Interprofessional Patient Care Research Articles

Fostering Interprofessional Geriatric Patient Care Skills for Health Professions Students Through a Nursing Facility-Based Immersion Rotation.

IntroductionInterprofessional (IP) clinical care is ideally taught in authentic environments; however, training programs often lack authentic opportunities for health professions students to practice IP patient care. Skilled nursing facilities (SNFs) can offer such opportunities, particularly for geriatric patient care, but are underutilized as training sites. We present an IP nursing facility rotation (IP-SNF) in which medical, pharmacy, and physical therapy students provided collaborative geriatric patient care.MethodsOur 10-day immersion rotation focused on four geriatric competencies common to all three professions: appropriate/hazardous medications, patient self-care capacity, evaluating and treating falls, and IP collaboration. Activities included conducting medication reviews, quarterly care planning, evaluating functional status/fall risk, and presenting team recommendations at SNF meetings. Facility faculty/staff provided preceptorship and assessed team presentations. Course evaluations included students' pre/post objective-based self-assessment, as well as facility faculty/staff evaluations of interactions with students.ResultsThirty-two students (15 medical, 12 pharmacy, five physical therapy) participated in the first 2 years. Evaluations (n = 31) suggested IP-SNF filled gaps in students' geriatrics and IP education. Pre/post self-assessment showed significant improvement (p < .001) in self-confidence related to course objectives. Faculty/staff indicated students added value to SNF patient care. Challenges included maximizing patient care experiences while allowing adequate team work time.DiscussionIP-SNF showcases the feasibility of, and potential for, engaging learners in real-world IP geriatric patient care in a SNF. Activities and materials must be carefully designed and implemented to engage all levels/types of IP learners and ensure valuable learning experiences.

Assessment of Perceptions of Professionalism Among Faculty, Trainees, Staff, and Students in a Large University-Based Health System

With a renewed focus on medical professionalism, an opportunity exists to better define its standards and application to meet the needs of an increasingly diverse workforce given the important association between interprofessional behavior and patient care. To examine the context of how professionalism is operationalized and perceived in diverse health care work and learning environments. A qualitative mixed-methods analysis of survey data collected from February to April 2015, was conducted followed by analysis of narrative data collected in June 2017. The setting was 2 health systems and 4 health professional and graduate schools. Participants were faculty, trainees, staff, and students (3506 survey respondents and 52 narratives) affiliated with the University of Pennsylvania and the University of Pennsylvania Health System. Data analysis was conducted in 2018 and 2019. Independent variables included the following respondent characteristics: gender identity, sexual orientation, race/ethnicity, position, generational age group, length of employment at institution, disability status, belief system or religion, and primary site of work or study. Survey questions were used to assess participants' perception and experiences of professionalism in the workplace as measured by a 5-point Likert-type scale. For the survey, there were 3506 respondents from a pool of 18 550 potential respondents (18.9% response rate). Of 3506 survey respondents, 2082 of 3231 (64.4%) were women, 331 of 3164 (10.5%) identified as gender or sexual minority groups, and 360 of 3178 (11.3%) were non-Hispanic Black individuals. In adjusted analyses, women compared with men (adjusted odds ratio [aOR], 1.8; 95% CI, 1.4-2.3) and Asian individuals (aOR, 2.0; 95% CI, 1.7-2.3) and Hispanic individuals (aOR, 2.0; 95% CI, 1.4-2.7) compared with non-Hispanic White individuals were more likely to value institutional professionalism. In addition, gender identity and sexual minority groups compared with heterosexual respondents (aOR, 1.5; 95% CI, 1.2-1.8) and non-Hispanic Black individuals compared with non-Hispanic White individuals (aOR, 1.3; 95% CI, 1.2-1.4) were statistically significantly more likely to consider changing jobs because of unprofessional behavior at work. The qualitative analysis of narratives revealed that marginalized populations (including but not limited to women, gender and sexual minority groups, racial/ethnic minority groups, those who identify as having a disability, and religious minority groups) reported (1) greater infringements on their professional boundaries, as well as increased scrutiny over their professional actions, and (2) a tension between inclusion vs assimilation. The findings of this study highlight the need for health care organizations to revisit how they define and operationalize professionalism to improve inclusivity.

Using Insights From Sports Psychology to Improve Recently Qualified Doctors' Self-Efficacy While Managing Acutely Unwell Patients.

Doctors experience a range of negative reactions when managing acutely unwell patients. These may manifest as emotions or behaviors. Without appropriate coping strategies, these emotions and behaviors can impede optimal clinical performance, which directly affects patient care. Athletes use performance enhancing routines (PERs) to minimize the effect of their negative emotions and behaviors on competitive performance. The authors investigated whether PERs could similarly improve recently qualified doctors' emotional and behavioral control while managing acutely unwell patients and whether the doctors perceived any effect on clinical performance. Twelve doctors within 2 years of graduation from medical school recruited from 2 sites in Sheffield and Chesterfield, United Kingdom, implemented PERs using the PERFORM (Performance Enhancing Routines For Optimization of Readiness using Metacognition) model over a 4-month period between April and December 2017. The doctors' perceptions of PERFORM's effect on their ability to manage patients was evaluated using self-reported mixed-methods data, including think-aloud commentaries, semistructured interviews, and self-efficacy scores. Doctors reported that PERFORM improved their ability to control negative emotions or behaviors during an acutely unwell patient in situ simulation, showing a statistically significant improvement in self-efficacy scores (P = .003, effect size = 0.89). Qualitative data revealed perceived improvement in aspects of clinical performance such as enhanced knowledge recall and decision making. These performance attributes appeared to positively impact interprofessional relationships and patient care. Doctors individualized their PERs and supported the wider implementation of PERFORM in health care education. This is the first study to employ individualized PERs based on sports psychology in a medical context. The PERFORM model could be introduced into existing acute patient management courses to provide emotional regulation coaching alongside clinical skills training. Further research might investigate PERFORM's effect in other environments where emotional and behavioral control is paramount, such as surgery.

Vpliv medpoklicnega izobraževanja medicinskih sester na njihovo medpoklicno sodelovanje

Uvod: Oskrba pacientov je kompleksna in zahteva učinkovito sodelovanje različnih profilov zdravstvene in socialne oskrbe. Medpoklicno izobraževanje je lahko uspešen način izboljševanja medpoklicnega sodelovanja in oskrbe pacienta. Namen pregleda literature je bil preučiti vpliv medpoklicnega izobraževanja medicinskih sester na njihovo medpoklicno sodelovanje z drugimi profili v zdravstvu in identificirati morebitne merske instrumente za preučevanje tega vpliva.Metode: S sistematičnim pregledom literature so bili pregledani znanstveni članki, objavljeni med letoma 2011 in 2018, navedeni v bibliografskih bazah CINAHL, MEDLINE in PubMed Central. Proučevani so bili članki, ki so obravnavali zaposlene in študente zdravstvene nege, ki so se medpoklicno izobraževali in tudi sodelovali z drugimi profili zdravstvene in socialne oskrbe pacientov.Rezultati: Izmed 1277 identificiranih objav je bilo v končno analizo vključenih devet virov. Sedem raziskav je poročalo o tem, da je bilo po medpoklicnem izobraževanju medpoklicno sodelovanje boljše, večja sta bila tudi medsebojno spoštovanje vključenih in medpoklicna samozavest, izboljšano pa pozitivno mišljenje o vlogi soudeleženih poklicev pri zdravstveni oskrbi. Dve raziskavi sta nasprotno poročali, da medpoklicno izobraževanje ne vpliva na zgoraj navedene dejavnike. Ugotovljena je bila prisotnost različnih merskih instrumentov za ocenjevanje vpliva medpoklicnega izobraževanja na medpoklicno sodelovanje.Diskusija in zaključek: Rezultati potrjujejo smiselnost vpeljave medpoklicnega izobraževanja v redni del študijskih programov zdravstvene nege. V prihodnje bi bila potrebna obsežnejša longitudinalna raziskava, ki bi preučevala medpoklicno izobraževanje medicinskih sester in potrdila njegov vpliv na medpoklicno sodelovanje v praksi.

Improving pharmaceutical care education in Uganda through sustainable experiential programs and research

AbstractThis paper details collaboration in elective global health Advanced Pharmacy Practice Experiences (APPEs) between six schools of pharmacy, four in the United States (U.S.) and two in Uganda. This collaboration was initiated to build capacity within Uganda to advance pharmacy practice by strengthening pharmaceutical care education and research, and to provide benefits in the global and public health education and research for U.S. students and each partner University. Makerere University and Mbarara University of Science and Technology in Uganda sought out collaborations to improve pharmacy education in Uganda and alleviate shortages in faculty they have experienced in expanding pharmacy training. In response to this need, Wilkes University, Binghamton University, the University of Minnesota, and East Tennessee State University developed faculty‐led APPEs to help model and teach the principles of clinical pharmaceutical care. These faculty‐led APPEs occur in various Ugandan locations throughout the year and incorporate Ugandan and U.S. students as co‐learners. Ugandan and U.S. faculty act as co‐facilitators of didactic, experiential, and research learning experiences. APPE activities include modeling the provision of pharmaceutical care, interprofessional patient care on inpatient wards, joint didactic lectures and case presentations, skills laboratory sessions, and research components. Developed to serve the needs of both the U.S. and Ugandan partners, the elective global health APPEs to Uganda have grown to be sustainable, mutually beneficial collaborations between the six schools of pharmacy and the Ugandan partners. Formal and informal communications between all of the entities involved have helped support continuity of these programs. We recommend such initiatives to other countries and institutions desiring to improve training for pharmaceutical care to advance pharmacy practice.

Systematic review of interprofessional oncology simulation

BACKGROUND With the evolving complexity surrounding cancer care, interprofessional education through simulation must be examined as a novel pedagogy. OBJECTIVE To provide a systematic review by way of an evolutionary concept analysis of interprofessional oncology simulation to advance understanding of its antecedents, attributes, and consequences. DESIGN Rogerian evolutionary concept analysis method. DATA SOURCES A convenience sample of peer-reviewed publications were retrieved from MEDLINE, CINAHL and PsycINFO from 2002-2019. RESULTS Literature investigating interprofessional oncology simulation is growing. Findings (N=16 articles) revealed congruent antecedents, while attributes included: (1) realistic oncology care scenarios, (2) training in complex oncology care, and (3) oncology care communication. The conceptual consequences were identified as improved interprofessional team, trainee, and patient care outcomes. CONCLUSIONS Findings advance knowledge in the growing area of interprofessional oncology simulation by providing conceptual clarification for healthcare providers. As professional organizations continue to emphasize interprofessional educational methods, additional research is critical in furthering this area of knowledge development.

The Overlap Between Geriatric Medicine and Palliative Care: A Scoping Literature Review.

With an increasing aging population worldwide, there is a growing need for both palliative care and geriatric medicine. It is presumed in medical literature that both specialties share similar goals about patient care and could collaborate. To inform future service development, the objective of this review was to identify what is currently empirically known about overlapping working practices. This article provides a scoping literature review on the relationship between geriatric medicine and palliative care within the United Kingdom. The review encompassed literature written between 1997 and 2019 accessed via Scopus, Web of Science, PubMed, and Google Scholar. Three themes were identified: (a) unclear boundaries between specialties, (b) communication within and between specialisms, and (c) ambiguity of how older people fit in the current health care system. We suggest that more empirical research is conducted about the overlap between palliative care and geriatric medicine to understand how interprofessional working and patient care can be improved.

Scaffolding Clinical Reasoning of Health Care Students: A Qualitative Exploration of Clinicians’ Perceptions on an Interprofessional Obstetric Ward

Purpose:Interprofessional education (IPE) on a ward supports students to generate interprofessional patient care plans as a means to learn about the roles, responsibilities, and clinical reasoning of other professions. We investigated how clinicians guide the clinical reasoning of students from their own and other professions and whether clinicians from nursing, midwifery, and medicine could scaffold students from all professions, that is, by providing just-in-time and tailored support.Methods:Nine supervising clinicians from medicine, nursing, and midwifery were interviewed and a repeat interview held 3 to 15 weeks later; one nurse supervisor was interviewed only once. Using conventional content analysis, themes were identified inductively. Next, we applied an existing scaffolding framework to conceptualise how clinicians supported the clinical reasoning in an IPE setting.Results:Themes were clinicians’ interventions and intentions, results of interventions and of IPE, characteristics of students and clinicians, interactions between clinicians and students, and logistics. Clinicians applied various interventions and expressed several intentions to guide the learning of students from all professions. Clinicians stimulated students’ clinical reasoning by structuring meetings, asking students to explain their thoughts to each other and through giving group assignments. Thus, clinicians used peer-assisted learning for the students. By collaborating with other supervising clinicians regarding the form and amount of guidance to give to the students, clinicians applied peer-assisted learning for themselves as well.Conclusion:Clinicians can learn to scaffold the clinical reasoning of students from different professions, when they are provided with training, good examples, and structures. An existing scaffolding framework can serve as an overview of aims and interventions to provide just-in-time guidance to students from all professions. The scaffolding framework is useful for training clinicians and for depicting the pedagogical approach for IPE wards.

Nurses' activities and time management during home healthcare visits.

AimTo describe nurses’ activities and time management during HHC visits from the perspective of master’s‐level nursing students.BackgroundThe shift from community‐based hospitals to home‐based, person‐centred services for patients with a variety of acute or chronic health problems challenges nurses’ professional competence and time management during home healthcare visits.Design and methodsA cross‐sectional study in accordance with STROBE guidelines. Observation sheets (n = 196) from two municipal home healthcare organisations were analysed with descriptive quantitative analysis.Ethical issues and approvalWhile no external ethical committee evaluation was necessary for this quality improvement study, research ethical principles were followed.ResultsThe nurses spent 50% of each eight‐hour shift on indirect patient contact activities and about 38% on direct patient contact activities. The majority of activities underlying the home visits could be linked to long‐term illnesses: medication (57%), blood samples (23%), wound care (17%) or measurement of blood pressure (14%). Patient education was offered during only 3.5% of visits.LimitationsThe accuracy of the students’ observations is related to their individual capacity to objectively and selectively observe.ConclusionsThere were a number of activities conducted for the patient, to promote continuous intra‐ and interprofessional patient care, but fewer nursing activities conducted with the patient. To ensure integrated, person‐centred, safe patient care, vital reforms are needed.Relevance to clinical practiceThe appropriate balance between indirect and direct patient contact activities should be discussed intra‐ and interprofessionally, delineated and made explicit in nurses’ work plans and nursing documentation, alongside discussions pertaining to relevant resource allocation.

Perioperative clinical pharmacy practice: Responsibilities and scope within the surgical care continuum

AbstractCurrent published guidelines for perioperative pharmacy services have limited information on the development and implementation of a robust clinical pharmacy program across the surgical continuum of care. This publication defines the responsibilities and scope of practice of the Perioperative Clinical Pharmacist (PCPh), supporting the PCPh as a critical member of the interprofessional surgical patient care team. Opportunities for pharmacist role integration into perioperative medication management processes are described along with published examples of successful PCPh practice models, including those with interventions targeted toward Enhanced Recovery Pathways (ERP). Recommended training and competencies for future and practicing perioperative pharmacists, in addition to considerations for precepting and scholarly activities, are also outlined. Finally, future developments in perioperative pharmacy practice are discussed, including technological advancements, improved predictive models, and expansion of collaborative practice agreements.

Developing Future Clinical Pharmacy Leaders in the Interprofessional Care of Children with Special Health Care Needs and Medical Complexity (CSHCN-CMC) in a Pediatric Pulmonary Center.

The health care needs of children with special health care needs and medical complexity (CSHCN-CMC) are multifaceted and often require the expertise of various disciplines. The medication-related needs of this population can be further complicated with off-label medication use, polypharmacy, and vulnerability to medication errors. Although clinical pharmacists are increasingly becoming a common part of inpatient, pediatric interprofessional patient care teams, their presence remains lacking in the outpatient or ambulatory care realm. Pediatric clinical pharmacists in the ambulatory care setting have the potential to help optimize medication use and safety through collaborative efforts as part of the interprofessional team. Since the late 1960s, Pediatric Pulmonary Centers (PPCs) provide training programs designed to develop interprofessional leaders who will improve the health status of CSHCN-CMC, specifically those with chronic respiratory and sleep-related conditions. The addition of pharmacists not only provides a more comprehensive care model for CSHCN-CMC, it creates an avenue to encourage the career paths of pediatric pharmacists in the ambulatory care setting. Here, we describe the addition of clinical pharmacy as part of an interprofessional patient care team and the development and implementation of a maternal child health (MCH) pharmacy discipline training model designed to mentor future pharmacist leaders in the care of CSHCN-CMC.

How Do Interprofessional Healthcare Teams Perceive the Benefits and Challenges of Interdisciplinary Ward Rounds.

PurposeInterdisciplinary bedside ward rounds have the capacity to facilitate coordinated interprofessional patient care. To be an effective means of care coordination, clinicians need an explicit understanding of how these rounds contribute to patient care. By identifying benefits and challenges to the effective use of interdisciplinary ward rounds, clinicians create an opportunity to improve interprofessional teamwork, care planning, and coordination of patient care.MethodsA survey was conducted with frontline professionals in two acute care and two rehabilitation wards from a metropolitan teaching hospital. There were 77 participants, representing medical officers, nurses, and allied health clinicians. Questions examined the perceived benefits and challenges of conducting interdisciplinary ward rounds in their units. Survey findings were coded for meaning and then grouped into themes.ResultsBenefits revealed a desired care delivery model challenged by the complexities of organizational and professional cultures. The themes of “being on the same page”, “focusing on patients”, and “holistic care planning” underpinned the ideas of collaboration and improved patient-centred care, that is, benefits to patients. Challenges centred on health professionals' time constraints and the coordination of teams to enable participation in rounds. The themes were more distinct, logistical barriers of “time”, “workforce”, and “care planning”.ConclusionOverall, clinicians recognise there are greater benefits to IBRs and have a willingness to participate. However, careful consideration is required to introduce and continually achieve the best from IBR as they require changes in organizational context and culture.

Validation study of patient-version of the Jefferson Teamwork Observation Guide (JTOG)

Pharmacy students are required to be licensed (intern-pharmacists). Colorado statute required a licensed pharmacist to supervise students while engaging in Interprofessional clinical experiences.Allow pharmacy students to participate in patient care activities when led by other interprofessional team members.Between 2010 and 2012 we engaged collaborators (other pharmacy/health professions schools, state board of pharmacy, Colorado Pharmacists Society, practitioners, and the public) to establish the need to change Colorado statutes. The law changed in 2012 and rules were drawn in 2013 allowing students to be supervised by non-pharmacists practitioners.Students now complete interprofessional practice experiences through retail pharmacy – community health center partnerships, community based primary care clinics, and early interprofessional practice experiences. All students (160) complete one interprofessional experience with roughly 50 students completing additional experiences. Students engage in collaborative patient visits, conduct medication reconciliation, and provide counseling and drug information services.Changing law allowed more pharmacy students to contribute to interprofessional patient care practices.

Clinical pharmacists in palliative care: effects on drug therapy and drug expenses

The effect of integrating clinical pharmacists in German palliative care units with regard to the quality of drug therapy and drug costs has yet not been evaluated. This work aims to assess the number of pharmaceutical interventions (PI) and the cost-benefit ratio of aclinical pharmacist taking part in the interprofessional patient care team on an inpatient palliative care unit in Germany. The number of and underlying reasons for the pharmacist-led recommendations were recorded and analyzed over a1-year period. In addition, the respective drugs and the acceptance rate of recommendations were assessed. To evaluate the cost-benefit ratio, the financial savings in the provision of drugs were recorded and compared with the expenses for the clinical pharmacy service. A total of 245 PI were performed. Most frequently, the pharmacist advised physicians on drug choices and drug dosages. The acceptance rate was 93%. The cost savings in the provision of drugs covered 83% of the expenses for the clinical pharmacy service. The results indicate that the integration of aclinical pharmacist is well suited to optimizing the interprofessional treatment of distressing symptoms with abeneficial economic outcome in palliative care. Consequently, the permanent integration of aclinical pharmacist on an inpatient palliative care unit seems to be beneficial and advisable.

Development of key performance indicators to capture in measuring the impact of pharmacists in caring for patients with epilepsy in primary healthcare: A Delphi consensual study

ObjectiveThis study was conducted to develop and achieve formal consensus on a core set of key performance indicators (KPIs) that can be captured in measuring the impact of pharmacists in caring for patients with epilepsy (PWE) visiting epilepsy clinics as outpatients in primary healthcare practice. MethodsIn this study, a comprehensive literature search and review was conducted to extract candidate KPIs. Interviews with key contacts (6 pharmacists, 2 neurologists, 3 nurses, and 3 PWE) were also conducted to supplement the inventory set of KPI candidates. A three-round Delphi technique was followed among a panel of 40 members to achieve formal consensus on a core list of KPIs. Consensual KPIs were ranked by the ratings of the panelists. ResultsThe final consensual core set contained 8 KPIs in the thematic activity areas of pharmaceutical care, medication reconciliation and best possible medication history, patient education/counseling, interprofessional patient care, competence, and performance efficiency/patient satisfaction. The KPIs related to therapy problems identified and resolved by pharmacist and provision of proactive comprehensive direct patient care by a pharmacist received significantly higher (p-value: 0.0001) scores compared to the KPI related to complaints about pharmacists received. ConclusionEight consensual KPIs to capture in measuring the impact of pharmacists in caring for PWE visiting epilepsy clinics as outpatients in primary healthcare practice were developed using the Delphi technique. If successfully adopted, implemented, captured, and analyzed, these consensual KPIs might help advance pharmaceutical care of PWE in primary healthcare practice.

Medication regimen complexity is associated with pharmacist interventions and drug‐drug interactions: A use of the novel MRC‐ICU scoring tool

AbstractBackgroundClinical pharmacists are established members of the interprofessional patient care team, but limited guidance for the optimal utilization of pharmacy resources is available. Objective measurement of medication regimen complexity offers a novel process for evaluating pharmacist activity. The purpose of this study was to evaluate the relationship between medication regimen complexity, as measured by a novel medication regimen complexity scoring tool (MRC‐ICU), and both pharmacist interventions and drug‐drug interactions (DDIs).MethodsThis was a multi‐center, prospective, observational study. The electronic medical record was reviewed to collect patient demographics, patient outcomes, and MRC‐ICU and modified MRC‐ICU (mMRC‐ICU) score at 24, 48 hours, and at discharge. Pharmacist interventions were recorded during the patients' intensive care unit (ICU) stay. DDIs were also evaluated at 24, 48 hours, and at discharge. Spearman's rank‐order correlation was used to determine any correlation between the MRC‐ICU score at each time point and the number of pharmacist interventions and DDIs.ResultsA total of 153 patients were evaluated from both centers. The median MRC‐ICU at 24 hours was 11 (interquartile range [IQR] 7‐15). MRC‐ICU at 24 hours was correlated with interventions at 24 hours (rs .439, P &lt;.001). Furthermore, MRC‐ICU was correlated with total DDIs (rs .4, P &lt; .001). A modified version of the MRC‐ICU was also correlated with number of pharmacist interventions (P &lt; .001) and DDIs (P &lt; .001).ConclusionsMedication regimen complexity showed a relationship with number of pharmacist interventions and number of DDIs.

Dental and Nurse Practitioner Student Attitudes About Collaboration Before and After Interprofessional Clinical Experiences.

The aim of this study was to investigate the effect that an interprofessional clinical experience (IPCE) had on dental and adult-gerontology primary care nurse practitioner (NP) students' attitudes towards health care collaboration. A survey study was conducted with dental and NP students before and after completing IPCE rotations in a dental clinic and a tertiary care setting in the 2016-17 academic year. All dental students (N=159) and all NP students enrolled in the adult-gerontology primary care program (N=37) participated in the IPCE. Students were asked to complete the Readiness for Interprofessional Learning Scale (RIPLS) survey anonymously prior to and immediately after the experience. All 37 NP students completed both pretest and posttest, for a 100% response rate on both. Among the dental students, 120 completed the pretest, for a 75% response rate, and 106 completed the posttest, for a 67% response rate. The results showed a significant increase in total RIPLS score for both the dental and NP students following the experience (p<0.001). Attitudes about teamwork and collaboration and about roles and responsibilities improved for both the dental and NP students (p<0.001) following the IPCE. There was a difference between dental students' and NP students' teamwork and collaboration subscale scores before IPCE (p=0.006), but it diminished after the intervention (p=0.09). These results suggest the IPCE succeeded in building positive attitudes about interprofessional collaboration between dental and NP students. Clinical rotations should be considered to enhance the scope of students' experiences with interprofessional patient care.

Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units.

BACKGROUND:The safety of hospitalized patients in the intensive care units (ICUs) is threatened due to incidents and adverse events, including medication errors. Medication error refers to any preventable event at different stage of medication process, such as prescription, transcription, distributing medication, and administration, which can lead to incorrect use of medicines or damage to the patient. This study aimed at investigating the effect of the interprofessional education of medication safety program on medication errors of physicians and nurses in the ICUs.MATERIALS AND METHODS:The study was conducted using a quasi-experimental method (single group, before and after) in 2017. The setting of the study included one ICU of selected teaching hospital affiliated to Isfahan University of Medical Sciences located in the Central Iran with a total of 23 beds. Participants included 50 members of the health-care team (physician, nurse, and clinical pharmacist) with at least 1 year of work experience in the ICUs. Participants were selected using censuses sampling method. Data were collected using a two-section self-made questionnaire. Data were analyzed through descriptive, analytical statistics, and version 16 of the SPSS software (P < 0.05).RESULTS:According to reporting of physicians, nurses, and clinical pharmacist, the medication error 1 month after implementation, the interprofessional education of medication safety program was significantly lower than before the implementation of it (P < 0.001).CONCLUSIONS:Interprofessional education helps to improve interprofessional collaboration and patient care through the promotion of various professions of health to increase interprofessional collaboration compared to single profession education, which individuals learn in isolation and merely in their profession. Therefore, interprofessional education of medication safety program can reduce medication error and promote patient safety in the ICUs.

Where Does the Patient Fit? An Analysis of Word Use Within the Context of Interprofessional Collaborative Care

Patient-centeredness is considered central to interprofessional collaborative patient care as a participatory, partnered approach between health care professionals and patients. Content analysis of 501 articles from the 1986, 1987, 1988, 1996, 2006, 2013, 2014, and 2018 volumes of a selected journal was undertaken. The purposes were to identify contexts in which the term patient was used in articles with a primary focus on interprofessional care and to identify trends in its usage. With Dilthey’s ideas on language as a framework, patient and its variations in the articles were coded under five categories. Findings suggest that the term patient appears predominantly as a modifier for activities enacted by experts and a platform for the discussion of relationships among professionals. There is limited evidence that use of the term patient fits within the context of partnership, suggesting that the language in published interprofessional collaborative research and discussion is currently largely expert, not patient-centered.

Incorporating integrative healthcare into interprofessional education: What do primary care training programs need?

Abstract The National Center for Integrative Primary Healthcare was established to support the incorporation of competency- and evidence-based Integrative Health (IH) curricula into educational programs in a movement toward interprofessional IH patient care. IH is healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle, emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies, conventional and complementary. A primary goal of the Center was to design an IH online course appropriate for interprofessional education. A study assessing the potential of and need for incorporating IH into interprofesional education was conducted. A survey was sent to educational programs to identify core IH competencies, curriculum priorities, and implementation barriers. Respondents (N = 422) were from complementary and integrative health (40%), primary care medical residencies (27%), nursing (9%), and pharmacy (9%). Patient-centered care and working interprofessionally were highest rated competencies. Highest rated content included nutrition/diet, patient-provider communication, behavior change, patient-centered care, physical activity and lifestyle counseling. Most (90%) felt it was important to offer IH content during their professional training. Time constraints, budget, and faculty expertise were the top barriers. The results demonstrated substantial interest and need for an interprofessional IH course. Common content areas and core IH competencies were identified.