Exploration of interaction and shared care arrangements of generalist community nurses and external nursing teams in a rural health setting

Abstract

Objective: The purpose of this pilot study was to determine the understanding of nurses within a shared care model and the degree of interaction evident in their practice in the shared care nursing environment in a rural care
setting. Sharing of care between different nursing teams can allow for the improved use of minimal resources available in rural communities. The objectives of the research were firstly, to identify the interactions of nursing teams in a shared care model and secondly, to determine how shared care is evident in their practice. The final objective was to draw attention to the importance of shared care models in rural health settings and to develop recommendations
to support shared care models.

Design: A qualitative, non experimental, grounded theory descriptive study was used in this research.

Setting: Primary care. 

Subjects: The sample comprised the generalist community health team, which consisted of registered nurses with more than 5 years post registration experience in community health nursing and two external nursing teams, comprised of a palliative care team and an aged care team.

Main Outcome Measures: Identification of the nursing interactions and shared care practices in order to develop recommendations to foster and support shared care models in changing health structures.

Results: The study generated four themes: a lack of understanding of each teams’ roles; difficulties in communication of information; the importance of setting shared goals in care planning; and the need for collaboration to ensure clarity in case coordination.

Conclusion: Results suggest that confusion around role, skills, communication, care planning and coordination of care within a shared care model are creating barriers to effective sharing of care. Co‑location of services should enhance sharing of care. These results should facilitate the development of care approaches that maximise health outcomes and contribute to a better understanding of collaborative processes that can assist in the provision of health care in rural settings.