title: Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice.
abstract: This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was "balancing intertwined responsibilities." In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon's contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.
authors.affiliation: a Department of Public Health and Caring Sciences, Caring Science , Uppsala University , Uppsala , Sweden.|b Centre for Clinical Research Sörmland , Uppsala University , Uppsala , Sweden.
authors.forename: Petronella
authors.initials: P
authors.lastname: Bjurling-Sjöberg
authors.affiliation: a Department of Public Health and Caring Sciences, Caring Science , Uppsala University , Uppsala , Sweden.
authors.forename: Barbro
authors.initials: B
authors.lastname: Wadensten
authors.affiliation: a Department of Public Health and Caring Sciences, Caring Science , Uppsala University , Uppsala , Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Pöder
authors.affiliation: c Institute of Health and Caring Sciences , University of Gothenburg , Gothenburg , Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Jansson
authors.affiliation: a Department of Public Health and Caring Sciences, Caring Science , Uppsala University , Uppsala , Sweden.|b Centre for Clinical Research Sörmland , Uppsala University , Uppsala , Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Nordgren
mesh_terms: D005260:Female; D066296:Grounded Theory; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009741:Nursing Staff, Hospital; D010348:Patient Care Team; D012941:Social Responsibility; D013548:Sweden
keywords: Grounded theory; intensive care unit; interprofessional care; interviews; practice; roles; teamwork