title: How do nurse practitioners in acute care affect perceptions of team effectiveness?
abstract: OBJECTIVE
  To describe how acute care nurse practitioners affect perceptions of team effectiveness.
  
  
  BACKGROUND
  Acute care nurse practitioners provide safe and effective care to patients. There is limited evidence of the effects of acute care nurse practitioner roles on healthcare teams, and many of the findings are contradictory. Research is lacking to describe how nurse practitioners affect perceptions of team effectiveness.
  
  
  METHODS
  A descriptive multiple-case study undertaken in two university-affiliated teaching hospitals in Canada.
  
  
  METHODS
  Data were collected from March-May 2009. Data sources included interviews (n = 59), time and motion study, non-participant observations, documents and field notes. Interviews were conducted individually or in groups using a semi-structured interview guide. Data were analysed within and across the cases to identify similarities and differences in perceptions of team effectiveness.
  
  
  RESULTS
  Team members believed the nurse practitioners improved the team's effectiveness. They identified six team processes they believed were improved by the addition of the nurse practitioners to the teams. The processes included decision-making, communication, cohesion, care coordination, problem-solving and focus on patients and families.
  
  
  CONCLUSIONS
  The study contributes to our understanding of how nurse practitioners affect perceptions of team effectiveness. Improved team communication and care coordination were believed to be particularly important. Nurse practitioner can facilitate patient- and family-centred care in healthcare teams.
  
  
  CONCLUSIONS
  Nurse practitioners improve perceptions of team effectiveness. Further work is needed in different contexts and with patients and families to determine their perceptions of team effectiveness.
  
  
  CONCLUSIONS
  The nurse practitioner role was believed to be particularly important to improve team communication and care coordination. This constitutes an added value of acute care nurse practitioners roles in healthcare teams. Nurse practitioner roles contribute to patient-centred care and can improve the quality and safety of the care provided to patients and families.
authors.affiliation: Faculty of Nursing, University of Montreal, Montreal, QC, Canada. kelley.kilpatrick@umontreal.ca
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
mesh_terms: D003142:Communication; D003657:Decision Making; D006801:Humans; D009722:Nurse Practitioners; D010348:Patient Care Team; D011792:Quebec
keywords: acute care; case study; healthcare team; interprofessional; nurse practitioner; perceptions; process; team effectiveness