Nurse practitioner interactions in acute and long-term care: an exploration of the role of knotworking in supporting interprofessional collaboration
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Abstract
BACKGROUND: Interprofessional care ensures high quality healthcare. Effective interprofessional collaboration is required to enable interprofessional care, although within the acute care hospital setting interprofessional collaboration is considered suboptimal. The integration of nurse practitioner roles into the acute and long-term care settings is influencing enhanced care. What remains unknown is how the nurse practitioner role enacts interprofessional collaboration or enables interprofessional care to promote high quality care. The study aim was to understand how nurse practitioners employed in acute and long-term care settings enable interprofessional collaboration and care. METHOD: Nurse practitioner interactions with other healthcare professionals were observed throughout the work day. These interactions were explored within the context of "knotworking" to create an understanding of their social practices and processes supporting interprofessional collaboration. Healthcare professionals who worked with nurse practitioners were invited to share their perceptions of valued role attributes and impacts. RESULTS: Twenty-four nurse practitioners employed at six hospitals participated. 384 hours of observation provided 1,284 observed interactions for analysis. Two types of observed interactions are comparable to knotworking. Rapid interactions resemble the traditional knotworking described in earlier studies, while brief interactions are a new form of knotworking with enhanced qualities that more consistently result in interprofessional care. Nurse practitioners were the most common initiators of brief interactions. CONCLUSIONS: Brief interactions reveal new qualities of knotworking with more consistent interprofessional care results. A general process used by nurse practitioners, where they practice a combination of both traditional (rapid) knotworking and brief knotworking to enable interprofessional care within acute and long-term care settings, is revealed.
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In healthcare, permanent teams are increasingly replaced by fluid combinations of expertise (knots) corresponding to the problem at hand.
“In healthcare, permanent teams are increasingly replaced by fluid combinations of expertise,”
From Using activity theory to transform medical work and learning (2021) · cites this paper as Hurlock-Chorostecki et al. 2015
The Background describes healthcare knotworking as short-lived collaboration among changing participants, and the Discussion describes an NP working within a team of changing professionals. Neither section says that permanent teams are increasingly being replaced; the paper supports the fluid-collaboration aspect, not the claimed trend. (LLM, conf=0.86)
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Cited by
Sorted by citations
Using activity theory to transform medical work and learning
Engeström, Y., & Pyörälä, E. (2021) · Medical Teacher · doi:10.1080/0142159x.2020.1795105 · Cited by 137 · see citing works
- Authors
- Hurlock-Chorostecki, C., van Soeren, M., MacMillan, K., Sidani, S., Donald, F., & Reeves, S.
- Affiliations
- Dalhousie University (CA)
- Toronto Metropolitan University (CA)
- St George's, University of London (GB)
- Corresponding author
- Reeves, Scott
- Venue
- BMC Nursing
- Published
- 2015-10-14
- Volume
- 14
- Issue
- 1
- Pages
- 50-50
- ISSN
- 1472-6955 (ISSN-L)
- PMC
- PMC4606543
- OpenAlex
- W2159336873
- Cited by
- 17
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 1 · 2016: 1
- FWCI
- 0.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Nursing (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
- Keywords
- nurse practitioners, knotworking, interprofessional collaboration, interprofessional care, acute care, long-term care, social practices
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