Interprofessional Intervention Research Articles

Capability to identify and manage critical conditions: effects of an interprofessional training intervention

BackgroundThe burden of critical illness is a global issue. Healthcare systems often fail to provide essential emergency and critical care for deteriorating patients, and the optimal strategy for ensuring safe care is not fully known. This study aimed to explore the capability to identify and manage critical conditions and to evaluate how an interprofessional training intervention that included theory as well as high-fidelity simulation (proACT) in the short and long term affected the capability.MethodsA questionnaire study was performed. A cross-sectional survey of all in-hospital nurses and physicians in a Swedish region (n538) and a longitudinal cohort of participants entering the proACT course during a six-month period (n99) were included. Descriptive and comparative statistics were generated. Additionally, qualitative content analysis was performed for free text answers.ResultsThe findings demonstrated that the intervention improved the individual healthcare professionals’ competence with a sustained effect over time. The coverage of proACT trained staff increased from 13.2% to 26.5%, but no correlation was observed with workplace conditions that support safe care. Collaboration and workplace climate were perceived to be mainly positive, but for safer care, an overall need for improved competence and staffing was emphasized.ConclusionsThe present study confirms previously identified issues and the need for improvements in the care of critically ill patients in general hospital wards. It supports the notion that a training intervention, such as proACT, can increase the capability to identify and manage patients with critical conditions. All healthcare professions increased the competence. Hence, more effort is needed to enable staff of all professions to participate in such training. Studies of interventions cover higher number of trained staff in the setting are warranted to clarify whether the training can also improve workplace conditions that support safe care of deteriorating and critically ill patients.

Evaluating pre-and post-oral health literacy of undergraduate nursing students on an oral-systemic health learning intervention.

Oral health is significantly linked with systemic health. Nurses play a crucial role in patient education. Improving oral health literacy in nursing students can pave the way for the seamless integration of oral health into nursing practice. This study aimed to evaluate an interprofessional co-designed oral-systemic health learning intervention using a pre-and-post study design that measured oral health literacy levels among Year 2 undergraduate nursing students. Evaluation was measured using the validated Comprehensive Measure of Oral Health Knowledge questionnaire before and after the semester-long education intervention. Data were analyzed using independent and paired t-tests and an analysis of variance one-way analysis of variance. A total of 78 out of 164 students (82% female, 42% aged 21-24, and 52% speaking English as a first language) participated in the pre- and post-study surveys. Statistically significant improvement was noted in pre-and-post total oral health literacy scores (Pre 14.92 [3.85] vs.. Post 15.85 [3.74], p=0.031). Students showed the highest proficiency in the domain of oral disease prevention, while oral cancer knowledge was the least mastered domain. Those without English as their first language and those with secondary education as the highest qualification showed the greatest improvement in oral health literacy scores post-intervention. This study highlights the efficacy of an interprofessional co-designed oral-systemic educational intervention in increasing oral health literacy among undergraduate nursing students. This intervention marks a preliminary step towards integrating oral health into future nursing practice. Further research is warranted to explore the enduring impact of these interventions on their future clinical endeavors.

Improving measurement of functional status among older adults in primary care: A pilot study.

Despite its importance for clinical care and outcomes among older adults, functional status-the ability to perform basic activities of daily living (ADLs) and instrumental ADLs (IADLs)-is seldom routinely measured in primary care settings. The objective of this study was to pilot test a person-centered, interprofessional intervention to improve identification and management of functional impairment among older adults in Veterans Affairs (VA) primary care practices. The four-component intervention included (1) an interprofessional educational session; (2) routine, standardized functional status measurement among patients aged ≥75; (3) annual screening by nurses using a standardized instrument and follow-up assessment by primary care providers; and (4) electronic tools and templates to facilitate increased identification and improved management of functional impairment. Surveys, semi-structured interviews, and electronic health record data were used to measure implementation outcomes (appropriateness, acceptability and satisfaction, feasibility, fidelity, adoption/reach, sustainability). We analyzed qualitative interviews using rapid qualitative analysis. During the study period, all 959 eligible patients were screened (100% reach), of whom 7.3% (n = 58) reported difficulty or needing help with ≥1 ADL and 11.8% (n = 113) reported difficulty or needing help with ≥1 IADL. In a chart review among a subset of 50 patients with functional impairment, 78% percent of clinician notes for the visit when screening was completed had content related to function, and 48% of patients had referrals ordered to address impairments (e.g., physical therapy) within 1 week. Clinicians highly rated the quality of the educational session and reported increased ability to measure and communicate about function. Clinicians and patients reported that the intervention was appropriate, acceptable, and feasible to complete, even during the COVID pandemic. These findings suggest that this intervention is a promising approach to improve identification and management of functional impairment for older patients in primary care. Broader implementation and evaluation of this intervention is currently underway.

A Pediatric Interprofessional Cardiac Intensive Care Unit Intervention: CICU Teams and Loved Ones Communicating (CICU TALC) is Feasible, Acceptable, and Improves Clinician Communication Behaviors in Family Meetings.

Parents of children in the pediatric cardiac intensive care unit (CICU) are often unprepared for family meetings (FM). Clinicians often do not follow best practices for communicating with families, adding to distress. An interprofessional team intervention for FM is feasible, acceptable, and positively impacts family preparation and conduct of FM in the CICU. We implemented a family- and team-support intervention for conducting FM and conducted a pretest-posttest study with parents of patients selected for a FM and clinicians. We measured feasibility, fidelity to intervention protocol, and parent acceptability via questionnaire and semi-structured interviews. Clinician behavior in meetings was assessed through semantic content analyses of meeting transcripts tracking elicitation of parental concerns, questions asked of parents, and responses to parental empathic opportunities. Logistic and ordinal logistic regression assessed intervention impact on clinician communication behaviors in meetings comparing pre- and post-intervention data. Sixty parents (95% of approached) were enrolled, with collection of 97% FM and 98% questionnaire data. We accomplished > 85% fidelity to intervention protocol. Most parents (80%) said the preparation worksheet had the right amount of information and felt positive about families receiving this worksheet. Clinicians were more likely to elicit parental concerns (adjusted odds ratio = 3.42; 95%CI [1.13, 11.0]) in post-intervention FM. There were no significant differences in remaining measures. Implementing an interprofessional team intervention to improve family preparation and conduct of FM is locally feasible, acceptable, and changes clinician behaviors. Future research should assess broader impact of training on clinicians, patients, and families.

The effectiveness of interprofessional peer-led teaching and learning for therapeutic radiography students and Speech and Language Therapy students.

Therapeutic Radiographers (RT) and Speech and Language Therapists (SLT) work closely together in caring for people with head and neck cancer and need a strong understanding of each others' roles. Peer teaching has been shown to be one of the most effective methods of teaching; however, no studies to date, have involved RT and SLT students. This research aims to establish the effectiveness and perceptions of peer-led teaching between undergraduate RT and SLT students in Ulster University. Twenty SLT students and 14 RT students participated. Knowledge tests were taken online before the peer-led teaching session (T1), after the session (T2) and 3 months later (T3). Students' perceptions of the experience were collected at the end of the session. Wilcoxon signed-rank tests were used to analyse the impact of the intervention on knowledge scores. Qualitative content analysis was used for open text response data. RT students' own professional knowledge score at T2 was statistically significantly higher than the score at T1; the score at T3 was not deemed to be statistically significantly higher. RT students' SLT knowledge score at T2 and T3 was found to be statistically significantly higher than the score at T1. SLT students' own professional knowledge score was not statistically significantly higher at T2 or T3 than T1. They did have a statistically significantly higher score at T2 on the RT test, but score at T3 was not deemed to be statistically significantly higher. The majority of students across both professions agreed or strongly agreed that the peer-led teaching experience had a positive impact on their learning. This investigation highlights the benefits of an interprofessional peer-led teaching intervention for RT and SLT students and the findings add to the evidence of more objective study of knowledge gain as a result of interprofessional peer teaching.

Interprofessional follow-up for people at risk of type 2 diabetes in primary healthcare – a randomized controlled trial with embedded qualitative interviews

Objective To examine the effects of an empowerment-based interprofessional lifestyle intervention program among people at risk of type 2 diabetes on knowledge, skills, and confidence in self-management, health, psychological well-being, and lifestyle characteristics, and to explore the participants’ perceptions of participating in the intervention. Design and methods In line with the Medical Research Council complex interventions research methods framework, we conducted a randomized controlled trial with embedded qualitative interviews in primary healthcare clinics in Norway between 2019–2021. Of the patients at risk (The Finnish Diabetes Risk Score Calculator (FINDRISC) ≥15 or Body Mass Index (BMI) ≥30) 142 accepted the invitation, and 14 participants from the intervention group participated in individual interviews after the 12-month follow-up. Our primary outcome was the Patient Activation Measure (PAM-13). Secondary outcomes were EQ-5D-5L, EQ-VAS, WHO-Overall health, WHO-Overall QOL, weight, height, waist circumference, and regularity of physical activity. We used thematic analysis to analyse the qualitative data. Results There was no clinically relevant differences of neither the primary nor the secondary endpoints between intervention and control group. As to the qualitative data, we identified two distinct features: ‘Meaningful perspectives on lifestyle changes’ and ‘Lifestyle change is not a linear process due to challenges faced along the way’ putting ownership of their choices in life into picture. Conclusion The negative results of the RCT stand in contrast to the findings given by the participants voices, perceiving the intervention as a key eye opener placing their health challenges in perspective. How to interpret these seemingly conflicting findings of participants being seen, heard, and understood, helping them to take more conscious ownership of their choices in life, and at the same time demonstrating no improvements in symptoms or measures, is a dilemma that needs further exploration. We should be careful to implement interventions that do not demonstrate any effects on the quantitative outcomes.

(333) - A Curricular Interprofessional Intervention Can Reduce Depression Symptoms in MCS Patients - A Multi-Center, Randomized Controlled Trial

(333) - A Curricular Interprofessional Intervention Can Reduce Depression Symptoms in MCS Patients - A Multi-Center, Randomized Controlled Trial

Teaming Up for Community Health Simulation Intervention: A Quasi-Experimental Study.

The aim of this study was to examine whether participating in a team-based simulation intervention would improve nursing students' empathy and commitment to addressing social determinants of health (SDOH) and interprofessional teamwork attitudes, beliefs, and behaviors. Outcomes were compared for intraprofessional versus interprofessional team participation. Nursing students must learn strategies to address SDOH, but this content is not well integrated in curricula. Teaming Up for Community Health was created to provide SDOH experiential team learning. Eighty-five nursing students participated in the intraprofessional comparison group or interprofessional intervention group. Surveys were completed before and after the intervention and two months later. Participants had heightened empathy and commitment to addressing SDOH at baseline. Interprofessional teamwork beliefs and behaviors improved for both groups. Experiential learning about SDOH should focus on improving students' self-confidence and performance. Based on the study results, experiential team learning should be threaded through curricula.

Interprofessional collaboration skills and motivation one year after an interprofessional educational intervention for undergraduate medical and nursing students

BackgroundThe increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other?MethodsDuring a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence.ResultsIn the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group.ConclusionsThe perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.

Community responses to persons with aphasia participating in CoActive therapeutic theatre: A pilot study.

Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised. The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy. The interprofessional treatment program involved PWA participating in a therapeutic theatre program using the CoActive Therapeutic Theater (CoATT) while also receiving speech-language therapy. Each year, the PWA performed a different, original therapeutic theatre production for a public audience, at the culmination of their interprofessional treatment program. In this paper, we share data obtained from perspectives of audience members who witnessed the theatre production and aphasia education during the first year of the study and friends and family of PWA who participated in the therapeutic theatre process during the second year of the study. Responses from audience members who participated in aphasia education and witnessed the therapeutic theatre performance by the PWA during the first year, indicated an increased knowledge of aphasia. Friends and family members of PWA who witnessed their loved ones engaging in the CoATT process through interprofessional treatment, in the second year, reported that their loved ones benefited from the CoATT process, which was distinct from other therapeutic processes to their knowledge and that they were impacted by watching their loved one perform. These initial findings create footing towards understanding impact of therapeutic theatre in combination with speech-language therapy in the lives of PWA. They help us to obtain an initial appreciation of how therapeutic theatre and aphasia education help connect PWA and their community. What is already known on this subject Caregivers and communities at large play a significant role in and substantially impact the recovery of their loved ones (Dalemans etal., 2010; Grawburget etal., 2013; Kniepmann & Cupler, 2014) with aphasia. However, existing research suggests that persons with aphasia (PWA) are often misunderstood, isolated and infantilised by their communities. What this paper adds to existing knowledge The findings of our study reveal that friends, families and extended communities of PWA gain a positive and deep understanding of challenges experienced by PWA through therapeutic theatre supported by speech language therapy, based in a new CoActive Therapeutic Theatre (CoATT) model. This PWA community also agrees that therapeutic theatre in combination with speech-language therapy provides confidence and camaraderie between PWAs and strengthen connection between all constituencies. These results support the need for interprofessional intervention within the framework of a Life Participation Approach to Aphasia (LPAA). What are the potential or actual clinical implications of this work? Treatment paradigms that bring PWAs in contact with their communities using an LPAA approach can increase confidence and social engagement for PWAs potentially leading to better outcomes for their individual speech-language therapy as well as create means of educating communities about PWA, and their stories.

Inter-Professional Education Interventions, and Practice Outcomes Related to Healthcare Setting and Patients Within Mental Healthcare: A Scoping Review.

This scoping review aimed to examine 1) types of inter-professional (IPE) interventions using Strosahl's typology framework, 2) practice outcomes related to healthcare setting and patients using Kirkpatrick's model of training evaluation, and 3) enablers and challenges related to the effectiveness of IPE interventions specific to the mental healthcare setting in order to guide the development of such future programs. This scoping review was conducted in accordance with the methodology of the Joanna Briggs Institute for scoping reviews. Several databases were searched for relevant studies from database inception until December 2023. Articles were included if it 1) involved IPE interventions within mental healthcare, 2) reported practice outcomes related to healthcare setting and patients, and 3) was published in English. Variables of interest included the mode of IPE intervention using Strosahl's typology, enablers, and challenges related to IPE interventions. Overall, 16 studies were included. IPE intervention outcomes within healthcare setting related to shifts in practice culture, engagement with family members, and increased collaborations with other inter-professional groups. Reported patient outcomes included clinical improvements (e.g., reduced depression and anxiety, psychotropic drug use, better psychosocial functioning), patient empowerment, satisfaction, and confidence in treatment. The enablers and challenges included resource limitations, inter-professional group and individual participation, and pedagogy. Future efforts in IPE mental healthcare practice can focus on garnering sustained institutional support, identifying and investing in committed faculty, encouraging greater learner participation, and making iterative changes to the IPE program structure to facilitate involvement of inter-professional disciplines for better patient care.

Multi-modal mindfulness training and well-being for healthcare students

IntroductionMindfulness is a mental state attained through focusing awareness on the present with calm acceptance of thoughts, feelings, and bodily sensations. This study evaluated impact of mindfulness activities on well-being of pharmacy and other healthcare students. MethodsResearch participants completed pre- and post-intervention questionnaires evaluating multi-modal mindfulness interventions. Due to the pandemic, sessions led by a certified mindfulness instructor were offered live online and recorded, supplemented by a well-being mobile app and reflective discussion component. Four composite scales were administered to participants. The Brief Resilient Coping Scale (BRCS), Five Facet Mindfulness Questionnaire (FFMQ-15), Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and Depression Anxiety Stress Scales (DASS-21) inventories measured resilient coping skills, awareness, and psychological symptoms, including stress, depression, and anxiety. Exploratory factor analysis and Cronbach's alpha were used to determine scale reliability and validity. ResultsThirty-six participants completed both pre- and post-intervention questionnaires (n = 36). Significant improvement was found in well-being for BRCS, FFMQ-15, and WEMWBS measures (P < .05). Change in DASS-21 was not significant (P = .19). Mobile app use enhanced foundational mindfulness skills. Awareness, connection, and coping themes were identified from written comments. ConclusionsEvaluation of this multi-modal interprofessional intervention provides further evidence of benefits of mindfulness for pharmacy and other healthcare students. The mobile app and mindful movement with reflection improved all attributes measured by the composite scales. Further research may explore alternative multi-modal mindfulness interventions and incorporation into healthcare education curricula. Interprofessional collaboration is encouraged among faculty to enhance mindfulness while connecting healthcare professionals.

Needs Assessment of Residents and Nurses for Interprofessional Cross‐Cultural Curriculum

AbstractBackgroundClinicians must learn to care for patients from different cultures. They must also work in teams for optimal outcomes. Few studies have analysed the intersection of cross‐cultural care and interprofessional education. We completed a needs assessment to determine what paediatric residents and nurses view as essential cross‐cultural components.MethodsWe led a sequential mixed‐methods study of residents and nurses at an urban tertiary care centre. We administered the ‘Residency Training in Cross Cultural Care’ instrument. Survey results informed focus group interview guide development. Thematic analysis of qualitative data was conducted following the five stages to qualitative research framework.FindingsThirty‐five residents (70%) and 46 nurses (66%) completed the survey. Five residents and six nurses attended a focus group. Five themes resulted: 1) lack of clinician diversity and cross‐cultural training, 2) effective cross‐cultural care not always delivered, 3) multiple challenges for delivery of effective cross‐cultural care, 4) call to action for enhanced cross‐cultural education and 5) different cross‐cultural educational needs between nurses and residents.DiscussionResidents and nurses conveyed that meaningful cross‐cultural care education is imperative, lacking, and must offer skills to improve patient care. They call for a robust cross‐cultural curriculum that is up to date and teaches about intersectionality.ConclusionWe have used this data to implement interprofessional interventions to meet their unique learning needs and enhance upstander skills by using facilitated discussions of techniques, case studies and role plays. Ultimately, teaching all clinicians to care for patients of other cultures may lead to more equitable care.

Tailored implementation of the FICUS multicomponent family support intervention in adult intensive care units: findings from a mixed methods contextual analysis

BackgroundThe Family in Intensive Care UnitS (FICUS) trial investigates the clinical effectiveness of a multicomponent, nurse-led interprofessional family support intervention (FSI) and explores its implementation in intensive care units (ICUs). The local context of each ICU strongly influences intervention performance in practice. To promote FSI uptake and to reduce variation in intervention delivery, we aimed to develop tailored implementation strategies.MethodsA mixed method contextual analysis guided by the Consolidated Framework for Implementation Research (CFIR) was performed from March to June 2022 on eight ICUs assigned to the intervention group. ICU key clinical partners were asked to complete a questionnaire on CFIR inner setting measures (i.e., organizational culture, resources, learning climate and leadership engagement) and the Organizational Readiness for Implementing Change (ORIC) scale prior to group interviews, which were held to discuss barriers and facilitators to FSI implementation. Descriptive analysis and pragmatic rapid thematic analysis were used. Then, tailored implementation strategies were developed for each ICU.ResultsIn total, 33 key clinical partners returned the questionnaire and 40 attended eight group interviews. Results showed a supportive environment, with CFIR inner setting and ORIC measures each rated above 3 (scale: 1 low—5 high value), with leadership engagement scoring highest (median 4.00, IQR 0.38). Interview data showed that the ICU teams were highly motivated and committed to implementing the FSI. They reported limited resources, new interprofessional information exchange, and role adoption of nurses as challenging.ConclusionWe found that important pre-conditions for FSI implementation, such as leadership support, a supportive team culture, and a good learning climate were present. Some aspects, such as available resources, interprofessional collaboration and family nurses’ role adoption were of concern and needed attention. An initial set of implementation strategies were relevant to all ICUs, but some additions and adaptation to local needs were required. Multi-component interventions are challenging to implement within complex systems, such as ICUs. This pragmatic, theory-guided, mixed methods contextual analysis demonstrated high readiness and commitment to FSI implementation in the context of a clinical trial and enabled the specification of a tailored, multifaceted implementation strategy.

Translating dementia care to public health: implementation analysis of a community center for people with dementia and family caregivers in Chile

AbstractBackgroundAs part of the National Plan of dementia in Chile, community centers for people with dementia have been developed (1). This program delivers support to the person living dementia and their family, integrating social and clinical aspects through a multicomponent interprofessional intervention, and has been highlighted as an innovative approach to dementia care (2‐4). There is limited knowledge on implementation aspects influencing its functioning as a public health initiative. This work seeks to analyze implementation outcomes of the first community center, called Kintun, in Santiago, Chile, 2013‐2022.MethodA qualitative study was conducted following a realistic approach (multiple data collection strategies and informants to analyze complex interventions). Key informants of program implementation were identified to participate in interviews or focus group, at different levels (macro‐level of centralized policy, meso‐level of intervention deliverers and coordinator, and micro‐level of user family caregivers). Table 1 summarizes informants, multiple data collection strategies, and implementation outcomes addressed. Interviews and focus group were audio‐recorded and transcribed. Deductive thematic analysis was used with predetermined codes describing implementation outcomes according to the Active Implementation Frameworks (Blanchard et al, 2017) and implementation outcomes by Proctor et al (2011).ResultThe Kintun program is on a full implementation stage. At a macro‐level, the program has not experienced significant administrative transformations, where fidelity is tensioned due to lack of updated centralized technical orientations. In contrast, at a meso‐level, program components have been locally modified or adapted. Several implementation drivers are identified, such as engagement with the local service network, tailoring according to context, and more recently, the COVID‐19 pandemic, and new policies (explicit health guarantee). The program is highly pertinent for all levels, however, the inception of new health policies challenges its place in the healthcare network.ConclusionIn the implementation of the first community center for people with dementia in Chile, at a policy macro‐level the program has been continuous and stable. Modifications and adaptations occurred at a meso‐level of implementation, informing of discrepancies in intervention fidelity. Due to the high influence of meso‐level on intervention implementation, it is necessary to explore the implementation processes of other eight centers.

Evaluation of changes in the cognitive, affective, and psychomotor domains of learning following an interprofessional intervention for malaria and its control among the Bedia tribe, a particularly vulnerable tribal group, in rural Eastern India.

The "Bedia" tribal people are found all over India; they are poor, illiterate, and confined culturally. In many parts of India, malaria, a disease caused by mosquitoes, is becoming more common. Raising awareness and educating people about it is the best method to stop disease and maintain good health. This study aimed to determine the perception, attitudes, and practices of a particularly vulnerable tribal group-the "Bedia"-in the rural region of eastern India. A questionnaire with 19 structured questions has been created. The Bedia participants received the questionnaire from us. They had already responded. The intervention took the form of several health education workshops that were created in response to the deficiencies identified in the pre-test assessment's replies. The identical questionnaire used for the pre-test evaluation was given to each participant for the post-test who attended the training sessions. The current study found that while the first cognitive domain question on malaria transmission was not statistically significant, changes in malaria breeding grounds, regions with higher mosquito numbers, and the source of information about malaria are. Their knowledge of the treatment for malaria and the agent used to treat it is statistically significant in the current study, but the fifth question on the most common symptom of malaria was not statistically significant. The answers to the questions about "What you will do if you see someone suffering from malaria," "How much time was spent in the malaria control program," "Malaria detection," and "Regular usage of bed-nets" in the affective and psychomotor domains all had statistical significance. Our research on interventions to raise awareness of malaria in this tribal region of northern West Bengal, eastern India, bordering Bangladesh, was published for the first time to our knowledge. In the majority of the items from the cognitive, psychomotor, and affective learning domains, we have seen significant changes.

Interprofessional collaboration in primary care: what effect on patient health? A systematic literature review

BackgroundIn a period of change in the organization of primary care, Interprofessional Collaboration (IPC) is presented as one of the solutions to health issues. Although the number of inter-professional interventions grounded in primary care increases in all developed countries, evidence on the effects of these collaborations on patient-centred outcomes is patchy. The objective of our study was to assess the effects of IPC grounded in the primary care setting on patient-centred outcomes.MethodsWe conducted a systematic literature review using the PubMed, Embase, PsycINFO and CINAHL databases from 01/01/1995 to 01/03/2021, according to the PRISMA guidelines. Studies reporting the effects of IPC in primary care on patient health outcomes were included. The quality of the studies was assessed using the revised Downs and Black checklist.ResultsSixty-five articles concerning 61 interventions were analysed. A total of 43 studies were prospective and randomized. Studies were classified into 3 main categories as follows: 1) studies with patients at cardiovascular risk (28 studies)—including diabetes (18 studies) and arterial hypertension (5 studies); 2) studies including elderly and/or polypathological patients (18 studies); and 3) patients with symptoms of mental or physical disorders (15 studies). The number of included patients varied greatly (from 50 to 312,377). The proportion of studies that reported a positive effect of IPC on patient-centred outcomes was as follows: 23 out of the 28 studies including patients at cardiovascular risk, 8 out of the 18 studies of elderly or polypathological patients, and 11 out of the 12 studies of patients with mental or physical disorders.ConclusionsEvidence suggests that IPC is effective in the management of patients at cardiovascular risk. In elderly or polypathological patients and in patients with mental or physical disorders, the number of studies remains very limited, and the results are heterogeneous. Researchers should be encouraged to perform studies based on comparative designs: it would increase evidence on the positive effect and benefits of IPC on patient variables.

The role of psychosocial factors in the interprofessional management of women with chronic pelvic pain: A systematic review.

Chronic pelvic pain (CPP) is a common pain disorder in women associated with negative biopsychosocial consequences. The multifactorial etiology and maintaining aspects of CPP logically require an interprofessional treatment approach. However, the effects of interprofessional treatment strategies on psychosocial factors remain unclear. The study aims to investigate how interprofessional therapy helps to treat psychosocial factors in women with CPP. The systematic review summarizes the current evidence of interprofessional treatment in women with CPP. A systematic literature review was performed in six databases (Medline, Web of Science, Cochrane Library, PEDro, CINAHL, and PsycINFO) until February 2023. Studies were selected in a two-step approach applying as inclusion criteria the search combinations of Chronic Pelvic Pain and CPP, synonyms for interprofessional therapies, and for female patients. Studies were excluded if they were not quantitative primary research published in English, if CPP was not defined appropriately, if the study population was not female adult patients, if the interprofessional intervention was not operationalized appropriately, if they were single case studies, and if outcomes did not include at least one of the psychosocial factors pain, depressive symptoms, pain catastrophizing, fear, or anxiety. Risk of bias of the included studies was rated with the McMaster Critical Review Form. Studies were summarized narratively. The review is registered in PROSPERO (CRD42023391008). Five studies with a total sample size of n = 186 women were included, three of them were uncontrolled retrospective before-after chart review. Only one study used a randomized controlled design, the other study used a non-randomized controlled group. The studies' methodological quality is adequate with perspective of study design. The multiprofessional treatment approaches used in the studies differed with regard to professions involved, therapy methods, and modalities. Psychosocial outcome measures were pain (five studies), depressive symptoms (three studies), and anxiety symptoms (four studies). Although interprofessional treatment strategies for women with CPP are recommended in existing guidelines, available evidence is scarce and does not allow for identification of the best interprofessional treatment approach. The effect on psychosocial factors remains unclear. More research is needed determining the best practice interprofessional treatment option for women with CPP.

Team experiences of the root cause analysis process after a sentinel event: a qualitative case study

BackgroundRoot cause analysis (RCA) is a systematic approach, typically involving several stages, used in healthcare to identify the underlying causes of a medical error or sentinel event. This study focuses on how members of a Norwegian RCA team experience aspects of an RCA process and whether it complies with the Norwegian RCA method.MethodBased on a sentinel event in which a child died unexpectedly during childbirth in a Norwegian hospital in 2021, the following research questions are addressed: 1. What was the RCA team’s experience of the RCA process? 2. Was there compliance with the Norwegian RCA method in this case? A case study was chosen out of the desire to understand complex social phenomena and to allow in-depth focus on a case.ResultsThe result covered three main themes. The first theme related to the hospital’s management system and aspects of the case that made it challenging to follow all recommendations in the Norwegian RCA guidelines. The second theme encompassed external and internal assessment. The RCA team was composed of members with methodological and medical expertise. However, the police’s involvement in the case made it complex for the team to carry out the process. The third and final theme covered intrapersonal challenges RCA team members faced. Team members experienced various challenges during the RCA process, including being neutral, dealing with role-related challenges, grappling with ambivalence, and managing the additional time burden and resource constraints. As anticipated in the RCA guidelines, the team’s ability to remain neutral was tested.ConclusionThe findings of this study can help stakeholders better comprehend how an inter-professional RCA teamwork intervention can affect a healthcare organization and enhance the teamwork experience of healthcare staff while facilitating improvements in work processes and patient safety. Additionally, these results can guide stakeholders in creating, executing, utilizing, and educating others about RCA processes.

Abstract 12869: Cardiac Intensive Care Unit Teams and Loved Ones Communicating (CICU TaLC) Intervention is Acceptable and Improves Interprofessional Clinician Communication and Teamwork in Pediatric Pre-Family Meeting Huddles

Introduction: Interprofessional teams often develop a care plan in pre-family meeting huddles before engaging with the family in the pediatric cardiac intensive care unit (CICU)—a process that can affect the course of the family meeting and alter team dynamics but often lacks optimal communication and teamwork. Hypothesis: An interprofessional team intervention for pre-meeting huddles in the CICU is acceptable and positively impacts teamwork. Methods: We enrolled and trained CICU clinicians in interprofessional communication skills with a focus on role clarity, then conducted a quasi-experimental pre-posttest study with clinicians participating in actual pre-family meeting huddles. Clinician acceptability was measured via survey and impact on team communication and teamwork in pre-meeting huddles was assessed using PACT novice, a TeamSTEPPS validated tool, on audio recorded and transcribed huddles. The tool evaluates the domains Team Structure , Leadership , Situation Monitoring , Mutual Support , and Communication on a five-point scale (1 = poor; 3 = average; 5 = excellent). Wilcoxon rank sum test assessed intervention impact on communication and teamwork at the meeting level comparing pre and post-intervention data. Results: 24 Clinicians enrolled in the intervention (92% retention) with 100% completion of training. All trained clinicians recommend CICU TALC to others and 96% believe it improved their participation in family meetings. In 58 huddles (28 pre and 30 post), team performance in all 5 domains were significantly (p&lt; 0.001) higher in post-intervention huddles than in pre-intervention. Median (IQR) comparisons: Team structure [pre 2.00 (1.75, 2.00) vs. post 5.00 (5.00, 5.00)], Leadership [pre 3.00 (2.00, 3.00) vs. post 5.00 (5.00, 5.00)], Situation Monitoring [pre 3.00 (2.75, 3.00) vs. post 5.00 (4.00, 5.00)], Mutual Support [pre 3.00 (2.00, 3.25) vs. post 5.00 (5.00, 5.00)], and Communication [pre 3.00 (2.00, 4.00) vs. post 5.00 (5.00, 5.00)]. Conclusion: It is acceptable to implement an interprofessional team intervention to improve team communication and teamwork in interprofessional pre-family meeting huddles. Future research should assess broader impact of the intervention on clinicians, patients, and families.