Embedded Files
By: Alexis Dostie
Barriers and solutions
Barriers and solutions
Six co-authors and medical professionals, Jennifer Tjia, Kathleen M. Mazor, Terry Field, Vanessa Meterko, Ann Spenard, and Jerry H. Gurwitz, all conducted a study to try and identify the perceived communication barriers between nurses and physicians and their impact on patient care and safety in the long-term care setting. They noted that it is a combination of behaviors from both nurses and physicians that contribute to ineffective communication in the long-term care (LTC) setting. Some of the barriers that were found through the methods used in this study were a lack of professionalism, language barriers, logistic challenges, and a lack of physician openness to communication (Tjia, 2009). These medical professionals feel that to improve the quality of nurse-physician communication, the development of structured communication interventions should be looked into (Tjia, 2009). For example, they mentioned the implementation of SBAR (Situation, Background, Assessment, and Recommendation), a format that is to help quicken and refine the delivery of patient information between nurses and physicians.
How This Study Was Conducted
How This Study Was Conducted
To conduct this study, 375 nurses were gathered to complete the self-administered questionnaire and a subsample of twenty-one nurses from the 375 were gathered to complete the qualitative telephone interview. The sample of 375 nurses was taken from twenty-six different nursing homes in Connecticut that had been recruited to participate in the study. The eligibility of the nurses chosen for this study was based on how many hours (more than eight) the nursing homes reported of direct patient care they had a month.
The questionnaire that was developed for the study addressed communication, specifically areas of nurse preparedness, time burden, openness, language comprehension and mutual understanding, frustration with the interaction and professional respect, and logistical barriers (Tjia, 2009). These areas of questions were then rated on a five-point Likert scale ranging from 1 (almost never) to 5 (almost always). A panel of inter-disciplines, two nurses and two geriatricians, was used to review and determine the validity of the questions before sending out the questionnaire for pilot testing and then on to the sample of 375 nurses (Tjia, 2009). A coffee incentive in the form of a gift certificate was included with the questionnaire and along with the instructions, there was a notice for confidentiality - no personal information was included, thus, this was to be turned in anonymously. In the end, a total of 325 completed questionnaires were received.
Next, to conduct the telephone interview, those who responded to the questionnaire were asked if they would like to participate in a semi-structured follow-up interview (Tjia, 2009). The goal for those sampled for the interview was to pick half randomly and the other half selectively. In total, ten nurses were randomly sampled and eleven were selectively sampled for the telephone interview (Tjia, 2009). Each interview lasted fifteen to twenty minutes and to analyze the interviews, each one was tape-recorded and transcribed after consent was given prior to the interview. The same five questions were asked in each interview. For example, one of the questions asked was “Think about the last time that you found it difficult to communicate with a physician. Please briefly describe what happened,” and another question was “What have you found to be particularly helpful in improving nurse-physician communication? What tips might you give a new nurse?” (Tjia, 2009).
Responses and Findings
Responses and Findings
This study yielded many helpful responses for the researchers, with many of the results confirming previous findings from other similar studies but in different medical settings. Through the questionnaire, it was found that twenty-eight percent of the nurses felt that they were being rushed or hurried by the physician which impaired their ability to collaborate (Tjia, 2009). Other findings found that thirteen to seventeen percent of nurses felt that their encounters with physicians were marked with rudeness and disrespect and twenty-four percent felt that they were bothering the physician if they had to make a phone call, among many other findings (Tjia, 2009). In the interviews, fifteen out of twenty-one of the nurses said that there was a lack of preparedness on their end when making a telephone call to a physician (Tjia, 2009). Another finding reports that there are several trust issues between nurses and physicians in patient management as described by the nurses interviewed (Tjia, 2009). In the interviews, many nurses also described a lack of responsiveness on behalf of the physician which makes it difficult to have effective communication (Tjia, 2009).
Tija et al. found that the major barrier for nurses was their preparedness and the major barrier for physicians was a lack of professional respect and timely callbacks, physician disinterest, and inadequate collaboration. They then highlighted the importance of preparedness and competency in nurse-physician communication to improve patient safety and care (Tjia, 2009). It was also noted that in previous studies, it was found that communication styles and training of nurses and physicians differences both contribute to communication errors (Tjia, 2009).
In the end, Tjia and her colleagues all emphasize the importance of their study in three terms. The first being the documentation of the problem itself as the ineffectiveness of nurse-physician communication continues to stay a relevantly important issue, even with forty years of research and improvement efforts (Tjia, 2009). The second being the framework that the study used to highlight the inter-relatedness of each stage of communication between nurses and physicians and the capability of its breakdown at any stage due to the behaviors of both nurses and physicians (Tjia, 2009). And the third and last being the identification of potential strategies to, once again, help improve the quality of nurse-physician communication by describing barriers not previously explained well in context (Tjia, 2009).
Work Cited
Work Cited
Tjia, J., Mazor, K. M., Field, T., Meterko, V., Spenard, A., & Gurwitz, J. H. (2009,September). Nurse-physician communication in the long-term care setting:Perceived barriers and impact on patient safety. Journal of patient safety. Retrieved October 30, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2757754/#S6title
Page updated
Report abuse