Physician-Nurse Practitioner Teamwork in Primary Care Practices in New York: A Cross-Sectional Survey.
Physician-Nurse Practitioner Teamwork in Primary Care Practices in New York: A Cross-Sectional Survey.
复制标题
纽约初级保健实践中的医师护士团队合作：横断面调查。
DOI：
10.1007/s11606-019-05509-2
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发表时间：
2020
影响因子：
5.7
通讯作者：
Friedberg,MarkW
中科院分区：
文献类型：
--
作者：
Poghosyan,Lusine;Ghaffari,Affan;Liu,Jianfang;Friedberg,MarkW
背景初级保健实践越来越依赖于不断增长的护士从业人员（NP），以满足初级保健需求。我们评估了在同一个初级保健实践中执业的NP和医生之间的团队合作，并确定了团队合作如何影响他们的工作满意度，离开目前工作的意图，和护理质量。设计一个交叉-2017年，采用横断面调查设计，从纽约州的NP和医生中收集数据。（398 NPs和186名医生）从476个初级保健的做法完成了调查，产生了27%的响应率为NPs和12%为physics.Main MeasuresThe调查工具包含验证的措施，团队合作和三个结果：工作满意度，意图离开，和感知的护理质量。简单和多层次的多变量回归modelsbuilt.Key ResultsMost参与者（76%）是适度满意或非常满意他们的工作（NP样本：75%;医生样本：77%），约10%打算离开他们目前的工作（NP样本：11%;医生样本：9%）。护理的平均感知质量是相同的NP和医生样本的平均值为8.5的11点量表。在控制了混杂因素后，较高的组织层面团队合作得分与较高的工作满意度相关（累积OR：3.00; 95% CI：1.85-4.88），意图离开的几率较低（OR：0.25; 95%CI：0.09-0.74），以及更高的感知护理质量（B=1.00; 95%CI：0.77-1.23）。结论这项研究提供了有关初级保健实践中NP-医生团队合作的证据。我们发现，绝大多数的NP和医生报告良好的团队合作，团队合作影响临床医生的工作满意度和意图离开，以及感知质量的护理在他们的做法。
BackgroundPrimary care practices increasingly rely on the growing workforce of nurse practitioners (NPs) to meet primary care demand. Understanding teamwork between NPs and physicians in primary care practices is critically important.ObjectiveWe assessed teamwork between NPs and physicians practicing within the same primary care practice and determined how teamwork affects their job satisfaction, intent to leave their current job, and quality of care.DesignA cross-sectional survey design was used to collect data from both NPs and physicians in New York State in 2017.Participants584 participants (398 NPs and 186 physicians) from 476 primary care practices completed the survey yielding a 27% response rate for NPs and 12% for physicians.Main MeasuresThe survey tool contained validated measures of teamwork and three outcomes: job satisfaction, intent to leave, and perceived quality of care. Simple and multi-level multivariable regression models were built.Key ResultsMost participants (76%) were either moderately satisfied or very satisfied with their job (NP sample: 75%; physician sample: 77%) and about 10% intended to leave their current job (NP sample: 11%; physician sample: 9%). The average perceived quality of care was the same across NP and physician samples with a mean of 8.5 on a 11 point scale. After controlling for confounders, a higher organizational-level teamwork score was associated with higher job satisfaction (cumulative OR: 3.00; 95% CI: 1.85-4.88), lower odds of intent to leave (OR: 0.25; 95% CI: 0.09-0.74), and higher perceived quality of care (b=1.00; 95% CI: 0.77-1.23).ConclusionsThis study produced evidence about NP-physician teamwork in primary care practices. We found the vast majority of NPs and physicians reported favorable teamwork, and that teamwork affects clinician job satisfaction and intent to leave as well as perceived quality of care in their practices.