Interdisciplinary communication in the intensive care unit

Background. Patient safety research has shown poor communication among intensive care unit (ICU) nurses and doctors to be a common causal factor underlying critical incidents in intensive care. This study examines whether ICU doctors and nurses have a shared perception of interdisciplinary communication in the UK ICU. Methods. Cross-sectional survey of ICU nurses and doctors in four UK hospitals using a previously established measure of ICU interdisciplinary collaboration. Results. A sample of 48 doctors and 136 nurses (47% response rate) from four ICUs responded to the survey. Nurses and doctors were found to have differing perceptions of interdisciplinary communication, with nurses reporting lower levels of communication openness between nurses and doctors. Compared with senior doctors, trainee doctors also reported lower levels of communication openness between doctors. A regression path analysis revealed that communication openness among ICU team members predicted the degree to which individuals reported understanding their patient care goals (adjR2 = 0.17). It also showed that perceptions of the quality of unit leadership predicted open communication. Conclusions. Members of ICU teams have divergent perceptions of their communication with one another. Communication openness among team members is also associated with the degree to which they understand patient care goals. It is necessary to create an atmosphere where team members feel they can communicate openly without fear of reprisal or embarrassment

The Impact of High-Fidelity Simulation Practice on the Perceived Confidence of Experienced ICU Nurses

the pre-evaluations however, not all scores improved between the three scenarios. In fact, four of the nine total scores collected remained the same. In a paired sample T-test the data indicated a positive correlation (p=.05) between pre and post scores for level of comfort with role and level of competence. No statistical significance was noted between the pre and post scores for level of confidence. Because the scores were improved between all the pre to post evaluations this lack of statistical significance is probably due to the small sample size. In the pilot study with six participants the data displayed statistical significance between all pre and post evaluations for improvement. These findings motivated a formal study. Although more research is needed, this small study did show simulated patient experiences can have a positive impact on a nurses’ self-perceptions improving their level of comfort and competence in caring for this population

AN ETHNOGRAPHIC STUDY OF INTERPROFESSIONAL COLLABORATION IN A PAEDIATRIC SETTING: INSIGHTS THROUGH THE LENS OF SCRIPTEDNESS

PhDInterprofessional collaboration (IPC) is when professionals from health and social care work together to provide a service for the patient or solve problems. Literature shows that although IPC is widely advocated, it is not always easy to achieve. IPC in the adult patient setting has been widely researched and despite the challenges, evidence shows several benefits. However, there is little IPC literature in hospitalised children’s settings. In view of this gap, the purpose of this study was to examine how healthcare providers enacted IPC in a paediatric setting. Goffman’s (1959) script theory and the different categories of scriptedness, guided the analytical process and gave structure and depth to the emerging findings, helping to see aspects of IPC that would otherwise remain invisible. This ethnography took place in a paediatric setting comprising of four wards namely; two medical, one surgical, and one oncology unit in one large hospital. Data collection and analysis were done iteratively and followed by time focusing exclusively on analysis and findings. The data corpus was generated through 114 hours of observation from 38 sessions, generating extensive field notes; 14 semi-structured formal interviews with professionals coming from seven different professions, and several informal interviews during observations. IPC was commonly observed during the weakly scripted encounters, mainly the unscheduled day-to-day interactions, not only because they were frequently observed, but also because the nature of these encounters was more conducive to IPC. Scriptedness also revealed that different professions contribute to the ward round IPC but not necessarily at the bedside. This became visible when the ward round was classified in five stages, guided by a multi-level metascript. Findings have added to the knowledge on IPC in paediatrics by highlighting how weak scripts guide the unscheduled encounters, and having a metascript guide the different stages of the ward round. This study has shown that the lens of scriptedness helps individuals discover how IPC is achieved during different encounters.University of Malt