Creating opportunities for interdisciplinary collaboration and patient‐centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting

Liu, RN Wei; Gerdtz, Marie; Manias, Elizabeth

doi:10.1111/jocn.13360

Cited by 33 publications

(26 citation statements)

References 26 publications

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“…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). 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).…”

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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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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“…At times, they would defer to alternative viewpoints to confirm or clarify their knowledge (Cranley, Doran, Tourangeau, Kushniruk, & Nagle, ). As the key personnel involved in medication administration nurses spent considerable time facilitating the collection of information, framing options for patients and other HPs and filtering information prior to deciding on the appropriate action as others have found (Johnson et al., ; Liu, Gerdtz, & Manias, ; Manias, Aitken, & Dunning, ).…”

Section: Discussionmentioning

confidence: 99%

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Bucknall

Fossum

Hutchinson

et al. 2019

Journal of Advanced Nursing

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Aims To describe nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in acute hospital settings. Background Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses’ medication administration decision‐making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. Design A descriptive exploratory study design. Methods Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio‐recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. Results Ninety‐five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. Conclusion Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses’ medication administration safety strategies.

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“…The benefits seen by pharmacy students' participation in the online medication management training program was enhanced by the inclusion of a simulated interprofessional communication activity. A recent study involving nurses, doctors and a pharmacist based on two medical wards in an acute hospital identified the interpersonal, authoritative and instructive styles used when communicating with patients about medication and highlighted the need for improved interprofessional collaboration in order to ensure safe, patient-centred care is employed during medication management (Liu et al 2016). By using simulation-based learning, this complex and high level discourse could be explored in ways that engender empathy, respect and safety whilst allowing students the opportunity to practise and rehearse dialogue with the interprofessional team and the patient.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a simulation-based hospital pharmacy training package for pharmacy students

Hattingh

Robinson

Kelly

2018

Int J Educ Technol High Educ

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This study describes the process undertaken to develop, implement and evaluate a simulation-based training package focused on medication management and reconciliation processes for final year pharmacy students about a patient's hospital journey. A five module training package was developed following a literature review and consultation with stakeholders. The simulation-based package immersed students in a real-life scenario and was delivered to final year pharmacy students over a six-week period in 2016. Data on knowledge, skills and confidence was collected via a survey in the week preceding engagement with the online training package and 1 week post completion of the training. The mean score was compared across four student categories: three categories incorporated students who had not completed a hospital pharmacy placement and one category comprised students who had completed a hospital placement. Qualitative feedback was collected via an online survey at the conclusion of the training program. Of the 79 participants, 44 (55.7%) completed both the pre and post-test surveys that showed the change in score was statistically significant. There was a significant positive change in mean test scores across all four student categories for the domains of skills, knowledge and confidence. Assessment of students' confidence according to 16 ranking statements also improved markedly post-training. Thirty-one students provided qualitative feedback that was generally positive. The positive outcomes reinforce the rationale to include online simulation-based methodologies as part of pharmacy education programs. The model provides a reproducible framework for online simulated learning activities that could be applied within various professions and educational environments.

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Creating opportunities for interdisciplinary collaboration and patient‐centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting

Abstract: Clinicians need to be encouraged to have regular conversations to talk about and challenge each other's practices. More emphasis should be placed on ensuring that patients are given opportunities to voice their concerns about how their medications are managed.

Cited by 33 publications

References 26 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

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Evaluation of a simulation-based hospital pharmacy training package for pharmacy students

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