Integrated nursing: a review of the literature

Abstract

Limited research suggests that successful implementation of integrated nursing increases perceptions of overall primary health care team functioning. This paper reviews those studies and also reports on the findings of relevant studies of teamwork in the wider primary care context. Effective teamwork is essential if the concept of a primary care-led NHS is to become a reality. Achieving effective teamwork however is fraught with difficulties and requires skilled facilitation to overcome obstacles such as fear of change, professional jealousies and diverse lines of accountability. The facets of good teamwork include a high level of participation by all members, support for innovation, clarity of team objectives, task orientation and mutual role understanding. The diversity of problems encountered in primary care makes auditing the collective work of teams very difficult. As a result, most research in nursing and primary health care teams has concentrated on team process rather than outcome. Efforts should now be channelled into refining existing methods of evaluation and developing new outcome measures.