Interprofessional Teamwork Collaborative Healthcare Delivery System Paper Getting Started: Interprofessional teams are part of practice trends we see devel

Interprofessional Teamwork Collaborative Healthcare Delivery System Paper Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).

For this assignment, consider the concept of interprofessional teamwork and patient outcomes.
Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.)
Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)
iCARE components are:

C ompassion

A dvocacy

R esilience

E vidence-Based Practice (EBP)

How could you contribute to an interprofessional team and patient outcomes through nursing actions of: compassion, advocacy, resilience, and evidence-based practice?
Select one scholarly nursing article from CINAHL as a resource for your paper. Additional scholarly sources can be used but are optional.
Use APA format throughout, particularly in citations and on the References page.
Please paraphrase throughout. One short quote is permitted.
The prepared paper template is RECOMMENDED for this assignment.

Elements of iCARE paper

Title page
Below are the headings to be used for this assignment.
Introduction: (No heading needed here in APA) Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting.

Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Compassion
Advocacy
Resilience
Evidence-Based Practice
Summary: Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.
References page: List any references used in APA format. Running head: TYPE SHORT TITLE IN ALL CAPS
Title
Your Name
Chamberlain College of Nursing
NR451 RN Capstone Course
Term and Year
1
TYPE SHORT TITLE IN ALL CAPS
2
Your title here
This paragraph(s) is to introduce the paper. Explain the type of work setting you are
discussing and whether interprofessional teams are present. If present, indicate a team function
that could be improved. If not present, indicate what type of team you think might work well in
this setting and how it might function. Remember this is a scholarly APA assignment so you
cannot use first person. Remember also that you will keep all the bolded headings and just
remove the non-bolded content when you start your paper.
Compassion
In this paragraph, describe a nursing action that could contribute to compassion through
interprofessional team support; describe how this might impact the culture of your unit or
organization; and possible impact on patient outcomes.
Advocacy
In this paragraph, describe a nursing action that could contribute to advocacy through
interprofessional team support; describe how this might impact the culture of your unit or
organization; and possible impact on patient outcomes.
Resilience
In this paragraph, describe a nursing action that could contribute to resilience through
interprofessional team support; describe how this might impact the culture of your unit or
organization; and possible impact on patient outcomes.
Evidence-Based Practice
In this paragraph, describe a nursing action that could contribute to evidence-based
practice through interprofessional team support; how this might impact the culture of your unit
or organization; and possible impact on patient outcomes.
TYPE SHORT TITLE IN ALL CAPS
3
Summary
Provide a clear and concise summary. Include a summary statement of how iCARE
components can support interprofessional teams and patient outcomes through nursing actions.
Address how you may be able to influence this process of support for interprofessional teams on
your unit or in your organization.
TYPE SHORT TITLE IN ALL CAPS
4
References
Select at least one scholarly nursing article from CINAHL as a resource for your paper.
Additional scholarly sources can be used but are optional.
RUBRIC
●
Introduction the type of work setting and interprofessional team features are described
(improvement or type of team) 25 points
●
Compassion nursing action related to compassion is described in support of the
interprofessional team. The culture of the unit and patient outcomes. 25 points
●
Nursing action related to advocacy is described in support of the interprofessional team,
the culture of the unit, and patient outcomes. 25 points
●
Resilience nursing action related to resilience is described in support of the
interprofessional team, the culture of the unit and patient outcomes. 25 points
●
Evidence-based practice nursing action related to EBP is described in support of the
interprofessional team, the culture of the unit and patient outcomes. 25 points
●
Summary explain how nursing actions of the iCARE components can support
interprofessional teams and patient outcomes. Address how you can influence support
for interprofessional teams on your unit or area of practice. 35 points
●
Mechanics and organization the discussion is well organized and logical. The structure is
clear and compelling to the reader. Paragraphs are linked together logically, and main
ideas stand out. 20 points
●
APA the writing includes error free grammar and spelling and is written in a logical
manner with complete sentences. APA format is used throughout. 20 points
●
Use of CINAHL article as required source from CCN library
Received: 25 January 2018
|
Revised: 21 April 2018
|
Accepted: 16 May 2018
DOI: 10.1111/jonm.12662
ORIGINAL ARTICLE
Resilience in nursing: The role of internal and external factors
Georgios Manomenidis1
1
Primary Health Care Lab, General Practice
and Health Research, Department of
Medical School, Aristotle University of
Thessaloniki, Thessaloniki, Greece
2
Department of Educational and
Social Policy, University of Macedonia,
Thessaloniki, Greece
Correspondence
Georgios Manomenidis, Department
of Medical School, Aristotle University
Thessaloniki, Thessaloniki 54124, Greece.
Email: george.mano@yahoo.gr
| Efharis Panagopoulou1 | Anthony Montgomery2
Abstract
Recent evidence shows that resilience can buffer the negative impact of workplace
stressors on nurses and is linked to favourable patient outcomes. However, the com‐
parative effectiveness of different contributing factors to nurses’ resilience has not
yet been examined. Our objective was to examine and compare the impact of indi‐
vidual characteristics, external factors and coping strategies on nurses’ resilience. A
descriptive cross‐sectional study was conducted. Data were collected from 1,012
Greek nurses working in eight hospitals in northern Greece. Resilience, anxiety and
depression, were measured using existing validated self‐ report instruments. In terms
of coping strategies, this study used the “Mental Preparation Strategies Scale” to as‐
sess the mental preparation strategies employed by nurses before the beginning of
their shift. Educational level, anxiety and the overall use of mental preparation strat‐
egies were the main predictors of nurse’s resilience ([F = 52.781, p = 0.000, R2 = 0.139,
Adjusted R2 = 0.137]). Resilient nurses were better educated {(b = 0.094. 95% confi‐
dence interval [CI] 0.038, 0.162)}, had lower anxiety ([b = −0.449, 95% CI −0.526,
−0.372]) and used more often mental preparation strategies before the beginning of
their shift ([b = 0.101, 95% CI 0.016, 0.061]). Findings provide information about
which subgroups of nurses are more vulnerable in terms of resilience, i.e. less edu‐
cated nurses, or nurses working in internal medicine wards.
KEYWORDS
coping, factors, nursing, predictors, resilience
1 | I NTRO D U C TI O N
patient safety (Manomenidis, Panagopoulou, & Montgomery, 2017).
In terms of risk factors, nursing burnout has been linked to personal‐
Nursing burnout is a critical issue worldwide (Cañadas‐De la Fuente et
ity factors; however, organisational variables have been traditionally
al., 2015). Studies show that about 40% of nurses in the USA are burnt
regarded as more relevant (Cañadas‐De la Fuente et al., 2015). For
out (Vahey, Aiken, Sloane, Clarke, & Vargas, 2004), while the rates in
example, high labour intensity (Khamisa, Peltzer, & Oldenburg, 2013),
some European countries are even higher (e.g. Greece 78%; Aiken et
role ambiguity (Kar & Suar, 2014), poor relationships at work (IIić et
al., 2012). Burnt out nurses develop both psychological (sleep distur‐
al., 2017) and lack of support at work (Tipandjan & Suresh, 2012) have
bances, impaired memory; Peterson et al., 2008) and physical prob‐
all been found to be associated with burnout.
lems (musculoskeletal disorders; Sorour & El‐Maksoud, 2012). At an
However, if one‐third or one‐half of practising nurses are report‐
organisational level, burnout results in nurses’ absenteeism (Lambert,
ing being burnt out, it is important to examine why the remaining
Barton‐Bellessa, & Hogan, 2015) and high turnover intention (Han,
one‐half or two‐thirds are not. Recently, the concept of resilience,
Han, An, & Lim, 2015). High levels of burnout in nurses is associated
defined as the capacity to respond to stress in a healthy way such
with high rates of health care‐associated infections (Galletta et al.,
that goals are achieved at minimal psychological and physical cost,
2016), suboptimal care (Elmariah, Thomas, Boggan, Zaas, & Bae,
has been identified as a key to enhancing quality of care, and sus‐
2017; Zarei, Khakzad, Reniers, & Akbari, 2016) and compromised
tainability of the health care workforce (Epstein & Krasner, 2013).
172
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© 2018 John Wiley & Sons Ltd
wileyonlinelibrary.com/journal/jonm
J Nurs Manag. 2019;27:172–178.
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MANOMENIDIS et al.
Resilience refers to the ability of an individual to bounce back, or to
cope successfully with adverse circumstances (Rutter, 2008).
173
2.2 | Measures
Research on resilience in nurses’ has highlighted its protec‐
Demographic characteristics were assessed with a socio‐demo‐
tive role against nursing turnover (McAllister & McKinnon, 2009),
graphic questionnaire that included items such as age, gender, mari‐
post‐traumatic stress disorder (Mealer, Jones, & Moss, 2012),
tal status, years of experience, education and working department.
emotional exhaustion (Manzano‐Garcia & Ayala‐Calvo, 2012) and
Resilience was assessed with the 25‐item Resilience Scale
burnout (Arrogante & Aparicio‐Zaldivar, 2017). Resilience has also
(Wagnild & Young, 1993). The items were measured in a seven‐
been linked to enhanced patient satisfaction (DeVoe, Fryer, Straub,
point Likert scale ranging from 0 “strongly disagree” to 7 “strongly
McCann, & Fairbrother, ), perceived better quality of care and better
agree”, assessing the degree of individual resilience. For the needs
attitudes towards patients (Williams et al., 2016).
of present study the short version of 14‐item scale was used (Lee
Nursing resilience has been studied in different clinical con‐
et al., 2015). The Resilience Scale (RS‐14) was translated from
texts, such as paediatric oncology (Zander et al., 2010), geriatric care
English to Greek and then validated through back‐translation and
(Benadé, du Plessis, & Koen, 2017), psychiatry (Prosser, Metzger, &
content validity testing by two skilled translators. The final form
Gulbransen, 2017), surgery (Gillespie, Chaboyer, & Wallis, 2009) and
of the instrument was pilot tested in a sample of nurses. The pos‐
intensive care (Mealer, Jones, & Meek, 2017). These studies show
sible scores for RS‐14 range from 14 to 98. Scores >82 indicate
that some nurses have developed highly adaptive mechanisms, or re‐
moderately high to high resilience and score of ≤73 indicate low
silient characteristics (Mealer et al., 2017) that allow them to continue
resilience (Lee et al., 2015). The Cronbach alpha coefficients were
to deliver high quality care and stay intact in spite of adverse situa‐
0.899.
tions in the hospital context for many years (Quattrin et al., 2006).
Anxiety and depression was assessed with the Hospital
In terms of factors contributing to resilience, studies have ex‐
Anxiety and Depression Scale (HADS) introduced by Zigmond
plored the influence of physiological factors (procedures that protect
and Snaith (1983). It contains 14 multiple‐choice questions, with
the body from stress responses, e.g. sympathetic nervous system;
two subscales: anxiety (HADS‐A) and depression (HADS‐D), with
Ortega & Saavedra, 2014), external factors (e.g. social network or
seven items in each domain. The score ranges from 0 to 21. It has
clinical setting; Cusack et al., 2016; Guo et al., 2017), internal factors
been translated and validated in Greek population (Mystakidou
(positive emotions, self‐efficacy; Çam & Büyükbayram, 2017) or de‐
et al., 2004) and has been previously used in nursing personnel
mographic variables (e.g. years of experience; Gillespie et al., 2009).
(Schmidt, Dantas, & Marziale, 2011). The internal consistency
Studies have also examined the protective role of different coping
coefficients for the (HADS‐A) and (HADS‐D) were α = 0.818 and
strategies employed mainly during work hours, as well as the pro‐
0.711 respectively.
tective role of leisure activities (Ablett & Jones, 2007; Mróz, 2015).
The mental preparation strategies that nurses use before the
However, the comparative effectiveness of different contrib‐
beginning of their shift were assessed by the “Mental Preparation
uting factors on nurses’ resilience has not yet been examined. To
Strategies Scale”, which was developed based on the “Switch On‐
develop interventions to enhance resilience among nurses it is im‐
Switch Off Model” (Manomenidis et al., 2016). It includes 10 items
portant to identify the specific contribution of stable versus variable
corresponding to five different categories of preparation strategies:
factors, as well as the contribution of internal versus external ones.
personal care (e.g. use of perfume/deodorant), religious rituals (e.g.
The purpose of this study was to examine and compare the impact
blessing oneself), use of caffeine/nicotine, social interaction (e.g.
of individual characteristics, external factors and coping strategies on
humour with colleagues) and relaxation (e.g. listening to music).
nurses’ resilience. Individual factors included demographic characteris‐
Participants respond “Yes” or “No”, whether they used each strategy.
tics (age, gender, education, marital status, years of experience) and men‐
A total score is produced indicating the total amount of preparation
tal health indicators (anxiety and depression). External factors included
strategies nurses use before the beginning of their shift. The internal
the hospital type and working department. In terms of coping strategies,
consistency coefficient was α = 0.76.
recent findings showed that coping strategies used by nurses’ to prepare
mentally for work immediately before the beginning of their shift have a
positive impact on stress (Manomenidis, Panagopoulou, & Montgomery,
2.3 | Sample/participants
2016). As a result, in this study we assessed the coping strategies em‐
Nurses working in all departments of the selected hospitals were
ployed by nurses immediately before the beginning of their shift.
considered eligible for the study. Participants were recruited by
poster displays in the nursing stations of all hospital departments.
2 | M ATE R I A L S A N D M E TH O DS
Inclusion criteria were at least 1 year of experience and a permanent
employment status. Sample size was determined using Gorstein’s
statistical equation (Gorstein, Sullivan, Parvanta, & Begin, 2007).
2.1 | Design
Based on previous studies conducted among Greek nurses on work
stress (Noula et al., 2010), the required sample size for an effect
A descriptive, cross‐sectional study was conducted in eight largest
size of 0.5% and 95% confidence interval was estimated to be 600
city hospitals of northern Greece.
nurses.
174
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2.4 | Data collection
Data were collected between January and May 2017. Ethical ap‐
proval was obtained from the scientific committee of the hospitals
MANOMENIDIS et al.
TA B L E 1
Demographic characteristics of the sample
Demographic variables
n
%
Gender
participating in the study (ethics approval statement 3/45933/2016).
Male
158
15.6
All nurses meeting the inclusion criteria received a questionnaire
Female
854
84.4
28.4
and were informed that participation was voluntary. Questionnaires
Age
were anonymous and a description of how confidentiality would be
50
251
26.3
128
12.6
each department. A total of 1,300 questionnaires were distributed,
with a response rate of 77.8% (n = 1,012).
2.5 | Data analysis
Data were exported to the Statistical Package for the Social Sciences
(SPSS), version 23 for data analysis (IBM Corp., Armonk, NY, USA).
Educational level
Master/PhD
Tertiary education
598
59.0
Secondary education
286
28.4
289
28.5
Years of experience
20
334
33.1
Internal medicine
711
75.6
ICU
230
24.4
years of experience, hospital type, working department and marital
status. Pearson’s R correlation was used to examine univariate as‐
sociations between resilience, anxiety, depression and mental prep‐
aration strategies. Variables showing a significant association with
resilience in the univariate analysis, were entered in a multiple regres‐
sion model as predictors, with resilience as the dependent variable.
Department
Hospital type
Second level
684
67.6
Third level
323
32.4
Married
771
77.7
Single
221
22.3
Marital status
3 | R E S U LT S
Demographic and job characteristics of the study sample are shown
in Table 1.
The mean score for resilience was M = 76.69 (SD = 16.22),
for anxiety M = 14.84 (SD = 5.83) and for depression M = 12.97
(SD = 5.61). The total mean score of preparation strategies used
by nurses was M = 5.09 (SD = 1.96). In particular, 77.2% (n = 778)
of nurses reported the use of socialising with colleagues, 75.8%
TA B L E 2
Strategies used by nurse before work
Coping strategy
Yes % (n)
No % (n)
Use of perfume/deodorant
75.8 (764)
24.2 (244)
Use of make‐up
38.1 (384)
61.9 (624)
(n = 764) of nurses reported the use of perfume/deodorant, 68.8%
Shower
41.2 (415)
58.8 (593)
(n = 694) the use of consumption of coffee and 60.9% (n = 614) of
Praying
25 (252)
75 (755)
nurses reported the use of listening to music (see Table 2).
Blessing oneself
44.6 (450)
55.4 (558)
Smoking
30.1 (303)
69.9 (705)
ucation (F2,997 = 6.342, p = 0.002). The biggest difference was ob‐
Drinking coffee
68.8 (694)
31.3 (313)
served between nurses with master and doctoral degrees (Μ = 5.67,
Humor
48 (484)
52 (524)
SD = 0.62) and nurses with a bachelor degree (M = 5.42, SD = 0.75).
Socialising with colleagues
77.2 (778)
22.8 (230)
Listening to music
60.9 (614)
39.1 (394)
There was a significant difference in resilience related to ed‐
A significant difference was also observed between nurses work‐
ing in the ICU and nurses working in internal medicine wards
t(935) = −1.725, p = 0.020 with the former showing higher levels
of resilience. Moreover, there was a positive association between
Multiple regression analysis showed that educational level, anx‐
resilience and the total frequency of mental preparation strate‐
iety level and the total use of mental preparation strategies were
gies (r = 0.100, p = 0.000). Resilience was negatively associated
the main predictors of resilience (F = 52.781, p = 0.000, R2 = 0.139,
with anxiety (r = −0.326, p < 0.001) and depression (r = −0.421, Adjusted R2 = 0.137) explaining 14% of the variance (Table 4). Nurses p < 0.001). All associations between resilience, demographic vari‐ who were resilient had a higher educational level, lower anxiety and ables, anxiety, depression and mental preparation strategies are used more often mental preparation strategies immediately before shown in Table 3. the beginning of their shift. | MANOMENIDIS et al. TA B L E 3 Correlations between resilience, psychometric questionnaires and coping strategies mental health. Previous studies have shown that individuals with mental health issues have a reduced ability to cope with stressors (Shastri, 2013). Resilience Resilience The positive association between resilience and the total use of 1 Anxiety –0.326** Depression –0.421** 175 strategies for mental preparation strategies before work represents an increased effort by resilient nurses to prepare for the upcoming shift using a multitude of strategies. In specific, results show a pos‐ Total score of strategies 0.100** Socialising with colleagues 0.142** Relaxation 0.117** with literature showing that social support can promote self‐pro‐ Personal care 0.020 tection (Shimoinaba, O’Connor, Lee, & Kissane, 2015) and modifies Religious rituals 0.017 current behaviours (Sippel, Pietrzak, Charney, Mayes, & Southwick, Use of caffeine/nicotine 0.045 2015). Congruently, Cameron and Brownie (2010) found that col‐ itive association between re... Purchase answer to see full attachment