Nursing perspectives on factors influencing interdisciplinary teamwork in the Canadian primary care setting.
OBJECTIVE
This study investigated nurses' roles and their perspectives on the factors that influence interdisciplinary teamwork within Canadian primary care setting.


BACKGROUND
Interdisciplinary teams have shown to lead to better system- and patient-level outcomes and, accordingly, have became important aspects of healthcare systems especially within primary care settings. Nurses play a key role in these primary care teams, particularly with respect to chronic disease management.


METHODS
A focused ethnography design using semi-structured individual interviews was conducted.


METHODS
Interviews were conducted with 20 primary care nurses between July 2010-May 2011. Interviews were recorded, transcribed, and content and thematic analysis was performed.


RESULTS
Nurses experienced increasing scope of practice and professional responsibility as they transitioned into the primary care setting. Nine major roles of primary care nurses were identified. Several factors that facilitate or hinder teamwork were identified and categorised under four theme areas: (1) organisation/leadership (e.g. having common goals and mandate, unclear descriptions of team members' roles); (2) team relationships (e.g. closed loop of communication, trust, respect); (3) process/support (e.g. unclear referral process and reporting structure, large patient panels); and (4) physical environment (e.g. decentralised model of care).


CONCLUSIONS
Nurses' roles within primary care setting appear to be focused mainly on case management. Minimal orientation and lack of preparation of nurses for their roles, vagueness of these roles among the interdisciplinary primary care team members and lack of communication appeared to be among the most important factors that influence teamwork and nurses' functioning within these teams.


CONCLUSIONS
Given that nurses play a key role in interdisciplinary primary care teams, particularly in managing chronic disease patients, approaches to improve chronic disease management and care of these patients should incorporate strategies to ensure effective preparation of these nurses for their roles within these teams and settings.
School of Public Health, University of Alberta, Edmonton, AB, Canada.
Fatima
F
Al Sayah
Olga
O
Szafran
Sandra
S
Robertson
Neil R
NR
Bell
Beverly
B
Williams
D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D005260:Female; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D057184:Practice Patterns, Nurses'; D059017:Primary Care Nursing
interdisciplinary; nurses; primary care; teamwork