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Title: | Nurse-to-nurse communication about multidisciplinary care delivered in the emergency department: An observation study of nurse-to-nurse handover to transfer patient care to general medical wards. | Authors: | O'Connor D.T.;Rawson H.;Redley B. | Monash Health Department(s): | Quality and Safety | Institution: | (O'Connor, Rawson, Redley) Centre for Quality and Patient Safety Research, Monash Health Partnership, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; Monash Health, Clayton Road, Clayton, VIC 3168, Australia | Issue Date: | 8-Sep-2020 | Copyright year: | 2020 | Publisher: | NLM (Medline) | Place of publication: | Australia | Publication information: | Australasian emergency care. 23 (1) (pp 37-46), 2020. Date of Publication: 01 Mar 2020. | Journal: | Australasian Emergency Care | Abstract: | BACKGROUND: Little is known about how Australian national safety standards for communicating multidisciplinary care are operationalised during high-risk care transitions. We examined transfer of care for complex patients from the emergency department (ED) to medical wards to explore nurse-to-nurse communication about multidisciplinary care provided in the ED. METHOD(S): Using naturalistic, mixed-methods design, observation, audit and interview data were collected from a convenience sample of 38 nurses during transfer of care for 19 complex patients from the ED to medical wards at a tertiary hospital. A focus group with 19 clinicians from multiple disciplines explored explanations for findings and recommendations. Quantitative data were analysed using frequencies and descriptive statistics; the Connect, Observe, Listen, Delegate (COLD) framework informed qualitative content analysis. RESULT(S): Nurses seldom communicated multidisciplinary care at patient transfer. Most handovers included Connect and Observe (63-95%) and Listen (90%); Delegate (42%) behaviours were infrequent. Behaviours consistent with good practice recommendations (90%) and known to increase communication risk (53%) were observed. Tensions between policies and clinical processes, and information quality negatively impacted transfers. CONCLUSION(S): This study revealed gaps in nurse-to-nurse communication about patients' multidisciplinary care. Complex factors negatively impact nurses' handover communication necessitating workarounds, and highlighting nurses' role as patient safety advocates.Copyright © 2020 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.auec.2019.12.004 | PubMed URL: | 31948933 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31948933] | ISSN: | 2588-994X (electronic) | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/34789 | Type: | Article | Subjects: | health care facility hospital emergency service human information processing *interdisciplinary communication male middle aged nurse organization and management patient safety *psychology qualitative research Victoria adult procedures clinical handover female health care facility hospital emergency service information processing interdisciplinary communication nurse organization and management patient safety psychology Victoria procedures clinical handover organization and management patient safety procedures *psychology qualitative research Victoria middle aged male *interdisciplinary communication information processing adult health care facility female clinical handover nurse human hospital emergency service |
Type of Clinical Study or Trial: | Qualitative study |
Appears in Collections: | Articles |
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