A Study On The Current State And Influnecing Factors Of Nurse-physician Collaboration In The First-class Hospitals Of Chongqing

Objective: To investigate the current state and influencing factors of nurse-physician collaboration in the first-class hospitals of Chongqing by questionnaire survey and qualitative interviews.To promote the implementation of nurse-physician collaboration in the first-class hospitals of Chongqing.And to provide information support and theoretical basis for improving implementation of nurse-physician collaboration in the first-class hospitals of Chongqing.Methods: A total of 1304 nurses and physicians from 6 first-class hospitals of Chongqing were recruited by convenient sampling,purposively sampling and cluster sampling method in quantitative research.They were surveyed by a questionnaire ?Nurse-Physician Collaboration Scale? in Chinese edition.All the data of questionnaires were input by Epi Data 3.1 and were analyzed by SPSS21.0.?=0.05 was selected as the test standard.In qualitative research,13 nurses and physician from emergency department,ICU,internal medicine department and surgical department were chosen to have a face-to-face semi-structured interview.All the data were analyzed by seven step analysis method of Colaizzi.The results were compared and summarized into themes.Results:1.The score of nurses and physicians on the evaluation of nurse-physician collaboration in the first-class hospitals of Chongqing was 78.42±15.16 with the average of each item 3.73±0.72.The dimensions from high to low is sharing of patient information with an overall score of 30.45±5.68 and average score of each item 3.80±0.71,joint participation in the cure/care decision-making process with an overall score of 37.27±7.84 and average score of each item 3.73±0.78 and the cooperativeness with an overall score of 11.10±2.67 and average score of each item 3.70±0.89.The scores of physician in each dimension and item were high than that of nurses,the difference was statistically significant.(P<0.01)2.The department,career interest and willingness of collaboration were related to physicians' evaluation on nurse-physician collaboration(P<0.05).The department,personnel status,cognition about vocational perspective,career interest and willingness of collaboration were related to nurses' evaluation on nurse-physician collaboration(P<0.05).The main factors related to physicians' evaluation on nurse-physician collaboration were department and willingness of collaboration while factors of nurses' evaluation on nurse-physician collaboration were career interest and willingness of collaboration through the logistic regression analysis.3.Lack of effective communication between nurses and physician,inadequate medical personnel,lack of working ability and the sense of responsibility,inadequate policy system of nurse-physician collaboration management,imperfect workflow and different status of nurses and physicians and the outdated traditional concept about nurse-physician collaboration are the main factors that affecting nurse-physician collaboration.Conclusion:1.The nurse-physician collaboration in the first-class hospitals of Chongqing is above a medium level.The physicians' evaluation on nurse-physician collaboration is higher than that of nurses.Both the nurses and doctors have a high recognition in nurse-physician collaboration.The undertaken of nurse-physician collaboration is at a wide scale but need to further strengthen cooperation in depth.2.In quantitative research,the department,career interest and willingness of collaboration were related to physicians' evaluation on nurse-physician collaboration while the department,personnel status,cognition about vocational perspective,career interest and willingness of collaboration were related to nurses' evaluation on nurse-physician collaboration.The main factors related to physicians' evaluation on nurse-physician collaboration were department and willingness of collaboration while factors of nurses' evaluation on nurse-physician collaboration were career interest and willingness of collaboration through the logistic regression analysis.In qualitative research,lack of effective communication between nurses and physician,inadequate medical personnel,lack of working ability and the sense of responsibility,inadequate policy system of nurse-physician collaboration management,imperfect workflow and different status of nurses and physicians and the outdated traditional concept about nurse-physician collaboration are the main factors that affecting nurse-physician collaboration.Suggestions:1.We should strengthen the training of professional interests of nurses,prevent the generation of nurses' occupational burnout and improve the working enthusiasm and satisfaction of nurses.2.We should pay attention to the attitudes and the willingness of nurses and doctors to collaboration,strengthen the training work of importance of collaboration,continue to improve the awareness of the medical personnel in cooperation.3.We should pay attention to the allocation of human resources in clinical department especially for the intensive care unit which is a high risk department and always with arduous treatment tasks,and to avoid nurse-physician conflicts or poor collaboration due to high work pressure and overload.4.The administration department should pay attention to nurse-physician collaboration,to try to create a harmonious working atmosphere for the medical staff,to construct the policy system for collaboration,to carry out nurse-physician collaboration in multi form and multi-channel,strengthen the staff training to improve the ability of medical staff,to carry out inter professional education,to promote the mutual understanding and professional penetration to improve the level of nurse-physician collaboration and the quality of medical and nursing care.