Fundamentals · chapter 15 · Evidence-Based Research, Quality Improvement, and Collaborative Practice
Interprofessional Approach to Health Care
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 5 practice questions with the reasoning.
Key points
Team-based nursing practice
As previously discussed, all nurses work with other nurses, health professionals, and administrative staff, and they collaborate in teams with other healthcare professionals, stakeholders, patients, and family members.
Scope of practice limits
Additionally, just like nurses, all members of interprofessional teams are bound by state regulations that govern the scope of their practice.
Provider orders and diagnoses
A provider is generally the only team member who can write patient care orders, particularly for medications and treatments (Pistoria, 2022). They make medical diagnoses and often provide supervision for patient care teams.
RN patient advocacy
RNs are often the first to detect condition changes and advocate for patient needs and desires.
LPN nursing supervision
A licensed practical nurse (LPN) has different educational requirements and fewer advanced skills than an RN and provides basic nursing care under the supervision of an RN or provider.
Assistive personnel duties
These team members help nurses provide patient care. Their duties may include taking vital signs; transferring, bathing, feeding patients; and otherwise providing patient comfort.
Pharmacist medication safety
They reconcile medications and ensure patients are not ordered new medications incompatible with their current ones. Their presence saves time and reduces medication errors by increasing the chance for the correct medication and dosage to be ordered the first time.
Interprofessional care team
The interprofessional care management approach provides holistic, engaged care from a team that includes healthcare professionals, the patient, and their loved ones.
Interprofessional approach impacts
Through transparency, shared decision-making, evidence-based practices, and quality improvement, the interprofessional approach impacts patient safety, resource allocation, care coordination, care quality, and patient outcomes.
Team-based resource use
In one study of over 110,000 primary care patients, team-based care patients were less likely to be seen in an emergency room or admitted to a hospital (Reiss-Brennan et al., 2016).
Patient self-care participation
For patients, there is evidence that having a care team improves the patient’s chances to participate in their own self-care (Morley Cashell, 2017).
Quality of care
Team-based care models have been shown to improve patient safety and quality of care.
Ineffective teamwork risks
Root cause analyses show that over 50 percent of adverse events are related to ineffective teamwork (Zajac et al., 2021).
Teamwork functioning requirements
Effective teamwork requires two separate types of functioning: the actions from team members necessary to reach goals and the ability of team members to combine their knowledge, skills, and attitudes to make the team sustainable and successful.
Terms to know
- provider
- A provider is generally the only team member who can write patient care orders, particularly for medications and treatments (Pistoria, 2022).
- licensed practical nurse (LPN)
- A licensed practical nurse (LPN) has different educational requirements and fewer advanced skills than an RN and provides basic nursing care under the supervision of an RN or provider.
- assistive personnel (AP)
- The category of assistive personnel (AP) includes a wide range of staff, such as nursing assistants (certified or not), home health aides, scrub techs, and medical assistants.
- respiratory therapist
- A respiratory therapist provides daily respiratory care such as breathing treatments and supportive care for many patients experiencing respiratory conditions.
- physical therapist
- A physical therapist evaluates and treats patients who have difficulty moving.
- occupational therapist
- An occupational therapist works with patients on activities of daily living.
- speech therapist
- A speech therapist works with patients on speech and communication and helps manage issues that occur with swallowing.
- resource
- A resource is anything required to perform effective patient care: both tangible items (such as supplies, patient rooms, financial resources, and staff) and intangible items (such as time and knowledge).
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
The graded version needs JavaScript. Every question is below anyway, with the answer and why.
Every question here, with the answer
A hospitalized patient has become deconditioned after bedrest and is having difficulty moving from the chair to the bed. The nurse is concerned about whether the patient can safely return home after discharge. Which interprofessional team member should the nurse anticipate involving?
- Chaplain
- Speech therapist
- Occupational therapist
- Physical therapist
Answer: Physical therapist
The physical therapist is the best choice because this patient’s primary issue is difficulty moving and safe discharge planning related to mobility. Occupational therapy focuses more on activities of daily living, speech therapy addresses communication and swallowing, and chaplains address spiritual needs.
During medication review, the nurse notices that a newly ordered medication may not be compatible with the patient’s current medication list. Which team member is most appropriate for the nurse to contact for support?
- Social worker
- Pharmacist
- Physical therapist
- Assistive personnel
Answer: Pharmacist
The pharmacist is the most appropriate team member because pharmacists reconcile medications and help ensure that new medications are compatible with current ones. The other team members have important roles, but they do not primarily address medication compatibility and dosing questions.
A nurse manager is explaining why the unit is moving toward a more interprofessional model of care. Which outcomes are identified in the section as areas affected by the interprofessional approach? Select all that apply.
- Eliminating the need for patient education
- Patient outcomes
- Care coordination
- Patient safety
- Care quality
Answer: Patient outcomes, Care coordination, Patient safety, Care quality
The section states that the interprofessional approach impacts patient safety, care coordination, care quality, and patient outcomes. It does not eliminate patient education; instead, collaborative teams increase patient education and engagement.
A quality improvement team writes this goal: “By January 31, care managers will complete patient care bundles for patients with diabetes at least 75 percent of the time.” Which SMART goal elements are clearly demonstrated in this wording? Select all that apply.
- Specific
- Measurable
- Timely
- Spiritual care
- Prescriptive authority
Answer: Specific, Measurable, Timely
The goal is specific because it identifies who will do what and for which patients, measurable because it includes 75 percent, and timely because it sets a completion date. Prescriptive authority and spiritual care are roles or services discussed elsewhere in the section, not SMART goal elements.
A charge nurse is leading an interprofessional project and wants to apply leadership strategies described in the section to improve teamwork. Which actions are appropriate? Select all that apply.
- Monitor plans and communicate changes
- Model effective teamwork
- Ensure the team is coordinated and understands the plan
- Use a debrief checklist at the end of the project
- Discourage team members from assisting each other so roles stay separate
Answer: Monitor plans and communicate changes, Model effective teamwork, Ensure the team is coordinated and understands the plan, Use a debrief checklist at the end of the project
The section describes leadership strategies that include coordinating the team, monitoring plans, communicating changes, encouraging team members to assist one another, modeling teamwork, and using brief and debrief checklists. Discouraging team members from assisting each other conflicts with the recommended teamwork approach.
Where every quote comes from
Section 15.6 Interprofessional Approach to Health Care of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.