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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 and Manias, Elizabeth 2016, Medication communication between nurses and doctors for paediatric acute care: an ethnographic study, Journal of clinical nursing, vol. In Press, pp. 1-41, doi: 10.1111/jocn.13606.

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Title Medication communication between nurses and doctors for paediatric acute care: an ethnographic study
Author(s) Borrott, Narelle
Kinney, Sharon
Newall, Fiona
Williams, Allison
Cranswick, Noel
Wong, Ian
Manias, ElizabethORCID iD for Manias, Elizabeth orcid.org/0000-0002-3747-0087
Journal name Journal of clinical nursing
Volume number In Press
Start page 1
End page 41
Total pages 41
Publisher Wiley-Blackwell Publishing
Place of publication Chichester, Eng.
Publication date 2016-10-05
ISSN 0962-1067
1365-2702
Keyword(s) collaborative practice
communication
ethnography
inter-professional interactions
language
medication communication
medication management
paediatrics
patient safety
Summary 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.
Language eng
DOI 10.1111/jocn.13606
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
1110 Nursing
1701 Psychology
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, John Wiley & Sons
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089988

Document type: Journal Article
Collection: School of Nursing and Midwifery
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