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

Borrott, N; Kinney, S; Newall, F; Williams, A; Cranswick, N; Wong, I; Manias, E; (2017) Medication communication between nurses and doctors for paediatric acute care: An ethnographic study. Journal of Clinical Nursing , 26 (13-14) pp. 1978-1992. 10.1111/jocn.13606. Green open access

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Abstract

AIMS AND OBJECTIVES: To examine how communication between nurses and doctors occurred for managing medications in inpatient paediatric settings. BACKGROUND: Communication between health professionals influences medication incidents' occurrence and safe care. DESIGN: An ethnographic study was undertaken. METHODS: Semi-structured interviews, observations and focus groups were conducted in three clinical areas of an Australian tertiary paediatric hospital. Data were transcribed verbatim and thematically analysed using the Medication Communication Model. RESULTS: The actual communication act revealed professionals' commitment to effective medication management and the influence of professional identities on medication communication. Nurses and doctors were dedicated to providing safe, effective medication therapy for children, within their scope of practice and perceived role responsibilities. Most nurses and junior doctors used tentative language in their communication while senior doctors tended to use direct language. Irrespective of language style, nurses actively engaged with doctors to promote patients' needs. Yet, the medical hierarchical structure, staffing and attendant expectations influenced communication for medication management, causing frustration among nurses and doctors. Doctors' lack of verbal communication of documented changes to medication orders particularly troubled nurses. Nurses persisted in their efforts to acquire appropriate orders for safe medication administration to paediatric patients. CONCLUSIONS: Collaborative practice between nurses and doctors involved complex, symbiotic relationships. Their dedication to providing safe medication therapy to paediatric patients facilitated effective medication management. At times, shortcomings in inter-disciplinary communication impacted on potential and actual medication incidents. RELEVANCE TO CLINICAL PRACTICE: Understanding of the complexities affecting medication communication between nurses and doctors helps to ensure inter-professional respect for each other's roles and inherent demands. Interdisciplinary education delivered in health care organisations would facilitate greater clarity in communication related to medications. Encouraging the use of concise, clear words in communication would help to promote improved understanding between parties, and accuracy and efficacy of medication management. This article is protected by copyright. All rights reserved.

Type: Article
Title: Medication communication between nurses and doctors for paediatric acute care: An ethnographic study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jocn.13606
Publisher version: http://dx.doi.org/10.1111/jocn.13606
Language: English
Additional information: This is the peer reviewed version of the following article: Journal of Clinical Nursing, which has been published in final form at http://dx.doi.org/10.1111/jocn.13606. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: collaborative practice, communication, ethnography, inter-professional interactions, language, medication communication, medication management, paediatrics, patient safety
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: http://discovery.ucl.ac.uk/id/eprint/1522192
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