Nurses' communication network position and perceptions of teamwork during evidence-based practice implementation

Teamwork and communication are essential to ensuring the provision of high-quality, safe, evidence-based nursing care. Open and effective communication among members of a team is recognized to facilitate implementation of evidence-based practices (EBPs) and communication is an essential element of teamwork; however, how these factors relate to one another during implementation is unknown. This study was designed to fill this gap by concurrently exploring nurses' perceptions of teamwork and communication within the context of the implementation of EBPs. The purpose of this study was to test the relationships between the positionality of nurses within communication networks for practice change and their perceptions of teamwork.

This exploratory, descriptive, cross-sectional survey study collected perceptions of teamwork, using the Nursing Teamwork Survey, and communication network data, using a sociometric survey. Teamwork scores, centrality and coreness of participants across two intensive care units (ICUs) were calculated. Data were analyzed across the whole network and subnetworks. Relationships between centrality measures and teamwork scores were analyzed using univariate regression models; coreness and teamwork perceptions were compared using t-tests. The assortativity coefficient was calculated to determine homophily. Data were collected between January to March 2019.

Across the two ICUs, 145 nurses reported overall high perceptions of teamwork (mean = 4.04). Few significant relationships were seen between communication centrality metrics or coreness and teamwork subscale measures within the whole network nor subnetworks. The assortativity coefficients suggest that those who are closely connected in these communication networks do not have similar perceptions of teamwork. The hypothesis that members central to the communication network would hold higher perceptions of teamwork was not supported in this analysis.

Although teamwork and communication are each established factors known to influence the implementation process of EBPs, this study did not reveal a clear relationship between nurses' positionality in communication networks and perceptions of teamwork during implementation. This finding was surprising; however, possible explanations for these findings offer insight into how to approach future research to understand team boundaries, team composition, and determining appropriate and meaningful measurements of teamwork during the implementation process.