Submitted to- Submitted by-
Respected Mam Balkeej Kaur
Mrs. Kamaljeet kaur Msc(N) First year
Msc (N) lecturer
CON, Muktsar, AIMS.
Nursing Profession is faced with lot of
complex health issues due to technological
and medical achievements, Increased
Elderly Population ,Increased Patients with
Much of the literature on collaboration describes what
it should look like as an outcome, but little is written
describing how to approach the developmental
process of collaboration.
Effects of Collaboration (Abramson & Mizrahi 1996).
Improved patient outcomes
Reduced length of stay
Increased nursing job satisfaction and retention
The roots of the word collaboration, namely co-, and
laborer, combine in Latin to mean “work together.”
That means the interaction among two or more
individuals, which can encompass a variety of actions
such as communication, information sharing,
coordination, cooperation, problem solving, and
Teamwork and collaboration are often used equally.
The description of collaboration as a dynamic process.
The collaborative process involves a synthesis of different
perspectives to better understand complex problems.
An effective collaboration is characterized by building and
sustaining “win-win-win” relationships
ISSUE-An issue used to be a matter for consideration or
Issue is the point in question an important subject of
debate or ligitation
Collaboration is the most formal inter organizational
relationship involving shared authority and responsibility
for planning, implementation, and evaluation of a joint
effort (Horde, 1986)
Mattessich, Murray and Monsey (2001) define
collaboration as a mutually beneficial and well-defined
relationship entered into by two or more organizations to
A concentrated effort of individuals and groups to attain a
PRINCIPLES OF COLLABORATION-A
STATE OF ART
A stands for
Assets,attitudes and values that each potential partner
Accountability to each other
Agreements to be mutual and documented
Acknowledgement of each others contributions
R stands for;
Respect for each partners
Responsibilities –well defined and agreed upon
T stands for;
Time and timing
Tact and talent
NEED FOR COLLABORATION
For increasing practical skills
To combine theoretical knowledge with sufficient
COMPETENCIES REQUIRED FOR
NURSE AS A COLLABORATOR
Mutual respect and trust
Giving and receiving feedbacks
TYPES OF COLLABORATION
Inter professional collaboration
1. Interdisciplinary collaboration- it is the term
used to indicate the combining of two or more
disciplines, professions, departments, or the like,
usually in regard to practice ,research, education and
2.Multidisciplinary collaboration- refers to
independent work and decision making, such as when
disciplines work side-by-side on a problem.
3.Transdisciplinary collaboration- efforts involve
multiple disciplines sharing together their knowledge
and skills across traditional disciplinary boundaries in
accomplishing tasks or goals. transdisiciplinary efforts
effects reflects a process by which individuals work
together to develop a shared conceptual framework
that integrates and extends discipline specific theories,
concepts, and methods to address a common
4. Interprofessional collaboration-has been
described as involving “ interaction of two or more
disciplines involving professionals who work together ,
with intention, mutual respect and commitments for
the sake of a more adequate response to a human
COLLABORATIVE ISSUES WITHIN
The nurse and the superintendent
The nurse and the head nurse /Departmental Nurse
The nurse and fellow nurse
COLLABORATIVE ISSUES OUTSIDE
Nurse and the physician
Nurse and the client
Nurse and the health care professionals
Nurse and pharmacist
Nurse and nutritionist
Nurse and the professional nursing organizations
MODELS OF COLLABORATION
Clinical school of nursing model (1995)
Dedicated education unit clinical teaching
Research joint appointment model ( 2000)
Practice research model (2001)
Collaboration clinical education Epworth Dakin
(CCEED) MODEL (2003).
The collaborative learning unit (British
Colombia) model 2005
The collaborative approach to nursing care(can-
CLINICAL SCHOOL OF NURSING
CLINICAL SCHOOL OF NURSING
Encompasses the highest level of academic and
clinical nursing research and education.
This was the concept of visionary nurses from both La
Trobe and The Alfred Clinical School of Nursing
The development of the Clinical School offers benefits
to both hospital and university.
Opportunities for exchange of ideas with clinical
nurses with increased opportunities for clinical
Dedicated education unit (DEU)
clinical teaching model (1999)
In this model a partnership of nurse executives, staff
nurses and faculty transformed patient care units into
environment of support for nursing students and staff
nurses while continuing the critical work of providing
quality care to acutely ill adults.
Key features of DEU are:
Uses existing resources
Supports the professional development of nurses
Allows for the clinical education of increased number
Exclusive uses of the clinical unit by school of nursing.
Use of staff nurses who want to teach as clinical
Preparation of clinical instructor for their teaching
role through collaborative staff and faculty
Faculty role to work directly with staff as a coach,
teaching/ learning resources to develop clinical
reasoning skills, to identify clinical expectations of
students , and evaluate student achievement.
Research joint appointment model
A Joint appointment has been defined by Lantz et al.
(1994),as “ a formalized agreement between two
institutions where an individual holds a position in
each institution and carries out specific and defined
The goal of this approach is to use the implementation
of research findings as a basis for improving critical
thinking and clinical decision making of nurses.
In this arrangement the researcher is a faculty
member at the educational institution with credibility
in conducting research and with an interest in
developing a research programme in the clinical
Outcomes identified by Donnelly ,Werfel, Wolfe
(1994) for the educational institutions are that it
becomes more in touch with the real world and more
readily able to identify research questions that have
PRACTICE RESEARCH MODEL
PRACTICE RESEARCH MODEL
It is an innovative collaborative partnership agreement
between Fremantle Hospital and Health Service and
Curtin University of Technology in Perth, Western
The partnership engages academics in the clinical
setting in two formalized collaborative appointments.
This partnership not only enhances communication
between educational and health services, but fosters
the development of nursing research and knowledge.
This model encouraged a close working relationship
between registered nurses and academics, and has also
facilitated strong links at the health service with the
Nursing Research and Evaluation Unit, medical staff
and other allied health professionals.
Practice – driven research development
Collaborative Partnership and Best Practice
The collaborative partnership was formed by nursing
health professionals, from the community health
service and the university who recognized the need to
bridge the theory- clinical practice gap and
acknowledged the futility of continuing to work in
isolation from each other.
In practical terms, this involved a formal contractual
arrangement between the organizations that led to the
establishment of a Nurse Research Consultant (NRC)
Role of Nurse Research Consultant
( NRC) in PRM
In the PRM, the role of the Nurse Research Consultant
(NRC) was articulated as that of mentor and
consultant on issues related to research, methodology
publications and dissemination.
Although the PRM was specifically designed to
enhance nursing research activity and the
implementation of evidence-based community health
nursing practice, the Model also encouraged the
involvement of the multi- disciplinary team to work to
achieve the aims of the partnership agreement
COLLABORATIVE CLINICAL EDUCATION
EPWORTH DEAKIN (CCEED) MODEL
In an effort to improve the quality of new graduate
transition, Epworth Hospital and Dakin University ran
a collaborative project (2003) funded by the National
Safety and Quality Council to improve the support
base for new graduates while managing the quality of
patient care delivery.
The Collaborative Clinical Education Epworth Dakin
(CCEED) model developed to facilitate clinical
learning, promote clinical scholarship and build nurse
Key findings of the 2005 CCEED program were-
Students learning objectives were met and satisfaction
Undergraduate clinical education was valued by
preceptors and managers as a workforce investment
Preceptors were enriched in their clinician role as a
result of their participation in the program and
reflection on the process.
Preceptors managed multiple roles in order to meet
demands of patient care and student learning.
The collaborative learning unit
(British Colombia) model 2005
The collaborative learning unit model was based on
the ‘dedicated education units’ concept develop,
successfully implemented and researched in Australia.
The collaborative learning unit model of practice
education for nursing is a clinical education
alternative to preceptor ship. In the CLU model,
students practice and learn on a nursing unit, each
following an individual set rotation and choosing their
learning assignment , according to their learning
Clinical nurses preparing to adopt the CLU model
have described a positive learning environment as one
where questions are expected . In CLU approach the
students are not attached to the units as an ‘extra set of
hands’ to augment the nursing workforce.
In this model , nursing faculty , clinical nurses and
students work collaboratively to enhance learning
opportunities as well as develop the professional
knowledge base of nursing.
The collaborative approach to nursing
care(CAN- care) model(2006)
The CAN-care model emerged as academic and
practice leaders acknowledge the need to work
together to promote the education , recruitment and
retention of nurses at all stages of their career.
The goal was to design an educationally dense ,
practice based experience to socialize second degree
students to the role of professional nurse.
A secondary goal was to enhance and support the
professional and career development of unit based
The essence of the CAN-care model is the relationship
between the nurse learner (student) and nurse expert
(unit based nurse ) , within the context of each
Through this model the student comes to know the
organizational context of nursing practice, the
multifaceted role of professional nurses, and assumes
responsibility for coming to know the meaning
nursing in each unique situation.
Collaboration and independent
practice: ongoing issues for nursing
Inter – professional collaboration and independent
practice: why these issues are important during the
twentieth century, the nursing profession has
undergone immense change.
Nursing has progressed from an occupation to a fully
licensed profession, with members that provide a
broad range of services independently and in a variety
of professional relationships with other providers.
This evolution has changed how nurses are educated,
clinically prepared, and how they perceive their role.
Starting With turn – of –the –century debates
concerning the appropriateness of professional
nursing practice, registered nurses began assessing not
only their licensure status but their roles related to
In the early years of nursing profession, it was
generally believed that the nurses served and cared for
their patients by assisting physicians. However the
perception of nursing often varied dramatically from
During wars and times of crises, nurses worked with
beside physicians conducting surgical procedures,
diagnosing care, and prescribing treatments and
The role of the public health nurse, as it developed
earlier in this century, was often independent with
nurses working with families of patients with
tuberculosis or other highly contagious diseases and
providing a broad range of interventions, both health
and socially focused.
Intrinsic to nursing is the collaborative process: nurses
and physicians working together and independently
assessing, diagnosing, and caring for consumers by
preparing patients histories, conducting physical and
psychosocial assessments, and reviewing and
discussing their cases with other health professionals
to determine the hanging health status of each client.
Nurses and physicians have understood the
importance of this overlap in scopes, practice, and
patient care , yet there is little literature and virtually
no legislation that clearly provides a balanced
accounting of the benefits of this working
1. Shebeer P. Basheer ,S. Yaseen Khan ‘ A concise text
book of “ ADVANCED Nursing Practice” published
by EMMESS , first edition , page no. 698-707.