Is Teamwork and Professional Autonomy Compatible and Result in Improved Hospital Care?
Abstract views: 553 / PDF downloads: 361
Keywords:Teamwork, Nursing Autonomy, Interprofessional Work, Quality of Care
To investigate the relationship between patient and nurse interdisciplinary teamwork with autonomy, an online survey in which 10,022 nurses in 32 hospitals participating in Turkey are made and evaluated the quality of nursing care. It was found that the basic variables of nursing autonomy, control over resources, relationship with doctors, emotional exhaustion and decision-making were correlated with each other, as well as the quality of care assessed with nurses and nurse satisfaction. Nursing autonomy has been positively associated with better perception of the quality of service provided and higher levels of job satisfaction. Analysis of teamwork by job characteristics showed that there is a small but significant difference in teamwork level between full-time and part-time nurses. There were no significant differences in terms of contract type (permanent and short term), service / unit's expertise, shift length or job title. Nurses with higher teamwork scores are significantly more likely to be satisfied with their jobs, planning to stay in their jobs, and burnout scores. Higher teamwork scores were associated with higher nurse-assessed quality of care, perceived quality improvement over the past year, and patients' confidence that they could manage their care upon discharge. Nurses with higher teamwork scores also resulted in higher levels of autonomy and were more involved in the decision-making process. There is a strong relationship between teamwork and autonomy; this interaction suggested synergy rather than conflict. Therefore, organizations encourage nurse autonomy without fear, as it can undermine teamwork.
Abbott A. The system of professions: an essay on the division of expert labour. Chicago: University of Chicago Press, 1988.
Aiken LH, Clarke SP, Sloane DM. Hospital restructuring: does it adversely aVect care and outcomes? J Nurs Admin 2000;30:457–65.
Aiken LH, Smith HL, Lake ET. Lower medicare mortality among a set of hospitals known for good nursing care. Med Care 1994;32:771.
Aiken LH, Patrician P. Measuring the organizational traits of hospitals: the revised nursing work index. Nurs Res 2000; 49:146–53.
Aiken L. et al. Nurse reports on hospital care in five countries. Health AV 2001;20:43–53.
Aiken LH, Sochalski JA, eds. Hospital restructuring in North America and Europe: patient outcomes and workforce implications. Med Care 1997;35(Supplement).
Aiken LH, Sloane DN, Lake ET, et al. Organization and outcomes of inpatient AIDS care. Med Care 1999;37:760– 72.
Allen D. The changing shape of nursing practice: the role of nurses in the hospital division of labour. London: Routledge, 2001.
Borrill C, West MA, Shapiro D, et al. Teamworking and eVectiveness in health care. Br J Health Care 2000;6:364–71.
Buchan J. Lessons from America? US magnet hospitals and their implications for UK nursing. J Adv Nurs 1994;19: 373.
Carter AJ, West MA. Sharing the burden: teamwork in health care settings. In: Firth-Cozens J, Payne J, eds. Stress in health professionals: psychological and organisational causes and interventions. Chichester: John Wiley, 1999: 191–202.
Casey N, Smith R. Bringing nurses and doctors closer together. BMJ 1997;314:617–8.
Dechairo-Marino AE, Jordan-Marsh M, Traiger G, et al. Nurse/physician collaboration: action research and the lessons learned. J Nurs Admin 2001;31:223–30.
Firth-Cozens J. Celebrating teamwork. Quality in Health Care 1998;7(Suppl):S3–7.
Firth-Cozens J. Multidisciplinary teamwork: the good, bad, and everything in between. Quality in Health Care 2001;10: 65–6
Hugman R. Power in the caring professions. London: Macmillan, 1991.
Irvine D, Sidnia S, McGillis Hall I. Finding value in nursing care: a framework for quality improvement and clinical education. Nurs Econ 1998;16:110–6.
Leatt P, Baker FR, Halverson PK, et al. Downsizing, reengineering and restructuring: long-term implications for healthcare organizations. Frontiers of Health Serv Manage 1997;13:27–39.
Maslach C, Jackson SE. Maslach burnout inventory manual. 2nd ed. Palo Alto, California: Consulting Psychologists Press, 1986.
McKee M, Aiken LH, RaVerty AM, et al. Organizationl change and quality of health care: an evolving international agenda. Quality in Health Care 1998;7:37–41.
Mechanic D, Aiken LH. A cooperative agenda for medicine and nursing. N Engl J Med 1982;307:747–50.
Putnam RD, Leonardi R, Nanetti RY. Making democracy work: civic traditions in modern Italy. Princeton: Princeton University Press, 1993.
RaVerty AM. The politics of nursing knowledge. London: Routledge, 1996.
Shortell SM, Zimmerman JE, Rousseau DM, et al. The performance of intensive care units: does good management make a diVerence? Med Care 1994;32:508–25.
Sochalski J, Aiken LA, Fagin C. Hospital restructuring in the United States, Canada and Western Europe: an outcomes research agenda. Med Care 1997;35:OS13.
Stacey M. Regulating British medicine. The General Medical Council. London: John Wiley, 1992.
Stein LI. The doctor-nurse game. Arch Gen Psychiatry 1967;16:699–703.
Stein LI, Watts DT, Howell T. The doctor-nurse game revisited. N Engl J Med 1990;322:546–9.
Strong P, Robinson J. The NHS under new management. Milton Keynes: Open University Press, 1990.
Traynor M. Managerialism and nursing: beyond oppression and profession. London: Routledge, 1999.
Walby S, Greenwell J, MacKay L et al. Medicine and nursing: professions in a changing health service. London: Sage, 1994.
Wicks D. Nurses and doctors at work: rethinking professional boundaries. Buckingham: Open University Press, 1998.
Zimmerman JE, Rousseau DM, DuVy J, et al. Intensive care at two teaching hospitals: an organizational case study. Am J Crit Care 1994;3:129–38.
Zwarenstein M, Bryant W. Interventions to promote collaboration between nurses and doctors (Cochrane Review) In: The Cochrane Library. Issue 2. Oxford: Update Software, 2001.
How to Cite
Copyright (c) 2021 ISPEC International Journal of Social Sciences & Humanities
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.