Delivering interprofessional care in intensive care: A scoping review of ethnographic studies

Abstract

Background: The sustained clinical and policy interest in the United States and worldwide in quality and safety activities initiated by the release of To Err Is Human has resulted in some high-profile successes and much disappointment. Despite the energy and good intentions poured into developing new protocols and redesigning technical systems, successes have been few and far between, leading some to argue that more attention should be given to the context of care. Objective: To examine the insights provided by qualitative studies of interprofessional care delivery in intensive care. Methods: A total of 532 article abstracts were reviewed. Of these, 24 met the inclusion criteria. Results: Articles focused on the nurse-physician relationship, patient safety, patients' families and end-of-life care, and learning and cognition. The findings indicated the complexities and nuances of interprofessional life in intensive care and also that much needs to be learned about team processes. Conclusion: The fundamental insight that interprofessional interactions in intensive care do not happen in a historical, social, and technological vacuum must be brought to bear on future research in intensive care if patient safety and quality of care are to be improved. © 2014 American Association of Critical-Care Nurses.