MAIN DISCUSSION POST:
The first incident involves an oncology patient who is wanting to stop all treatments. The patient is a 65-year-old female who wants to spend her time with her family at home. The patient is no longer interested in doing any treatment. The family is upset and wants the patient to continue with her treatments, but the patient is tired and wants better life quality. The collaborators are the oncology physician, social workers, and hospice care/palliative care team. The setting is a hospital with many inpatient units, infusion centers, and radiation therapy centers. The goal for this particular patient is to give the patient a better quality of life at home. The family feels that hospice care is a death sentence and needs the physician and the treatment team to explain to the family the purpose of palliative care with hospice. The oncology physician is the leading physician in the case of the patient. The social workers help with getting referrals made to hospice and setting up home care for the patient. The hospice nurses are there to help answer any questions the patient or family might have concerning palliative care.
The second incident involves a 75-year-old man who has cancer and wants all treatment types to prolong his life. The patient has young children and mentioned that he wants to live long enough to watch his oldest son graduate from high school. The patient is married and has three young children under the age of 16. The patient is admitted to an inpatient unit in the hospital and has a hospitalist attending the patient’s case. The admitting physician consulted the oncologist for referring all treatment regimens. The patient and the wife’s goal is all types of treatments to help the patient have more time with family. Social workers are working on the patient’s case to provide home care and get that set up for the patient at home. The patient receives his first doses of chemotherapy and will continue to get his chemotherapy at an infusion center. The collaborators are the oncologist, oncology advanced practice nurse, the attending physician, social workers, and a pharmacist.
Contrasting, Comparing, and Similarities of the two Interactions
What was alike between the two incidents is that they involved patients who wanted their wishes to be advocated. Both of these patients were oncology patients who had very little time to live. Both patients wanted to have a better quality of life, and both wanted the patient to live longer. There were treatment teams involved in both of these incidents.
What was different between the two of these incidents is that the families were not on the same page as the patient. One of the families wanted the patient to prolong treatment to promote longer life; the patient did not want to continue treatments. The other family wanted the same goal for the patient. They were on the same page as the patient. The patient that wanted to prolong his lifespan was willing to try novel treatments. The other was not wanting to try any more treatments. One family understood palliative treatment goals, and the other family did not understand palliative treatment goals.
Ultimately, the patients’ goals were better quality of life and control of their cancer or medications’ unsavory side effects. Moreover, both families were willing to help the patient succeed in their treatment regimen. The oncology patient needed to be advocated for by the treatment team regarding their wishes. Moreover, the families and the patient needed to understand the importance of palliative treatment for both of these circumstances.
One Suggestion/Practice as to how Poor Collaboration Could be Improved
One suggestion that could help with improving Interdisciplinary Professional Collaboration (IPC) is having education for healthcare professionals. Setting up scenarios for healthcare professionals to work through in developing their communication with each other is one suggestion. The better the healthcare team can collaborate and communicate with each other will improve the outcomes for the patient. Having effective and clear communication regarding the care of the patient will help the patient’s overall well-being. Many healthcare professionals have said they lack effective communication skills to collaborate efficiently with other healthcare professionals from varying backgrounds. Since healthcare professionals come from different backgrounds, it can lead to barriers to collaboration. All healthcare professionals must know how to communicate and work together to help the patient improve their health. Moreover, oncology patients can have nurses, oncology specialty, hospice, therapy teams, and social workers for the patient or setting up a treatment regimen. (James, Page, & Sprague, 2016; Moss, Seifert, & O’Sullivan, 2016; Prentice, Engle, Taplay, & Stobbe, 2015).
James, T.A., Page, J.S., & Sprague, J. (2016). Promoting Interprofessional Collaboration in Oncology Through a Teamwork Skills Simulation Programme. Journal Of Interprofessional Care, 30(4), 539-541. https://doi.org.ezp.waldenulibrary.org/10.3109/13561820.2016.1169261
Moss, E., Seifert, P. C., & O’Sullivan, A. (2016). Registered Nurses as Interprofessional Collaborative Partners: Creating Value-Based Outcomes. OJIN: The Online Journal of Issues in Nursing, 21(3), 4. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol21No03Man04
Prentice, D., Engel, J., Taplay, K., & Stobbe, K. (2015). Interprofessional Collaboration: The Experience of Nursing and Medical Students’ Interprofessional Education. Global Qualitative Nursing Research, 2, 1-9. https://doi-org.ezp.waldenulibrary.org/10.1177/2333393614560566
REPLY QUOTE EMAIL AUTHORWeek 9 Main Discussion Post-ReyesBuniL
This week’s discussion delves into interprofessional collaboration (IPC), its definition, and IPC’s significance in practice. This paper aims to describe IPC and its outcome through two scenarios in the Primary care clinic.
Prentice et al. (2015) describe IPC “as practice and education where individuals from two or more professional backgrounds meet, interact, learn together, and practice with the client at the center of care” (p.1). However, Campoe (2020) states that IPC is a “tool nurses use to build success, bringing recognition to the nursing profession via respect, trust, ethical communication, and collaboration” (p.297).
Patients also seek their primary care provider for preoperative medical clearance. The first scenario involves Team A’s patient, who had to reschedule his surgery since his provider could not medically clear him. The medical assistant scheduled the appointment without retrieving the preop documents and failed to communicate to the team this patient’s reason for scheduling the visit. The nurse does not scrub the appointment list, and the team does not huddle daily to review their upcoming visits. The patient completed preoperative blood work and EKG during the appointment, and a cardiology referral was indicated due to an abnormality in the EKG. The procedure had to be canceled pending medical and cardiac clearance. The patient verbally expressed his discontent and frustration over the handling of his care.
The second scenario involves Team C’s patient requiring preoperative medical clearance. The medical assistant scheduled the visit after receiving the preoperative documents from the surgical and anesthesia teams, which she forwarded a copy to the nurse and the provider. The provider ordered the blood work and EKG required, which the patient completed a week before the scheduled visit. During one of the team’s daily huddles, the provider and nurse reviewed the results and established the care plan. The patient was medically cleared by the provider, and all documents were sent to the surgical team. The patient’s surgical procedure was performed as scheduled.
The scenarios described above actually happened in the Primary care clinic and involved patients who receive medical care from two different providers. The primary care team is composed of the provider, the nurse, and the medical assistant. The scenarios highlight the importance of communication and respect for another’s knowledge and skills to provide timely and high-quality and safe patient care.
Josi et al. (2020) reported on the outcome of their ethnographic study on IPC practice between advanced practice nurses, registered nurses, and medical practice assistants. The authors utilized semi-structured interviews and observations and concluded that role clarification, team functioning, collaborative leadership, interprofessional conflict resolution, patient-centered care, and interprofessional communication significantly influence IPC collaboration among health professionals (Josi et al., 2020, pp. 10-11).
Adams & Feudale (2020) state that “communication error result in poor patient outcomes” (p229). Huddle is a form of communication to enhance IPC practice, which offers learning opportunities, information sharing, establishing accountability, developing trust, and mutual respect (McBeth et al., 2017, p. 71). Therefore, communication in IPC practice is essential in building trust and comfort in nursing and improving the quality of care, patient satisfaction, and adherence to care, leading to positive health outcomes (Afriyie, 2020, p. 438). Also, the Interprofessional Education Collaborative Expert Panel (2011) reported that communication is a core aspect of IPC practice and must be conducted “responsively and responsibly to support the team approach to maintaining the health and treatment of disease” (p.23).
Adams, H. A. (2018). Implementation of a Structured Rounding Tool for Interprofessional Team Rounds to Improve Communication and Collaboration in Patient Care. Pediatric Nursing, 44(5), 229-246. Retrieved from https://doi-org.ezp.waldenulibrary.org.
Afriyie, D. (2020). Effective communication between nurses and patients: an evolutionary concept analysis. British Journal of Community Nursing, 25(9), 438-445. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.12968/bjcn.2020.25.9.438.
Campoe, K. (2020). IPC during COVID. MEDSURG Nursing, 29(5), 297-298. Retrieved from https://doi-org.ezp.waldenulibary.org.
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. American Association of Colleges of Osteopathic Medicine. Retrieved from https://www.aacom.org/docs/default-source/insideome/ccrpt05-10-11.pdf?sfvrsn=77937f97_2.
Josi, R., Bianchi, M., & Brandt, S. K. (2020). Advanced practice nurses in primary care in Switzerland: an analysis of interprofessional collaboration. BMC Nursing, 19(1), 1-12. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1186/s12912-019-0393-4.
McBeth, C. L. (2017). Interprofessional Huddle: One Children’s Hospitals’ approach to improving patient flow. Pediatric Nursing, 43(2), 71-95. Retrieved from https://doi-org.ezp.waldenulibrary.org.
Prentice, D., Engel, J., Taplay, K., & Stobbe, K. (2015). Interprofessional collaboration: The experience of nursing and medical students’ interprofessional education. Global Qualitative Nursing Research, 2. Retrieved from https://doi.org/10.1177/2333393614560566.
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