Bedside Nurses' Perceptions of Effective Nurse-Physician Communication in General Medical Units: A Qualitative Study

Kato, Hiroyuki; Clouser, Jessica Miller; Talari, Preetham; Vundi, Nikita; Adu, Akosua; Karri, Kishore; Isaacs, Kathy; Williams, Mark V.; Chadha, Romil; Li, Jing

doi:10.7759/cureus.25304

Cited by 3 publications

(1 citation statement)

References 30 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This not only increases the likelihood of errors in carrying out medication orders [ 17 ], but also leads to underreporting of errors [ 8 , 30 , 31 ]. Recognizing nurses as active members of the healthcare team and encouraging their active participation in patient care is essential [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

A grounded theory of the implementation of medical orders by clinical nurses

Asadi,

Ahmadi,

Mohammadi

et al. 2024

BMC Nurs

View full text Add to dashboard Cite

Objective To explore the process of implementing medical orders by clinical nurses, and identify specific areas of concern in the implementation process, and uncover strategies to address these concerns. Background The implementation of medical orders is a crucial responsibility for clinical nurses, as they bear legal accountability for the precise implementation of directives issued by medical practitioners. The accurate implementation of these orders not only shapes the quality and safety of healthcare services but also presents numerous challenges that demand careful consideration. Method This study employed a qualitative design using a grounded theory approach to construct a comprehensive theoretical framework grounded in the insights and experiences of nurses operating within the hospital settings of Iran. The study encompassed 20 participants, comprising 16 clinical nurses, two nurse managers, and two specialist doctors working in hospital settings. The selection process involved purposeful and theoretical sampling methods to ensure diverse perspectives. Data collection unfolded through in-depth, individual, semi-structured interviews, persisting until data saturation was achieved. The analytical framework proposed by Corbin and Strauss (2015) guided the process, leading to the development of a coherent theory encapsulating the essence of the study phenomenon. Findings The primary finding of the study underscores the significance of ‘legal threat and job prestige’ highlighting diverse repercussions in case of errors in the implementation of medical orders. At the core of the investigation, the central variable and the theory of the study was the ‘selective and tasteful implementation of orders to avoid legal and organizational accountability.’ This indicated a set of strategies employed by the nurses in the implementation of medical orders, encapsulated through three fundamental concepts: ‘accuracy in controlling medical orders,’ ‘untruth documentation,’ and ‘concealment of events. The formidable influence of legal threats and job prestige was further compounded by factors such as heavy workloads, the doctor’s non-compliance with legal instructions for giving verbal orders, the addition of orders by the doctor without informing nurses, and pressure by nursing managers to complete documentation. The resultant psychological distress experienced by nurses not only jeopardized patient safety but also underscored the intricate interplay between legal implications and professional standing within the healthcare framework. Conclusion Alleviating staff shortages, enhancing the professional rapport between doctors and nurses, offering legal support to nursing staff, implementing measures such as recording departmental phone conversations to deter the non-acceptance of verbal orders, fostering an organizational culture that embraces nurse fallibility and encourages improvement, and upgrading equipment can ameliorate nurses’ apprehensions and contribute to the safe implementation of medical orders.

show abstract

Section: Discussionmentioning

confidence: 99%

A grounded theory of the implementation of medical orders by clinical nurses

Asadi,

Ahmadi,

Mohammadi

et al. 2024

BMC Nurs

View full text Add to dashboard Cite

show abstract

A comprehensive analysis of different types of clinical rounds in hospital medicine

Shaik,

Aggarwal,

Singh

et al. 2023

Baylor University Medical Center Proceedings

View full text Add to dashboard Cite

Nurses’ Perception Regarding the Quality of Communication between Nurses and Physicians in Emergency Departments in Saudi Arabia: A Cross Sectional Study

et al. 2023

View full text Add to dashboard Cite

Background: One of the defining characteristics of safe and highly reliable patient care is effective team communication. It is becoming increasingly crucial to improve communication among healthcare team members since social and medical conditions change quickly. Main aim: The present study seeks to assess nurses’ perception of the quality of communications between physicians and nurses and associated factors in the emergency departments of selected government hospitals in Saudi Arabia. Methods: A cross-sectional study was carried out in five hospitals in Jazan and three hospitals in Hail City, Saudi Arabia, on a convenience sample of 250 nurses total using self-administered questionnaires. Independent sample t-tests and one-way ANOVA were used for the data analysis. Ethical considerations were adhered to throughout the conduct of the study. Results: The mean score of all domains of nurses’ perceptions of the quality of nurse–physician communication in emergency departments was 60.14 out of 90. The highest mean score was observed in the openness subdomain, followed closely by relevance and satisfaction, with mean percentages of 71.65% and 71.60%, respectively. Age, level of education, years of experience, and job position had significant positive correlations with nurses’ perceptions of the quality of nurse–physician communication. (p = 0.002, 0.016, 0.022, and 0.020, respectively). Post hoc tests showed that nurses older than 30, those with diplomas, those with more than 10 years’ experience, and those in supervisory positions had more positive perceptions of the quality of nurse–physician communication. On the other hand, there was no significant difference in the mean scores of quality of nurse–physician communication with regard to participants’ sex, marital status, nationality, and working hours (p > 0.05). Multiple linear regression showed that none of the independent factors affected the nurses’ perceptions of the quality of nurse–physician communication in emergency departments (p > 0.05). Conclusions: Overall, the quality of communication between nurses and physicians was not satisfactory. Future research should be meticulously planned, using validated outcome measures, that will capture and reflect the goals of communication among healthcare teams.

show abstract

Bedside Nurses' Perceptions of Effective Nurse-Physician Communication in General Medical Units: A Qualitative Study

Cited by 3 publications

References 30 publications

A grounded theory of the implementation of medical orders by clinical nurses

A grounded theory of the implementation of medical orders by clinical nurses

A comprehensive analysis of different types of clinical rounds in hospital medicine

Nurses’ Perception Regarding the Quality of Communication between Nurses and Physicians in Emergency Departments in Saudi Arabia: A Cross Sectional Study

Contact Info

Product

Resources

About