How do nurse practitioners in acute care affect perceptions of team effectiveness?

AIMS AND OBJECTIVES: To describe how acute care nurse practitioners affect perceptions of team effectiveness.

BACKGROUND: Acute care nurse practitioners provide safe and effective care to patients. There is limited evidence of the effects of acute care nurse practitioner roles on healthcare teams, and many of the findings are contradictory. Research is lacking to describe how nurse practitioners affect perceptions of team effectiveness.

DESIGN: A descriptive multiple-case study undertaken in two university-affiliated teaching hospitals in Canada.

METHODS: Data were collected from March-May 2009. Data sources included interviews (n = 59), time and motion study, non-participant observations, documents and field notes. Interviews were conducted individually or in groups using a semi-structured interview guide. Data were analysed within and across the cases to identify similarities and differences in perceptions of team effectiveness.

RESULTS: Team members believed the nurse practitioners improved the team's effectiveness. They identified six team processes they believed were improved by the addition of the nurse practitioners to the teams. The processes included decision-making, communication, cohesion, care coordination, problem-solving and focus on patients and families.

DISCUSSION: The study contributes to our understanding of how nurse practitioners affect perceptions of team effectiveness. Improved team communication and care coordination were believed to be particularly important. Nurse practitioner can facilitate patient- and family-centred care in healthcare teams.

CONCLUSION: Nurse practitioners improve perceptions of team effectiveness. Further work is needed in different contexts and with patients and families to determine their perceptions of team effectiveness.

RELEVANCE TO CLINICAL PRACTICE: The nurse practitioner role was believed to be particularly important to improve team communication and care coordination. This constitutes an added value of acute care nurse practitioners roles in healthcare teams. Nurse practitioner roles contribute to patient-centred care and can improve the quality and safety of the care provided to patients and families.