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

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journal contribution
posted on 2017-07-01, 00:00 authored by N Borrott, S Kinney, F Newall, A Williams, N Cranswick, I Wong, Elizabeth ManiasElizabeth Manias
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.



Journal of clinical nursing






1978 - 1992


Wiley-Blackwell Publishing


Chichester, Eng.







Publication classification

C Journal article; C1 Refereed article in a scholarly journal

Copyright notice

2016, John Wiley & Sons