Nurse-physician Collaboration Research Articles

The role of machine learning in the improvement of physician-nurse relationships when the management of burn patients: A narrative review

In recent years, machine learning (ML) has emerged as a transformative technology in healthcare, providing significant advancements in patient care and management. Burn care, which necessitates comprehensive and coordinated efforts due to the severe and multifaceted nature of burn injuries, particularly benefits from ML's capabilities. This literature review investigates how ML enhances the collaboration between physicians and nurses in managing burn patients. In the present study, significant findings show that ML's predictive analytics can predict patient outcomes and complications, helping with proactive care strategies. ML-driven decision support systems offer real-time, evidence-based recommendations, ensuring consistent care approaches. In addition, ML-powered virtual simulations improve training and comprehension of roles, while advanced electronic health records (EHR) systems streamline documentation and information sharing. Continuous quality improvement is supported by ML's data-driven insights, leading to improved patient monitoring and management. Ultimately, integrating ML in burn care significantly improves physician-nurse collaboration, resulting in better patient outcomes. This includes reduced infection rates and shorter hospital stays. This highlights the vital role of ML in transforming healthcare delivery and professional collaboration in managing complex conditions like burn injuries.

Perceptions and Behaviors of Nurses and Physicians During Bedside Rounds in Medical-Surgical Units.

Communication and collaboration among health care professionals during bedside rounds improve patient outcomes and nurses' and physicians' satisfaction. To determine barriers to nurse-physician communication during bedside rounds and identify opportunities to improve nurse-physician collaboration at an academic medical center. A survey with Likert-scale and open-ended questions regarding professional attitudes toward nurse-physician communication was administered to 220 nurses and physicians in medical-surgical units to assess perceptions of participation in bedside rounds. After the survey was given, observational data from 1007 bedside rounds were collected via a standardized data collection tool. Nurses and physicians perceived different barriers to including nurses in bedside rounds. Nurses most often cited being unaware that bedside rounds were occurring (38 of 46 nurses [83%]); physicians most often cited nurse unavailability (43 of 52 physicians [83%]). Of 1007 observed rounds, 602 (60%) involved in-person contact of nurses and physicians; 418 (69%) of the 602 included a conversation between the nurse and physician about the nurse's concerns. Of 355 rounds with no in-person or telephone contact between nurses and physicians, the medicine team did not contact the nurse in 284 (80%). Conversations about nurses' concerns occurred more often after physician-initiated contacts (73% of 369 contacts) and nurse-initiated contacts (74% of 93 contacts) than after chance encounters (57% of 140 contacts). Initiating discussions of care between nurses and physicians and discussing nurses' concerns during bedside rounds have multiple benefits.

The Influence of Compassion, Health Literacy Competencies, and Nurse-Physician Collaboration on Patient-Centered Care among Clinical Nurses

The Influence of Compassion, Health Literacy Competencies, and Nurse-Physician Collaboration on Patient-Centered Care among Clinical Nurses

Survey on nurse-physician communication gaps focusing on diagnostic concerns and reasons for silence

Diagnosis improvement requires physician-nurse collaboration. This study explored nurses’ concerns regarding physicians’ diagnoses and how they were communicated to physicians. This cross-sectional study, employing a web-based questionnaire, included nurses registered on Japan’s largest online media site from June 26, 2023, to July 31, 2023. The survey inquired whether participants felt concerned about a physician’s diagnosis within a month, if they communicated their concerns once they arose, and, if not, their reasons. The reasons for not being investigated were also examined. The nurses’ frequency of feeling concerned about a physician’s diagnosis and the barriers to communicating these concerns to the physician were evaluated. Overall, 430 nurses answered the survey (female, 349 [81.2%]; median age, 45 [35–51] years; median years of experience, 19 [12–25]). Of the nurses, 61.2% experienced concerns about a physician’s diagnosis within the past month; 52.5% felt concerned but did not communicate this to the physician. The most common reasons for not communicating included concern about the physician’s pride, being ignored when communicating, and the nurse not believing that a diagnosis should be made. Our results highlight the need to foster psychologically safe workplaces for nurses and create educational programs encouraging nurse involvement in diagnosis.

Unlocking the Potential of the HEART Pathway: Predicting MACE and Facilitating Nurse-Physician Collaboration in Chest Pain Unit.

The HEART pathway serves as a tool for predicting major adverse cardiac events (MACE) among patients presenting with acute chest pain, aiding in early discharge of low-risk patients and reducing unnecessary cardiac investigations. This study aimed to evaluate physician-nurse reliability of the HEART pathway. Moreover investigates the efficacy of HEART pathway to predict 3-month MACE in patients with acute chest pain. We conducted a prospective study on 97 patients experiencing acute chest pain. A team of three professionals - a nurse, a cardiology resident, and a cardiology attending physician - performed risk stratification. We assessed inter-rater reliability among the raters as well as explored 3-month MACE outcomes. Excellent pairwise agreements were found between the raters. Overall agreement among raters was excellent, with an ICC of 0.84 (95% CI: 0.73 - 0.97). The HEART pathway score exhibited strong predictive power (AUC: 0.85) for 3-month MACE. At a cut-off score of 4, sensitivity, specificity, and negative predictive values were 87.5%, 58.9%, and 95.8%, respectively. The HEART pathway score effectively predicts 3-month MACE in patients with acute non-traumatic chest pain. Moreover, the high agreement among the attending physician, the resident physician, and the nurse suggests that nurses could use this tool, potentially reducing the workload on physicians.

The Physician Is on Campus

Abstract The purpose of this project was to determine if physician participation in simulation affects students’ perceptions of nurse/physician communication and collaboration. Fifty-five students participated in six groups. Three groups had a physician present and involved during their eight-hour pediatric simulation; the others continued with current practice, which involved phone contact with an individual posing as a physician. There was a statistically significant difference in two items on the Nurse Attitudes About Communicating and Collaborating With Physicians tool when pre- and post-simulation means were compared. Findings are consistent with previous research, indicating simulation-based learning can improve students’ perceptions of nurse-physician collaboration.

Night Physician-Nurse Collaboration: Developing the Scale of Physicians' Difficulties and Exploring Related Factors in Acute Care Hospitals.

Responding to inpatient deterioration is less favorable at night than during the day, and this may be related to barriers in collaboration between physicians and nurses. However, there had been no way to assess the problem. This study aimed to develop a scale for physicians to measure difficulties in nighttime collaboration with nurses in response to deteriorating inpatients and to identify factors associated with the developed scale scores. We developed a draft scale of Nighttime Collaboration Difficulties between Nurses and Physicians for Physicians (NCDNP-P) based on key informant interviews with physicians. Psychometric validations, including structural validity, criterion-related validity, and reliability tests, were conducted among physicians who worked on night duty or on call in acute-care hospitals in Japan using a cross-sectional web-based questionnaire. Multiple linear regression analyses were performed using independent variables including individual backgrounds, style of working at night, and facility characteristics. By performing exploratory factor analysis, we confirmed the structural validity of the NCDNP-P, consisting of seven items and two domains (Domain 1: Dissatisfaction with reporting, Domain 2: Barriers to working with nurses). Cronbach's alpha and McDonald's omega coefficients were 0.81-0.84 and 0.81-0.89, respectively. The criterion-related validity for interprofessional collaboration was confirmed. Multiple regression analysis revealed that the variables employment status, number of night shifts, frequency of nighttime calls about patients under another physician's charge, and handover between physicians before changing shifts were statistically significantly associated with NCDNP-P scores. We developed the NCDNP-P, confirming its reliability and validity. Identified factors reflect physicians' characteristics and the problems experienced working at night and may be associated with barriers in nighttime collaboration. The NCDNP-P can highlight issues in clinical settings and lead to the consideration of initiatives to address such issues.

Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors.

Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. The present study utilized a cross-sectional survey design following quantitative methods. This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. Research ethics approval was obtained from the researcher's university. Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.

Leaders' individualized consideration, team commitment and patient loyalty: The role of social and task‐related contexts

AbstractDrawing from transformational leadership (TFL) theory and research on contextual leadership, we examined a conditional process model of leadership in nursing teams to predict patient loyalty. Using TFL's individualized consideration dimension as a salient facet of the construct in care services, we first posited that nurses' team affective commitment would partially mediate the impact of nurse leadership. We further conceptualized nurse–physician collaboration, organizational formalization and task feedback as discrete contexts that may curb the influence of head nurses' individualized consideration. In a three‐wave, multisource and multilevel study, we surveyed 654 nurses and 1770 patients from 91 hospital units. We found that team‐level head nurses' individualized consideration positively and partially related to patient loyalty through nurses' team commitment and that higher levels of nurse–physician collaboration, organizational formalization and task feedback were associated with reduced influence of individualized consideration on team commitment and patient loyalty. We discuss the implications of these findings for advancing theory and research on TFL and contextual factors of leadership.

Implementation of the ID-PALL Assessment Tool for Palliative Care Needs: A Feasibility and Prevalence Study in a Tertiary Hospital.

Identifying patients who require palliative care is a major public health concern. ID-PALL is the first screening instrument developed and validated to differentiate between patients in need of general versus specialized palliative care. This study aimed to (1) evaluate user satisfaction and the facilitators and barriers for ID-PALL use and (2) assess the prevalence of patients who require palliative care. A mixed methods study with an explanatory sequential design. Over a six-month period, patients admitted to two internal medicine wards of a Swiss tertiary hospital were screened by nurses and physicians with ID-PALL, two to three days after hospitalization. Nurses and physicians completed a questionnaire and participated in focus groups. Out of 969 patients, ID-PALL was completed for 420 (43.3%). Sixty percent of patients assessed needed general palliative care and 26.7% specialized palliative care. From the questionnaire and focus groups, five subthemes were identified concerning facilitators and barriers: organization, knowledge, collaboration, meaning, and characteristics of the instrument. ID-PALL was recognized as an easy-to-use and helpful instrument that facilitates discussion between health care professionals about palliative care. The difficulties in using ID-PALL in nurse-physician collaboration and the paucity of referrals to the palliative care team were highlighted. ID-PALL helped to identify a very high prevalence of palliative care needs among internal medicine patients in a tertiary hospital setting. Although regarded as helpful and easy to use, challenges remain concerning interprofessional implementation and inclusion of palliative care specialists, which may be met by automatic referrals in case of specialist needs.

Sequential Mediation Effects of Organizational Support and Collaboration on Missed Nursing Care.

It is necessary to find ways to mediate the relationship between role overload and missed nursing care in settings where nursing staffing is inadequate. This study aimed to identify the single and multiple sequential mediation effects of organizational support, nurse-physician collaboration, and nurse-nurse collaboration on the relationship between role overload and missed nursing care. Data were collected from 237 registered Korean nurses working in general wards in October 2022. The measures used were the modified role overload scale, nurse-physician collaboration scale, nurse-nurse collaboration scale, a short version of the Perceived Organizational Support Scale, and the modified Missed Nursing Care Scale. Data were analyzed using PROCESS macro in SPSS. A hypothesis test was performed using Model 81, proposed by Hayes, which includes serial multiple mediators. Organizational support, nurse-physician collaboration, and nurse-nurse collaboration showed a mediation effect on missed nursing care. Organizational support, nurse-physician collaboration, and nurse-nurse collaboration showed significant multiple sequential mediation effects on the relationship between role overload and missed nursing care. When the indirect effect sizes of nurse-physician collaboration were compared with those of nurse-nurse collaboration in both single and multiple sequential mediation paths, the indirect effect of nurse-physician collaboration was greater than that of nurse-nurse collaboration on the relationship between role overload and missed nursing care. As an alternative strategy to reduce missed nursing care in situations with insufficient nursing staffing, organizational support should precede nurse-physician and nurse-nurse collaboration. In particular, improving nurse-physician collaboration shows promise in mitigating missed nursing care.

Intensive Care Unit Nurses' Professional Autonomy: A Scoping Review.

Intensive care unit (ICU) nurses' professional autonomy is a critical factor affecting their ability to sustainably provide high-quality care to patients who are critically ill and to their families. However, in the absence of a systematic or scoping review of ICU nurses' professional autonomy, limited information and evidence are available on this topic. The aim of this scoping review was to clarify the extent and type of evidence on ICU nurses' professional autonomy. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The following research questions were addressed: (1) Which areas of interest and trends regarding ICU nurses' professional autonomy have been explored in studies published in scientific journals? And (2) What is known about ICU nurses' professional autonomy? The data sources included MEDLINE, CINAHL Ultimate, PsycINFO, Cochrane Library, and Ichushi-Web of the Japan Medical Abstracts Society databases. Identified studies were mapped based on their aim, design, methodology, and key findings and categorized according to their focus areas. Of the 734 identified studies, 16 were analyzed. The identified categories were as follows: "relationship between professional autonomy and mental issues," "experiences and processes of exercising professional autonomy," "relationship between professional autonomy and nurse-physician collaboration," "relationship between professional autonomy and demographic characteristics," "concept of professional autonomy," "barriers to professional autonomy," and "team approach to improve professional autonomy." Most studies have focused on the relationship between professional autonomy and mental health issues and nurse-physician collaboration and few included interventions to enable or promote the exercise of professional autonomy, highlighting a research gap. Future research should identify factors that inhibit the professional autonomy of ICU nurses and that can be changed through interventions and should develop educational and organizational change-based interventions to modify the factors.

Addressing the Nursing Workforce Crisis Through Nurse-Physician Collaboration

This Viewpoint explores root causes of the nurse staffing shortages in the US and proposes solutions that involve physicians.

Effect of nurse-physician collaboration on the incidence of complications, negative emotions and quality of life in cervical cancer patients: a randomized controlled study

ABSTRACT The aim of this study was to evaluate the effect of nurse-physician collaboration on the incidence of complications, anxiety and depression, quality of life, and satisfaction with nursing care among cervical cancer patients undergoing three-dimensional intracavitary brachytherapy. In this randomized, single-blinded, placebo-controlled trial, 92 eligible cervical cancer patients were equally divided into two groups upon admission. The control group was given routine nursing, and the intervention group received a nurse-physician collaboration in addition to routine care. Anxiety, depression, and health-related quality of life in both groups were assessed and compared at baseline and discharge. The intervention group had significantly fewer complications and showed marked improvements in mental health and quality of life compared to the control group. Satisfaction with nursing care was substantially greater in the intervention group. These results support the clinical adoption of a nurse-physician collaborative care model in the management of cervical cancer with three-dimensional intracavitary brachytherapy.

PRAKTEK KOLABORASI DOKTER-PERAWAT TERHADAP KEPUASAN KERJA DOKTER UMUM DI RSUD NGANJUK

Background: RSUD Nganjuk is a type B hospital. Patient care in RSUD Nganjuk inpatient unit is done by group of specialists from different disciplines, general practitioners, nurses, and other health personnel. But there are still many obstacles that occur in collaborative practice. Physician-Nurse interactions affect the quality of collaboration practices and physician’s job satisfaction.
 Method: The study is a quantitative study with cross sectional approach. Populations consisted of all physicians in RSUD Nganjuk. The sampling method used in this study is total sampling. There are 18 respondents. Analysis of the data using multiple linear regression statistical test.
 Result and Discussion: The result of this study showed the value of F calculating (7,75) > t table value (4,221), and probability value was 0,02. That’s means that the physician-nurse collaboration significantly influences physician’s job satisfaction. Regression equivalent showed: Y = 0,267 X1 + 0,078 X2 + 0,452 X3 + 0,470 X3.Whereas determinant coefficient 0,614. This implied that physician-nurse collaboration simultaneously influence as much as 61,4% to physician’s job satisfaction. Physician-nurse collaboration variable practice that influence physician’s job satisfaction is mutual interest (p=0,03) The other factor: communication (p=0,17), scope of practice (p=0,77), and common goal (p=0,05) has not yet been influence in physician’s job satisfaction.
 Conclusion: There was a significant influence among the collaboration variable practice consisting of communication (X1), the scope of practice (X2), mutual interests (X3), and a common goal (X4) simultaneously on physician’s job satisfaction at the inpatient unit of RSUD Nganjuk. The most influential factor is the common goal.

A blended learning using contextual teaching learning: strengthening nursing students’ procedural knowledge and interprofessional collaboration

Introduction:The level of knowledge about the types of teaching instruction through blended learning in nursing education is still lacking. This study aims to develop blended learning using contextual learning and evaluate its effect on procedural knowledge and interprofessional collaboration. Methods: A quasi-experimental study was conducted from January to March 2022. The total participants were 96 students from one of the nursing departments in Indonesia, who were equally divided into experimental and control groups. The experimental group received a blended learning method with a combination of contextual learning for 400 minutes for four meetings. Meanwhile, 48 students in the control group received traditional blended learning. Mann-Whitney U test to compare between treatment and control groups. The instrument used to measure the interprofessional education variable was the Nurse–Physician Collaboration Scale and procedural knowledge was measured through a test of 25 multiple choice questions about procedural knowledge. Results: The implementation of blended learning based on contextual teaching significantly increased their procedural knowledge (pre M = 43.30 vs post M = 79.00), and interprofessional collaboration (pre M = 58.08 vs post M = 83.79) with p-value < 0.01. Conclusions: Blended learning using contextual learning was effective for increasing procedural knowledge and interprofessional collaboration in nursing students. The application of this instruction is highly recommended for nursing departments in higher education institutions as an effort to achieve qualified health workers for sustainable development and well-being.

Nurses' Perceptions of Nurse-Physician Collaboration and Quality of Care in Public Hospitals.

Nurse-physician collaboration is a fundamental part of the healthcare information flow, while poor or improper collaboration could result in poor healthcare outcomes and increased medical errors. This study investigated the relationship between nurse-physician collaboration and the perceived quality of healthcare services offered in Jordanian public hospitals, and associated factors. A descriptive correlational research design was used. A sample of 385 nurses employed in five Jordanian public hospitals was recruited. Nurse-Physician Collaboration Scale was used to assess collaboration, while the HEALTHQUAL scale was used to evaluate healthcare service quality. The IBM SPSS software (version 26) was used to analyze the data. There was a positive correlation between nurse-physician collaboration and the perceived quality of healthcare services provided to patients (r = 0.778, p < .01). There was variability in the perception of nurse-physician collaboration based on gender, RN-to-patient staffing ratios, age, and income level (p < .05). No association was found between nurses' demographics and their perceptions of the quality of healthcare services provided to patients. Healthcare organizations should implement effective practices to promote nurse-physician collaboration, which could subsequently improve the quality of tangible services provided to patients.

Effects of Nurse-Nurse Collaboration and Nurse-Physician Collaboration on Nursing Performance in Nurses: The Mediating Effect of Patient Safety Management Activities

Effects of Nurse-Nurse Collaboration and Nurse-Physician Collaboration on Nursing Performance in Nurses: The Mediating Effect of Patient Safety Management Activities

THE EFFECTS OF ALTRUISTIC LEADERSHIP ON PHYSICIAN-NURSE COLLABORATION AND LEADER-MEMBER EXCHANGE IN HEALTHCARE ORGANIZATIONS

Bu çalışmanın amacı; hekim ve hemşirelerin alturistik liderlik algıları, hekim hemşire iş birliğine eğilimleri ve lider üye etkileşimi düzeylerinin belirlenmesi; hekim ve hemşirelerin alturistik liderlik algılarının hekim hemşire iş birliğine olan eğilimleri ve lider üye etkileşimi düzeyleri üzerinde etkisinin olup olmadığının tespit edilmesidir. Bu kapsamda Ankara’da faaliyet gösteren bir vakıf üniversitesine bağlı eğitim araştırma hastanesinde görev yapmakta olan toplam 192 hekim ve hemşireden elde edilen veriler değerlendirilmiştir. Analizler sonucunda katılımcıların alturistik liderlik algıları ve lider üye etkileşimi düzeyleri orta seviyenin üzerinde; hekim hemşire iş birliğine yatkınlıkları ise yüksek düzeyde bulunmuştur. Yürütülen regresyon analizlerinden elde edilen bulgulara göre ise alturistik liderlik alt boyutlarının hekim hemşire iş birliği ve alt boyutları ile lider üye etkileşimi ve alt boyutları üzerinde istatistiksel olarak anlamlı ve pozitif yönde etkilere sahip olduğu belirlenmiştir. Araştırma bulgularından elde edilen sonuçlar doğrultusunda hekim hemşire iş birliği ve lider üye etkileşimi düzeylerini artırma amacında olan sağlık yöneticilerine alturistik liderlik davranışları sergilemeleri önerilmektedir.

Family Nurse Practitioner Autonomy and Physician Collaboration in Rural vs Urban Settings

Family Nurse Practitioner Autonomy and Physician Collaboration in Rural vs Urban Settings