Nurse-physician communication in the long-term care setting: perceived barriers and impact on patient safety.
Nurse-physician communication in the long-term care setting: perceived barriers and impact on patient safety.
复制标题
DOI：
10.1097/pts.0b013e3181b53f9b
复制
发表时间：
2009-09
影响因子：
2.2
通讯作者：
Gurwitz JH
中科院分区：
文献类型：
--
作者：
Tjia J;Mazor KM;Field T;Meterko V;Spenard A;Gurwitz JH
卫生保健提供者之间的明确和完整的沟通是安全病人管理的先决条件，也是联合委员会2008年国家病人安全目标的主要优先事项。本研究旨在探讨长期照护环境下，护士对护医沟通之认知。混合方法的研究，包括自填式问卷和定性半结构化的电话采访持牌护士从26 LTC设施在康涅狄格州。问卷测量感知开放沟通，相互理解，语言理解，挫折，专业尊重，护士准备，时间负担和后勤障碍。定性访谈的重点是确定以前可能没有考虑过的有效护士与医生沟通的障碍，并征求护士克服这些障碍的建议。375名护士完成了问卷调查，21名护士完成了定性访谈。护士发现了几个障碍，有效的护士-医生沟通：缺乏医生的开放性沟通，后勤挑战，缺乏专业精神，语言障碍。感觉医生匆忙是最常见的障碍（28%），其次是找到一个安静的地方打电话（25%）和难以到达医生（21%）。在定性访谈中，有共识认为，护士需要简短，并准备与医生沟通时，相关的临床信息，医生需要更开放的倾听。护士和医生的行为相结合，导致在LTC设置无效的沟通。这些研究结果对患者安全有重要意义，并支持发展结构化的沟通干预措施，以提高护士与医生的沟通质量。
Clear and complete communication between health care providers is a prerequisite for safe patient management and is a major priority of the Joint Commission's 2008 National Patient Safety Goals. The goal of this study was to describe nurses' perceptions of nurse-physician communication in the long-term care (LTC) setting. Mixed-method study including a self-administered questionnaire and qualitative semi-structured telephone interviews of licensed nurses from 26 LTC facilities in Connecticut. The questionnaire measured perceived openness to communication, mutual understanding, language comprehension, frustration, professional respect, nurse preparedness, time burden and logistical barriers. Qualitative interviews focused on identifying barriers to effective nurse-physician communication that may not have previously been considered and eliciting nurses' recommendations for overcoming those barriers. Three-hundred seventy-five (375) nurses completed the questionnaire and 21 nurses completed qualitative interviews. Nurses identified several barriers to effective nurse-physician communication: lack of physician openness to communication, logistic challenges, lack of professionalism, and language barriers. Feeling hurried by the physician was the most frequent barrier (28%), followed by finding a quiet place to call (25%) and difficulty reaching the physician (21%). In qualitative interviews, there was consensus that nurses needed to be brief and prepared with relevant clinical information when communicating with physicians and that physicians needed to be more open to listening. A combination of nurse and physician behaviors contributes to ineffective communication in the LTC setting. These findings have important implications for patient safety and support the development of structured communication interventions to improve quality of nurse-physician communication.