Healthcare practices are everchanging in a bid to realize better and more efficient patient results. From the type of education and research activities that healthcare practitioners receive and undertake, to the service rendered to patients, there are notable changes that have occurred in the Canadian healthcare system. Interprofessional practise (IPP) is also referred to as interdisciplinary practice as it deals with creating a team of experts in various fields who work towards a common goal. In healthcare, interprofessional or interdisciplinary practice is also known as interprofessional patient-centred collaboration. Contemporary nursing practice involves interdisciplinary patient-centred collaboration to realize quality patient care and services. Healthcare reform is believed to be a consequence of IPP among healthcare practitioners. Through IPP, patient outcomes are improved, mortality and morbidity rates reduce, and patient medication dosages are optimized. At the same time, there is an evident increase in job satisfaction and reduction of extra work among nurses and other healthcare practitioners working in Canadian hospitals. Interprofessional practice is an important issue in Canadian nursing as it can realize benefits to multiple stakeholders in the healthcare system, such as nurses and patients through its integration and implementation.
Sides of IPP in Canadian Nursing
When looking at the issues relating to IPP in Canadian nursing, one has to look at both sides of the issue. The first side of the issue stems from interprofessional education and research. Interprofessional education is defined as when two or more professionals from various interrelated disciplines learn together about each other’s profession (Bosch & Mansell, 2015). Interprofessional education realizes that no known discipline can handle both healthcare needs and social care needs of patients who have complex conditions. This thus brought the need for interprofessional education where each professional is taught about interrelated practice and when they need to apply it to the care of a patient (Donato et al., 2016). In previous years, each profession was individually taught, to enable the students to dispense their respective services proficiently. This was a faulty approach as it expected them to be able to work collaboratively, yet they had not been taught how to do so before joining healthcare facilities (Donato et al., 2016). Through interprofessional education, students from various healthcare discipline are taught collaboratively and placed in collaborative practicum to ensure they appreciate the model of patient-centred interprofessional collaboration.
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The second issue in IPP stems from Canadian nursing practices. IPP for Canadian nurses ensures that patients social and healthcare needs are meet (CNA, 2011). IPP in nursing ensures that each provider can give their best in their area of specialization, thus reducing duplication of services. This, in turn, helps in enhancing public access to services, thus generating client's and healthcare organization's best value for the cost (Virani, 2012). IPP also ensures that nurses can work as teams with other healthcare providers in the facility to enhance collaboration. Collaboration ensures that the previous fragmentation of healthcare services witnessed in healthcare is dealt with to realize seamless care of clients in healthcare facilities. This thus reduces instances of provider and client dissatisfaction, miscommunication, medication errors, legal lawsuits and in worst-case scenarios, death of patients through avoidable circumstances (Bosch & Mansell, 2015). Although the issue of IPP is an ideal way to enhance the quality care of patients, it can be hard for nurses to realize it in their practice for numerous reasons that will be discussed within the report.
IPP in Canadian Nursing Definition
In the past decades, healthcare faculties had developed a range of competencies to gauge professionalism. There have been an array of attitudes, skills, knowledge and behaviors that have been set as necessary for an individual’s success in the field of nursing (Canadian Interprofessional Health Collaborative, 2010). Interprofessional collaboration in healthcare systems transpires when two or more vocations work hand in hand to realize shared goals (Green & Johnson, 2015). IPP can be defined as when learners, patients, practitioners, communities and families advance and sustain interprofessional working relationships to enable optimum health outcomes (Canadian Interprofessional Health Collaborative, 2010). The key elements of this collaboration include partnerships, trust, shared decision making and respect; while collaboration is enhanced by collaborative leadership, role clarification, effective interprofessional communication and client-centred focus to care or services (Canadian Interprofessional Health Collaborative, 2010). As such, the general objective of inclusive practice and interprofessional education is to deliver healthcare organization’s clients with improved health outcomes.
Significance of IPP in Canadian Nursing
IPP is a significant aspect for nurses in Canadian hospitals. Through IPP, patient outcomes are improved as collaboration between nurses and other healthcare practitioners is enhanced. This then leads to reduced mortality and morbidity rates of patients from avoidable circumstances. It is also significant as it ensures patient medication dosages are optimized, thus aiding nursing practice. It also results in the prevention of adverse drug reactions while allowing nurses to serve larger groups of people (Green &Johnson, 2015). This is realized when nurses work within their scope in IPP from the interdisciplinary education they receive thus meet the needs of many patients. This also helps to reduce extra work as each healthcare practitioner handles their specific task with the patient (Donato et al., 2016). Through IPP, nurses are also prevented from duplicating the services they render to their patients thus enhance public access to services which then generates the best value for the cost ( Gougeon, Johnson & Morse, 2017 ). As a result of contemporary nursing practice and education, IPP is an important aspect that each nurse must be aware of for better interdisciplinary collaboration.
Opinions and Beliefs About IPP in Canadian Nursing
Collaboration is key in all healthcare fields if practitioners want to realize the best outcomes for their clients. Evidence shows that the fields of nursing research, education and clinical practice are interrelated (Green & Johnson, 2015). This, therefore, means that research informs nursing education which impacts clinical practice and patient care in healthcare facilities. Equally, research is influenced by nursing practice, needs of patients and healthcare practitioners and the educational systems (Green & Johnson, 2015). I, therefore, believe that the integration of IPP is a significant step towards realizing collaborative care by not only Canadian nurses but also other healthcare practitioners. I also believe that IPP is key in creating a culture of care in Canadian healthcare facilities and among nurses; that remains comprehensive, inclusive, and rounded for the care of patients (Gougeon, Johnson & Morse, 2017). I also believe that for collaboration to occur, active communication and professional ethics must be learnt, while client-centred care and evidence-informed decision making must be utilized (CNA, 2011). Canadian nurses, therefore, need to support and facilitate the implementation of IPP in various healthcare facilities to reap its benefits.
Factors Affecting IPP Using the Issue Framework
Historical analysis
Nursing practices had, for the longest time, involved only a few providers (nurses and doctors), which made Canadian nursing long-lasting but also led to numerous avoidable complications. In the previous centuries, medicine and nursing was known to be related as medicine dealt with curing diseases while nursing deals with health. It become hard for nurses and physicians to outline specific tasks, thus resulted in repetitions of tasks among nurses as IPP had not yet been implemented (Virani, 2012). By 1978, aspects of intersectoral cooperation begun being advocated for although nursing was still heavily dependent on nurses to fulfil their duties intra-professionally (McDonald & McIntyre, 2017). However, the Kirby commission of 2002 brought about the need for interdisciplinary teams working together in Canadian nursing, citing the benefits such as better health outcomes (McDonald & McIntyre, 2017). A key issue for IPP, however, is that different providers have to work alongside each other whereby some may not have undergone interdisciplinary education thus may hamper the collaborative process (Donato et al., 2016). All in all, IPP results in better health outcomes and increases efficiency for nurses in Canada.
Critical Feminist Analysis
Feminist analysis is conducted to find out aspects of gendered practice. In the previous centuries, nursing was believed to be a female profession while medicine was thought to a male profession. It had been observed that nurse’s input in healthcare was not regarded as much as women and nurses were seen to have a subordinate status (McDonald & McIntyre, 2017). Nurses, therefore, tried to influence doctors indirectly for their inputs to be considered. However, as the 20 th century was coming to an end (1990), it was documented that assertive nurses who disagreed with physicians and other healthcare professionals in the team had their opinions heard and respected (McDonald & McIntyre, 2017). As such, it became evident that these members had to learn collaboratively to bring about equal participation between nurses and other healthcare professionals. The critical feminist approach does not favor females over males or nurses over other healthcare practitioners. It tries to get rid of the apparent inequalities on the healthcare team by giving each member a unique voice.
Social and cultural analysis
Many health professions have branched out to form unique professions in Canadian healthcare in the past fifty years. Healthcare practitioners identified themselves as having unique skills grouped themselves and advanced their educational levels on their areas of expertise (McDonald & McIntyre, 2017). This was aimed at building on their unique profession and increase recognition from the community, other healthcare practitioners and legal and government agencies. Some of these professions are self-regulated, and the practitioners have a territorial approach which hinders IPP that calls for collaborative practice (Virani, 2012). Professionalization of self-regulated practice, therefore, affects the implementation of IPP, thus affecting Canadian nursing. However, unregulated staff end up performing tasks that these upcoming professions and regulated professionals in the past would do (CNA, 2011). Skilling up is, however, perceived differently by some nurses who believe that it only aims to advance physicians biomedical goals rather than nursing unique goals. It also results in discrimination of professional staff as unregulated professionals work for lesser salaries as compared to regulated staff (Virani, 2012). IPP might have numerous benefits, but some nurses might be against its implementation since they see that it reduces the chances of patients being seen by regulated professionals who will increase their health outcomes.
Political analysis
In the past, nurses have been oppressed, and their voices were not heard. Canadian nurses as a group have gone through extreme measures to ensure their voices were heard. They had formed organizations to help advocate for them. Their state of powerlessness stemed from them being underpaid and seen as subordinates to physicians (White et al., 2015). The Regulated Health Professions Act of 1991 aimed at self-regulating health professions to provide some latitude for interchangeability among healthcare practitioners (McDonald & McIntyre, 2017). With IPP, skills are mixed and matched to ensure more healthcare providers can offer more services to reduce the number of providers per patient. Nurses, therefore, need to voice out their concerns on IPP as they have organizations that will lobby their issues in IPP. The lack of a governing framework on IPP has led to the contentious issue of role accountability and skill mix (Butcher et al., 2015). Having a governing framework will ensure that IPP is regulated, thus redesigning Canadian nursing practices and care delivery of patients.
Ethical analysis
Nurses are involved in the care of their patients to help enhance their quick recovery. Collaboration among Canadian nurses is a professional responsibility that leads to better patient outcomes (McDonald & McIntyre, 2017). Nursing practice is met with unplanned for complexities that require nurses to conduct ethical analysis to choose the best solution for their patients and themselves. Through implementing IPP, nurses may feel that a patient's health is at stake as they do not get attended to by specialists rather by unregulated healthcare practitioners (White et al., 2015). Nurses must, therefore, perform ethical analysis in IPP and ensure that the unregulated care providers that they assign or delegate tasks to can meet the requirements that each patient needs to ensure they provide the best care (White et al., 2015). Through IPP, nurses are accountable for regular communication, their decision of delegating tasks, setting standards, teaching, and continued supervision of unregulated care providers.
Economic analysis
An economic analysis on IPP implementation as a contemporary issue in Canadian healthcare is important as it reveals hidden agendas and those that benefit from economic discourses. IPP is primarily aimed at increasing patient care and outcomes through ensuring that various healthcare professionals are well versed with multiple professional knowledge (McDonald & McIntyre, 2017). Another secondary benefit of IPP is that it leads to reduced government and organization expenditure. Through maximizing on efficiency, healthcare organizations and the Canadian government can realize greater measurable outcomes for much less (McDonald & McIntyre, 2017). This occurs at the expense of professionals who are left out as unregulated care providers are given their jobs. Moreover, IPP could lead in the overreliance of these unregulated providers though organizations and governments insistence on cost calculations, thus influencing Canadian nurses and their work accountability (White et al., 2015). It could also result in questions regarding quality assurance of the care provided to patients from nurse practitioners and the community, which will call for healthcare providers accountability.
Barriers to resolution
IPP is advocated for by different parties which have different reasons for preferring it. Collaboration is necessary to every profession that wishes to achieve success. However, in Canadian nursing, although IPP insists on collaboration in educating nurses and in practicing nursing, some barriers hinder it from meeting the needs of various stakeholders. First, IPP must be informed by interprofessional education and research. Significant barriers to education come from a lack of financial support and scheduling difficulties in institutions of higher learning (Butcher et al., 2015). Second, there is a lack of clear role allocation that comes with IPP. Hospitals have both unregulated and regulated healthcare providers who serve similar purposes and lack a clear understanding of their role in Canadian hospitals (Bosch & Mansell, 2015). Next is the issue of ineffective communication among nurses and other healthcare providers. Nurses know the value of interpersonal communication to the well-being of the patient. However, with IPP, this becomes quite challenging as sometimes the patient suffers from sudden changes in health and needs dire care.
Strategies for resolution
To ensure nurses are better equipped for IPP, interprofessional education has to be taught to nursing students. This would mean that dedicated staff and healthcare organizations teach and fund nursing students with interest in interprofessional education (Butcher et al., 2015). The professionals should also emphasize on the importance of communication in IPP. Nurses and other team members should know the roles they are supposed to play and how to execute them to increase accountability among nurses and other healthcare providers in Canadian hospitals (Butcher et al., 2015). Organizations and governments should also create a framework that guides managers and healthcare practitioners on what is expected from them. Navigating through issues of communication in IPP can be done by insisting on the importance of communication among healthcare providers (Bosch & Mansell, 2015). It can also be beneficial to create a unique framework to be followed when patients need instant decisions to be made, and the healthcare providers are not within communication range.
Conclusion
Interprofessional practice in Canadian nursing is an important contemporary issue. IPP can realize benefits to multiple stakeholders in the healthcare system, such as nurses and patients through its integration and implementation. Real collaboration in education and practice with interprofessional teams can lead to no vel nursing practices and thinking . It can also help in facilitating a culture of care that stays holistic, comprehensive, and inclusive for the care of patients. The various issues affecting IPP implementation have been discussed, and the barriers have been identified. The strategies to IPP implementation have also been discussed thus giving rise to three main recommendations. First, there is a need for regulating IPP to ensure each professional in the care continuum of IPP knows their role to increase accountability. Second, more research should however be done on the reasons why nurses might be against its implementation to understand how to ensure all nurses are on board with IPP. Moreover, research should be done on the various ways of incorporating self-regulated and regulated professional in IPP to ensure that they can offer patients their professional care.
References
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