Complexities of emergency communication: clinicians’ perceptions of communication challenges in a trilingual emergency department

Pun, Jack; Chan, Engle Angela; Murray, Kristen A.; Slade, Diana; Matthiessen, Christian M.I.M.

doi:10.1111/jocn.13699

Cited by 33 publications

(28 citation statements)

References 39 publications

(73 reference statements)

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“…We found that the CNs and the DOCs play a vital role in maintaining information flow within their own and across other professions in the ED, and this finding is congruent with the results of a previous study that reviewed effective communication in CL [16]. Similar to the study findings, Pun et al [36, 37] found that information was repeated several times. We found some differences between CL activities performed by CNs and DOCs.…”

Section: Discussionsupporting

confidence: 91%

Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department

Husebø

Olsen

2019

Scand J Trauma Resusc Emerg Med

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BackgroundThe provision of safe, high quality healthcare in the Emergency Department (ED) requires frontline healthcare personnel with sufficient competence in clinical leadership. However, healthcare education curriculum infrequently features learning about clinical leadership, and there is an absence of experienced doctors and nurses as role models in EDs for younger and less experienced doctors and nurses. The purpose of this study was to explore the activities performed by clinical leaders and to identify similarities and differences between the activities performed by charge nurses and those performed by doctors on-call in the Emergency Department after completion of a Clinical Leadership course.MethodsA qualitative exploratory design was chosen. Nine clinical leaders in the ED were shadowed. The data were analyzed using a thematic analysis.ResultsThe analysis revealed seven themes: receiving an overview of the team and patients and planning the shift; ensuring resources; monitoring and ensuring appropriate patient flow; monitoring and securing information flow; securing patient care and treatment; securing and assuring the quality of diagnosis and treatment of patient; and securing the prioritization of patients. The last two themes were exclusive to doctors on-call, while the theme “securing patient care and treatment” was exclusive to charge nurses.ConclusionsCharge nurses and doctors on-call perform multitasking and complement each other as clinical leaders in the ED. The findings in this study provide new insights into how clinical leadership is performed by charge nurses and doctors on-call in the ED, but also the similarities and differences that exist in clinical leadership performance between the two professions. Clinical leadership is necessary to the provision of safe, high quality care and treatment for patients with acute health needs, as well as the coordination of healthcare services in the ED. More evaluation studies of this Clinical Leadership course would be valuable.

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Section: Discussionsupporting

confidence: 91%

Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department

Husebø

Olsen

2019

Scand J Trauma Resusc Emerg Med

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“…Medication communication has been assessed ethnographically from the interplay viewpoint between nurses, patients, physicians and students (Liu, Gerdtz, & Manias, 2015, 2016;Rutledge, Retrosi, & Ostrowski, 2018;Schoenthaler, Allegrante, Chaplin, & Ogedegbe, 2012;Tobiano et al, 2019), but also concerning professionals’ tendency to follow communicated guidelines (Karttunen et al, 2020). Studies of medication communication have been conducted on emergency situations concerning language barriers (Pun, Chan, Murray, Slade, & Matthiessen, 2016), racial issues affecting medication communication (Schoenthaler et al, 2012) and environmental issues of communication (Liu et al, 2014;Manias, Cranswick, et al, 2019;Yu et al, 2018). Nevertheless, the relative frequency of a wide variety of specific communication issues has not been measured using incident reports submitted in acute care.…”

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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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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“…Extensive research shows that health communication—between patients and clinicians, as well as between clinicians—is vital to quality health care (Pun, Chan, Matthiessen, Slade, & Murray, ; Slade et al, ). When health communication is unclear or inaccurate, patient safety is significantly compromised.…”

Section: Introductionmentioning

confidence: 99%

Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study

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Complexities of emergency communication: clinicians’ perceptions of communication challenges in a trilingual emergency department

Cited by 33 publications

References 39 publications

Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department

Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department

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

Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study

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