a Faculty of Health, School of Nursing , York University, York University Centre for Aging Research and Education , Toronto , Ontario , Canada.
Health Commun. 2019 Aug;34(9):1053-1059. doi: 10.1080/10410236.2018.1455141. Epub 2018 Mar 22.
Older people present with complex health issues on admission to hospital and are at high risk for functional decline and related complications. Thus, they require the services of diverse health-care professionals working in concert to support their functioning. Despite nurses' central role in caring for this patient population, and evidence indicating that interprofessional communication is a persistent challenge for nurses in acute-care settings, little is known about nurses' views on interprofessional communication in care preserving functioning in acutely admitted older people. To fill this knowledge gap, we gathered acute-care staff nurses' perspectives on interprofessional communication in a function-focused, interprofessional approach to hospital care for older adults. Thirteen focus groups were conducted with a purposeful, criterion-based sample of 57 nurses working in acute-care hospitals. Thematic analysis revealed two overarching themes capturing nurses' perspectives on key factors shaping interprofessional communication in a function-focused interprofessional approach to care (1) context of direct communication and (2) context of indirect communication. The first theme demonstrates that nurses preferred synchronous modes of communication, but some ascribed greater importance to unstructured forms of direct information-sharing, while others stressed structured direct communication, particularly interprofessional rounds. The second theme also documents divergence in nurses' views on asynchronous communication, with some emphasizing information technology and others analog tools. Perceptions of some modes of interprofessional communication were found to vary by practice setting. Theoretical and pragmatic conclusions are drawn that can be used to optimize interprofessional communication processes supporting hospitalized older people's functioning.
老年人在住院时会出现复杂的健康问题,他们功能下降和相关并发症的风险很高。因此,他们需要各种医疗保健专业人员的协同服务,以支持他们的功能。尽管护士在照顾这一患者群体方面发挥着核心作用,并且有证据表明,跨专业沟通对于急性护理环境中的护士来说是一个持续存在的挑战,但对于护士在急性入院老年人的功能保护护理方面的跨专业沟通观点知之甚少。为了填补这一知识空白,我们采用了以功能为重点的跨专业方法,收集了急性护理工作人员护士对老年人医院护理的跨专业沟通的观点。对在急性护理医院工作的 57 名护士进行了 13 个重点小组讨论,采用了有目的、基于标准的抽样方法。主题分析揭示了两个总体主题,这些主题抓住了护士对在以功能为重点的跨专业方法中塑造跨专业沟通的关键因素的看法(1)直接沟通的背景和(2)间接沟通的背景。第一个主题表明,护士更喜欢同步的沟通模式,但有些人认为非结构化的直接信息共享形式更为重要,而另一些人则强调结构化的直接沟通,特别是跨专业查房。第二个主题还记录了护士对异步沟通的看法存在分歧,一些人强调信息技术,另一些人强调模拟工具。发现一些跨专业沟通模式的看法因实践环境而异。得出了理论和实践上的结论,可用于优化支持住院老年人功能的跨专业沟通流程。