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Issues for optometrists relating to interprofessional relations in a hospital and medical center.

Managed care and the changes in the health care system are golden opportunities for the optometric profession. There is a major role for optometry in the medical center and there is a major role for optometry in the various managed health care programs. Optometry is well positioned as a primary health care profession. The leaders of this noble profession must be on the alert and plan and work diligently to include optometry in all aspects of the ever-changing health care system.

Health Facilities↗

The rehabilitation team: staff perceptions of the hospital environment, the interdisciplinary team environment, and interprofessional relations.

Although inpatient rehabilitation is an interdisciplinary activity organized around a treatment team, there is a limited understanding of the workings of the interdisciplinary process. To elucidate staff perceptions of key aspects of the rehabilitation treatment process, we surveyed staff (n = 113) from selected inpatient teams. The staff completed social psychological instruments that measure perceptions of the hospital environment (The Ward Atmosphere Scale [WAS]), the team's environment (the Group Environment Scale [GES]), and interprofessional relations (Interprofessional Perception Scale [IPS]). Rehabilitation staff generally endorse the team approach, but express concerns over professional boundaries. Interprofessional difficulties seemed to be independent of team membership or professional training. Compared with published data from other settings, rehabilitation teams resembled task-oriented groups, but showed significant differences across teams in their perceptions of the team and hospital environments. The task-oriented character of rehabilitation teams, team-specific characteristics, and discord in interprofessional relationships may need to be considered in studies of rehabilitation teams effectiveness.

Adult↗

Medicolegal education and crisis in interprofessional relations.

An increase in malpractice claims is only one indication of the problem physicians and attorneys have in their interprofessional relations. This note explores the factors, such as increased specialization and social responsibility, that have given these professionals a myopic view of their respective roles. The note suggests that the crisis in interprofessional relations can be alleviated by interdisciplinary education in professional schools. It examines the problems inherent in current interdisciplinary programs and offers a model program jointly taught to law and medical students. The model course uses a problem solving approach that forces each student to examine the methods and limitations of both professions and to develop a concept of the professional's role in society.

Education, Medical↗

Interprofessional relations between doctors and nurses: perspectives from South Wales.

Interprofessional relations between doctors and nurses: perspectives from South Wales This paper discusses findings from a study of interprofessional relationships between doctors and nurses in medical wards in three provincial general hospitals in south Wales. The aim of the research was to investigate the changing nature of doctor-nurse relations, and in particular, how far the notion of the doctor-nurse game, as developed by Leonard Stein (Stein 1967, 1990), remains relevant to contemporary hospital work. The present paper concentrates on a subset of the findings concerned with doctors' and nurses' accounts of the hospital division of labour and the extent of any overlap in their work activities. Semi-structured interviews were conducted with 20 doctors and 39 nurses in their places of work over a period of 4 months. Inductive analysis of the data indicated that, whilst doctors and nurses perceived their roles in largely traditional terms, there was some recognition of blurring of occupational boundaries, especially when considering work pressures, working at night and differences in practice in more specialized clinical areas. Although nurses were generally reluctant to challenge doctors' authority, some used the notion of patient 'advocacy' to frame and justify their questioning of particular decisions. Whilst doctors valued 'experience' in nurses and saw experienced nurses as the group who might most legitimately move into doctors' territory, nurses valued formal education and saw advanced nursing qualifications as the route to role expansion.

Attitude of Health Personnel↗

Attitudes of pharmacists and nurses toward interprofessional relations and decentralized pharmaceutical services.

Pharmacists' and nurses' attitudes toward pharmacist-nurse relations and pharmaceutical services were surveyed before and after the implementation of satellite pharmacies at a 600-bed teaching hospital. The same questionnaire was distributed two months before decentralization (phase 1) and nine months after decentralization was completed (phase 2). Sixty questions about the pharmacy services and the drug treatment process were to be answered using a seven-point, Likert-type scale. Overall response rates for the two phases were 62% and 45%, respectively. Pharmacists' satisfaction with all measured aspects of pharmaceutical services increased after decentralization of services; nurses' satisfaction increased for all measures except pharmacist-conducted medication histories. Pharmacists' satisfaction with the nursing department was greater after decentralized services were implemented. Most aspects of role conflict, one of four measured antecedents to interdepartmental conflict, improved subsequent to decentralization of services. Because of changes in personnel between the two phases of the study, the results may represent the opinions of different people, rather than actual changes in satisfaction. The attitudes of nurses and pharmacists toward overall distributive pharmaceutical services and toward certain aspects of interprofessional relations improved after pharmaceutical services were decentralized.

Attitude of Health Personnel↗