Medication communication between nurses and doctors for paediatric acute care: An ethnographic study

Borrott, Narelle; Kinney, Sharon; Newall, Fiona; Williams, Allison; Cranswick, Noel; Wong, Ian C. K.; Manias, Elizabeth

doi:10.1111/jocn.13606

Cited by 23 publications

(27 citation statements)

References 42 publications

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“…However, in our study, the frequent reasons for communication delay were found more in the false assumption of colleagues` work processes (26%) and lack of task coordination than technical access barriers (5.2%). Similar to our findings, Borrott et al (2017) reported nurses’ frustration in the lack of verbal enforcement of changed digital prescriptions. To avoid delays in the implementation of prescriptions in the future, enforced verbal communication is needed, especially outside the ward round periods (Borrott et al, 2017).…”

Section: Discussionsupporting

confidence: 91%

“…In the PuBMed database, a search using the keywords medication incident OR medication error AND communication yielded 11 hits in the year 2000, 97 hits in 2010 and 127 hits in 2018. Errors in medication communication being linked with medication incidents have been studied from specific viewpoints, such as within diverse care‐provider settings or between them (Petersen, Foged, Madsen, Andersen, & Nørholm, 2018), in speciality practices (Keers et al, 2018;Liu, Manias, & Gerdtz, 2014;Manias, Cranswick, et al, 2019;Tobiano, Chaboyer, Teasdale, Raleigh, & Manias, 2019) or among specific patient age group settings (Borrott et al, 2017). Evidence of medication communication exists for a variety of care process situations (Braaf, Rixon, Williams, Liew, & Manias, 2015a;Liu, Manias, & Gerdtz, 2012;Manias, Braaf, et al, 2019;Yu, Li, Gao, Liu, & Lin, 2018), and concerning a diverse range of communication methods (Foged, Nørholm, Andersen, & Petersen, 2017;Redley & Botti, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Syyrilä

Vehviläinen‐Julkunen

Härkänen

2020

Journal of Clinical Nursing

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Aim To identify the types and frequencies of communication issues (communication pairs, person related, institutional, structural, process and prescription‐related issues) detected in medication incident reports and to compare communication issues that caused moderate or serious harm to patients. Background Communication issues have been found to be among the main contributing factors of medication incidents, thus necessitating communication enhancement. Design A sequential exploratory mixed‐method design. Methods Medication incident reports from Finland (n = 500) for the year 2015 in which communication was marked as a contributing factor were used as the data source. Indicator phrases were used for searching communication issues from free texts of incident reports. The detected issues were analysed statistically, qualitatively and considering the harm caused to the patient. Citations from free texts were extracted as evidence of issues and were classified following main categories of indicator phrases. The EQUATOR’s SRQR checklist was followed in reporting. Results Twenty‐eight communication pairs were identified, with nurse–nurse (68.2%; n = 341), nurse–physician (41.6%; n = 208) and nurse–patient (9.6%; n = 48) pairs being the most frequent. Communication issues existed mostly within unit (76.6%, n = 383). The most commonly identified issues were digital communication (68.2%; n = 341), lack of communication within a team (39.6%; n = 198), false assumptions about work processes (25.6%; n = 128) and being unaware of guidelines (25.0%; n = 125). Collegial feedback and communication from patients and relatives were the preventing issues. Moderate harm cases were often linked with lack of communication within the unit, digital communication and not following guidelines. Conclusions The interventions should be prioritised to (a) enhancing communication about work‐processes, (b) verbal communication about digital prescriptions between professionals, (c) feedback among professionals and (f) encouraging patients to communicate about medication. Relevance to clinical practice Upon identifying the most harmful and frequent communication issues, interventions to strengthen medication safety can be implemented.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Syyrilä

Vehviläinen‐Julkunen

Härkänen

2020

Journal of Clinical Nursing

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“…Despite the differences seen in the domains of meaning and preferences for partnership, the domains of biomedical cause, fault, control and effectiveness of natural treatments are areas where mothers' perception and the providers' understanding of this perception were the same. The years of experience in both physician and advanced practice providers groups (Table ) likely contributed to improved agreement, as is consistent with previous research in this field (Borrott et al, ). Additionally, agreement between providers and parents was likely impacted by the diversity of roles within the treatment team, as well as the consistency in the providers during hospitalisation.…”

Section: Discussionsupporting

confidence: 86%

“…It is evident in this study that advanced practice providers have an understanding of mothers' perception of illness. Nurses and doctors have different communication styles (Borrott et al, ) and have fundamental differences including status, gender, training and patient care responsibilities (Thomas et al, ). Many similarities were found between all healthcare providers and mothers, which may indicate that paediatric providers in general have a relationship with their patients and families that fosters understanding regarding perception of illness.…”

Section: Resultsmentioning

confidence: 99%

“…There are known fundamental differences between nurses and doctors (Thomas, Sexton, & Helmreich, ) that likely result in variations in the way each group is taught to communicate with their patients and the way they perceive their patients' perception of illness (Blake, Leach, Robbins, Pike, & Needleman, ; Borrott et al, ; Manojlovich, ). If variability in communication methods exists already between provider groups, this variability may translate into differences in the perceptions being measured in this study.…”

Section: Discussionmentioning

confidence: 99%

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Understanding mothers' perception of child's illness: Adapting the CONNECT Instrument for pediatrics

Magner

Bragg

Treat

et al. 2019

Journal of Clinical Nursing

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Aims and objectives:To adapt the CONNECT Instrument for use in the paediatric population, to assess validity of this instrument after its adaptation and to assess concordance between mothers' perception of their child's illness and providers' understanding of mothers' perceptions. Background:The CONNECT Instrument (Patient Education and Counseling, 73, 2008, 232-239) was validated in an adult outpatient population to characterise both patients' perspectives and physicians' understanding of their patients' perspectives for several dimensions of the illness experience. However, this did not include the paediatric population or advanced practice providers.Design: A two-part prospective, cross-sectional, observational study to assess the validity of CONNECT for Pediatrics and to assess perception of illness. Methods:The CONNECT Instrument (Patient Version) was adapted from its original form and modified to CONNECT for Pediatrics to facilitate use in the inpatient paediatric population. Eighty-five participants were enrolled including mothers, advanced practice providers and physicians from 2013-2014 during a child's scheduled admission to a paediatric epilepsy monitoring unit. Principal components analysis and inter-item reliability were analysed, and differences in the six mean domain scores were assessed using repeated measures analysis of variance (RM-ANOVA). Reporting of this research adheres to the STROBE guidelines (See Appendix S1).Results: Our analysis indicated that the modifications made provided a relatively valid and reliable instrument. There were overall statistically significant differences between the mother and physician groups, specifically in the domains of meaning and preference for partnership. Conclusions:Paediatric advanced practice providers and physicians do have an understanding of mothers' perception of illness.Relevance to clinical practice: The ability of physicians and advanced practice providers to understand mothers' perceptions of illness is increasingly important in a changing healthcare environment. CONNECT for Pediatrics facilitates the identification of mothers' perception of their child's illness and provides the opportunity for paediatric advanced practice providers and physicians to understand parents' perception of illness.

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Unsafe doctor–nurse interactions in the process of implementing medical orders: A qualitative study

et al. 2023

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AimThis study aimed to explore challenges faced by clinical nurses in the process of implementing medical orders.DesignA qualitative study using inductive content analysis.MethodsSemi‐structured individual interviews were carried out with 17 participants including nurses, nurse managers and medical doctors who were purposefully selected. The collected data underwent inductive qualitative content analysis.ResultsThe main research finding was the category of ‘unsafe doctor–nurse interaction’. It included three subcategories: ‘conflicts in documenting and executing orders’, ‘not accepting the nurse's suggestions for writing and correcting orders’ and ‘failure to accept the responsibility of orders by the doctor’. Challenges in the professional relationship between doctors and nurses cause mistrust and conflict. They also enhance nurses' concerns about professional and legal issues in the workplace and endanger patient safety.

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Medication communication between nurses and doctors for paediatric acute care: An ethnographic study

Cited by 23 publications

References 42 publications

Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Understanding mothers' perception of child's illness: Adapting the CONNECT Instrument for pediatrics

Unsafe doctor–nurse interactions in the process of implementing medical orders: A qualitative study

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