Interprofessional Learning in Adult Critical Care: Early findings of a focused ethnographic study

Park, Vikki (2016) Interprofessional Learning in Adult Critical Care: Early findings of a focused ethnographic study. In: 31st BACCN Annual Conference 2016, 18th - 20th September 2016, Glasgow, Scotland, UK.

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Abstract

Background:
Due to its complexity, critical care requires numerous professionals to effectively work together (Rose 2011). This clinical setting has the potential to share interprofessional knowledge (Wagter et al. 2012) and Paradis et al. (2014) emphasise that there remains limited knowledge in this area, despite recognition that interprofessional collaboration in critical care units improves patient safety and quality. Further exploration is needed to ascertain how different critical care staff working together also learn with and from each other in this particular environment.

Aim:
To explore the culture of interprofessional learning (IPL) within adult critical care settings.

Method:
The multi-site research is in fulfilment of doctoral study. Data collected over 12 months, in 3 different NHS Hospital critical care units, is scheduled for completion in January 2017. A focused ethnography was chosen, to develop a rich description of the interprofessional learning culture, and this involves participants being observed in clinical practice and interviewed. At completion of the study, it is anticipated that approximately 90 hours of observation and 12-36 hours of interviews will have been generated. Data is being analysed using the principles of Grounded Theory and the constant comparison method.

Findings:
Early analysis of findings, from two of the three study sites, already suggests that IPL does exist in critical care settings and it is complex. It confirms staff are a rich source of knowledge and there appear to be numerous conduits which facilitate effective IPL. Interprofessional Learning is not linear; the depth and recognition of IPL is variable, it is influenced by internal drivers and also by external influences. The adult critical care IPL culture can be shaped by the organisation and by groups, but also individuals in the setting. Variability can be accounted for theoretically by considering a changeable holistic IPL ‘climate’ which is repeatedly influenced by the individuals in the setting at any given time.

Conclusion:
Whilst data collection remains incomplete; preliminary findings shed light on the intricacies and influencing factors leading to interprofessional learning within adult critical care. This research reveals numerous ways interprofessional learning takes place within adult critical care settings and the influential factors have been found to be multi-faceted. Critical care staff can be affected by both intrinsic and extrinsic influences therefore, individuals behaviour and engagement with IPL may be symptomatic of these extensive factors. 3 research themes are emerging: ‘Creating Space & Time for IPL’, ‘Collaborative IPL’ and ‘IPL & Humanistic Values’. The emerging theoretical framework is underpinned with social constructionism, socio-cultural learning theory and complexity.

Implications for practice:
This study provides increased understanding of the components which facilitate effective IPL in the adult critical care setting. It has the potential to improve the quality of care for patients and to promote knowledge development of critical care staff. The research findings could optimise the environmental design of learning spaces in adult critical care; ‘creating space for IPL’. The importance of safeguarding time and opportunity for IPL could also be factored into daily critical care practises and adopting a humanistic approach to IPL and team working may also prove beneficial to IPL in adult critical care settings. This exploratory study invites further research into IPL in adult critical care settings to improve the quality of care provided.

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