Author Affiliations: Hahn School of Nursing and Health Science, University of San Diego (Dr Nibbelink), CA; College of Nursing, The University of Iowa (Dr Dunn Lopez), Iowa City; University of California, San Diego; Department of Surgery (Dr Reeves), Division of Hospital Medicine (Dr Horman), and Clinical Professor, School of Medicine (Dr El-Kareh), La Jolla.
Comput Inform Nurs. 2024 Apr 1;42(4):267-276. doi: 10.1097/CIN.0000000000001108.
Errors in decision making and communication play a key role in poor patient outcomes. Safe patient care requires effective decision making during interdisciplinary communication through communication channels. Research on factors that influence nurse and physician decision making during interdisciplinary communication is limited. Understanding influences on nurse and physician decision making during communication channel selection is needed to support effective communication and improved patient outcomes. The purpose of the study was to explore nurse and physician perceptions of and decision-making processes for selecting interruptive or noninterruptive interdisciplinary communication channels in medical-surgical and intermediate acute care settings. Twenty-six participants (10 RNs, 10 resident physicians, and six attending physicians) participated in semistructured interviews in two acute care metropolitan hospitals for this qualitative descriptive study. The Practice Primed Decision Model guided interview question development and early data analysis. Findings include a core category, Development of Trust in the Communication Process, supported by three main themes: (1) Understanding of Patient Status Drives Communication Decision Making; (2) Previous Interdisciplinary Communication Experience Guides Channel Selection; and (3) Perceived Usefulness Influences Communication Channel Selection. Findings from this study provide support for future design and research of communication channels within the EHR and clinical decision support systems.
决策和沟通中的错误在患者预后不良中起着关键作用。安全的患者护理需要通过沟通渠道在跨学科交流中进行有效的决策。对影响护士和医生在跨学科交流中决策的因素的研究有限。了解在沟通渠道选择过程中对护士和医生决策的影响，有助于支持有效的沟通和改善患者预后。本研究的目的是探索护士和医生在选择中断或非中断的跨学科沟通渠道时的看法和决策过程，研究地点在医疗-外科和中级急性护理环境中。在这项定性描述性研究中，26 名参与者（10 名注册护士、10 名住院医师和 6 名主治医生）在两家急性护理大都市医院参加了半结构化访谈。实践引发决策模型指导了访谈问题的开发和早期数据分析。研究结果包括一个核心类别，即对沟通过程的信任发展，由三个主题支持：（1）对患者状况的理解推动沟通决策；（2）以前的跨学科沟通经验指导渠道选择；（3）感知的有用性影响沟通渠道选择。这项研究的结果为电子健康记录和临床决策支持系统中的沟通渠道的未来设计和研究提供了支持。
