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Interprofessional intensive care unit team interactions and medical crises: a qualitative study
Dominique Piquette1, Scott Reeves, Vicki R Leblanc
1Department of Critical Care, Sunnybrook Health Sciences Centre, Wilson Centre, University Health Network & University of Toronto, Toronto, Ontario, Canada. dompiquette@yahoo.com
Journal of Interprofessional Care
|April 24, 2009
Summary
Acute medical crises in the intensive care unit (ICU) alter team interactions. Nurses suggest structured feedback post-crisis to improve interprofessional collaboration and address team needs.
Area of Science:
- Medical Sociology
- Healthcare Management
- Critical Care Medicine
Background:
- Interprofessional collaboration is linked to improved patient outcomes in intensive care units (ICUs).
- Effective interprofessional interactions are challenging in high-acuity settings with unpredictable medical crises.
Purpose of the Study:
- To explore intensive care unit (ICU) healthcare professionals' perceptions of how acute medical crises influence team interactions.
- To understand the temporal dynamics of interprofessional relationships surrounding critical events.
Main Methods:
- Conducted 25 semi-structured interviews with ICU nurses, staff physicians, and respiratory therapists.
- Utilized an inductive thematic analysis approach for transcribed interview data.
Main Results:
- Interprofessional interactions evolve through three temporal phases around medical crises: pre-crisis (mutual respect), crisis (hierarchy, tolerance for incivility), and post-crisis (divergent perceptions).
- Nurses reported unexpressed emotions and questions post-crisis, with a perceived need for systematic interprofessional feedback sessions.
Conclusions:
- Acute medical crises significantly impact the nature and effectiveness of interprofessional collaboration in the ICU.
- Systematic post-crisis feedback mechanisms may be beneficial for addressing the specific needs of ICU healthcare professionals, particularly nurses.
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