del i det interprofessionella teamet och beskriven utifrån variabler. Vid analys av riktlinjerna utifrån granskningsmallen, framkom det att i elektiva riktlinjer var det 4 sjukhus som hade över 75 % av variablerna i sina riktlinjer, vid akuta 8 och urakuta 11. Slutsats Riktlinjerna är mer samstämmiga i beskrivningen av operationssjuksköterskans roll vid urakuta riktlinjer dock inte alltid med en arbetsbeskrivning. En tydlig framställning av operationssjuksköterskans roll skulle kunna uppnås genom att använda variabler i den framtagna granskningsmallen och därmed bidra till ökad patientsäkerhet och mer likvärdig vård. / Background Cesarean delivery continues to increase internationally and somewhat nationally and also includes risks. The frequency varies greatly in Sweden's counties and is believed to be partly due to that the criteria and routines for cesarean sections differ. Aim To describe how the operating room nurse in the interprofessional team in cesarean section is stated in guidelines at Swedish hospitals that perform cesarean sections.  Method A total survey of Sweden's hospital guidelines for cesarean sections led to the use of a cross-sectional study with a quantitative descriptive design. The guidelines were color-coded based on a systems theory perspective and a review template was made to be able to uniformly describe how the operating room nurse is presented in each guideline. A reliability test on the template was done and Cronbach's alpha was calculated to be 0.891. Result 29 of 41 of Sweden's hospitals that perform cesarean sections are represented in the study. The operating room nurse was ultimately identified based on four structures; directly mentioned, indirectly mentioned, part of the interprofessional team and described based on variables. When analyzing the guidelines based on the review template, it emerged that in elective guidelines, there were 4 hospitals that had over 75 percent of the variables in their guidelines, in acute 8 and in emergency 11.  Conclusion The guidelines are more consistent in the description of the operating room nurse in emergency procedures, although not always with a work description. A clear presentation of the operating room nurse could be achieved by using variables in the developed review template and thus contribute to increased patient safety and more equal care.

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