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The effect of a teamwork intervention on staff perception of teamwork and patient care on a medical surgical unit (Marguet & Ogaz 2019)

Absence of conflict of interest.

Citation

Marguet, M. A., & Ogaz, V. (2019). The effect of a teamwork intervention on staff perception of teamwork and patient care on a medical surgical unit. Nursing Forum, 54(2), 171-182.

Highlights

  • The study’s objective was to examine the impact of a teamwork intervention on participants’ job satisfaction, perceived level of teamwork at work, and satisfaction with the perceived level of teamwork. 

  • The study used an interrupted time series design, surveying participants to compare their job satisfaction and perceptions of teamwork before and after the intervention. 

  • The study suggested that there was no significant relationship between the intervention and any of the attitude outcomes that the study examined. 

  • This study receives a low evidence rating. This means we would not be confident that any estimated effects are attributable to the intervention; other factors are likely to have contributed. However, the study did not find statistically significant effects. 

Intervention Examined

Teamwork Intervention

Features of the Intervention

Effective teamwork is important to reducing or eliminating missed nursing care in medical-surgical settings. This intervention targeted nursing staff in a medical-surgical unit of a hospital. The intervention drew on other teamwork studies and models. It consisted of four 2.5-hour team workshops over a two-week period with four to six participants per session. Each workshop included didactic presentations, case scenarios, and debriefings and covered key teamwork concepts related to mutual performance monitoring, shared mental models, closed-loop communication and more. Workshops included time for staff to discuss what they learned and how it could impact their practice. The workshops were led by other staff under a "train-the-trainer" model; these staff attended a two-day training workshop prior to recruitment.  

Features of the Study

The study used an interrupted time series design to compare participants’ job satisfaction and perceptions of teamwork before and after the intervention. The original sample was 21 nursing staff who worked in one medical surgical unit at a Midwest metropolitan hospital. Nursing staff who volunteered completed a pretest survey one week before the intervention began. Then one week after the last training workshop, posttest surveys were distributed. All participants were female. In the original sample, nine were licensed practical nurses (LPNs), seven were nursing assistants or patient care assistants (NA/PCAs), and the remaining five were registered nurses (RNs). About three-quarters were younger than 45 years of age. The analytic sample for the teamwork analysis is 12 of the original participants who completed both the pretest and posttest. Information on the characteristics of the analytic sample is not provided. The data source is a study-developed survey that combined items from two other surveys: the Nursing Teamwork Survey (NTS) and the Misscare Survey.  

Findings

Attitudes

  • The study suggested that there was no significant relationship between the teamwork intervention and respondents’ satisfaction in their current position; satisfaction as an RN, LPN, or NA/PCA; satisfaction with the level of teamwork in their unit; or perceptions of teamwork.   

Considerations for Interpreting the Findings

The authors compared the outcomes of participants measured before and after they participated in the teamwork intervention. CLEAR’s guidelines require that the authors must observe outcomes for multiple periods before the intervention to rule out the possibility that participants had increasing or decreasing trends in the outcomes examined before enrollment in the program. That is, if participants who had increasing job satisfaction tended to enroll in the program, we would anticipate further increases over time, even if they didn’t participate in the program. Without knowing the trends before program enrollment, we cannot rule this out.  

Causal Evidence Rating

The quality of causal evidence presented in this report is low because the authors did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the teamwork intervention; other factors are likely to have contributed. However, the study did not find statistically significant effects. 

Reviewed by CLEAR

September 2022