A mixed-methods pilot study of the factors that influence collaboration among registered nurses and registered practical nurses in acute care

Abstract

Objective: Staffing models employing registered nurses (RNs) and registered practical nurses (RPN) have created the opportunity for enhanced collaboration in acute care settings. However, little is understood about how these nurses collaborate and the factors that influence their collaboration. The purpose of this pilot study was to examine the factors that influenced collaboration among RNs and RPNs at one acute care hospital in Canada in order to understand and improve nursing collaborative practice.Methods: Using an explanatory, sequential mixed methods design, data were collected over several months in 2016 from the nurses using a questionnaire and individual telephone interviews. Sixty-five RNs and RPNs working on medical, surgical and emergency units completed the “Nurse-Nurse Collaboration Scale” survey and ten RNs and RPNs participated in the telephone interviews.Results: Quantitative analysis showed lower scores among younger nurses across most domains of the survey: conflict management, communication, shared processes, coordination and professionalism. Qualitative analysis revealed working to full scope of practice was a facilitator of RN-RPN collaboration, and older age and poor interpersonal skills were barriers to successful collaboration.Conclusions: The results provide discussion for identification of strategies to improve collaborative practice among nurses such as establishing joint education programs for RNs and RPNs, and the use of models or frameworks to guide collaborative practice in healthcare organizations.