IDEAS home Printed from https://ideas.repec.org/a/wly/jocnur/v25y2016i19-20p2943-2957.html
   My bibliography  Save this article

Creating opportunities for interdisciplinary collaboration and patient‐centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting

Author

Listed:
  • Wei Liu
  • Marie Gerdtz
  • Elizabeth Manias

Abstract

Aims and objectives This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Background Patient‐centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in‐depth analysis of medication interactions among nurses, doctors, pharmacists and patients. Design A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. Methods A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy‐six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. Findings Clinicians’ use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients’ illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision‐making about their health care treatment. In addition, the video method revealed clinicians’ extensive use of body language in communication processes for medication management. Conclusions The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient‐centred medication management in an acute hospital setting. Language discourses shaped and were shaped by complex power relations between patients and clinicians and among clinicians themselves. Relevance to clinical practice Clinicians need to be encouraged to have regular conversations to talk about and challenge each other's practices. More emphasis should be placed on ensuring that patients are given opportunities to voice their concerns about how their medications are managed.

Suggested Citation

  • Wei Liu & Marie Gerdtz & Elizabeth Manias, 2016. "Creating opportunities for interdisciplinary collaboration and patient‐centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute ho," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(19-20), pages 2943-2957, October.
  • Handle: RePEc:wly:jocnur:v:25:y:2016:i:19-20:p:2943-2957
    DOI: 10.1111/jocn.13360
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jocn.13360
    Download Restriction: no

    File URL: https://libkey.io/10.1111/jocn.13360?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Pilnick, Alison, 2003. ""Patient counselling" by pharmacists: four approaches to the delivery of counselling sequences and their interactional reception," Social Science & Medicine, Elsevier, vol. 56(4), pages 835-849, February.
    2. Wei Liu & Marie Gerdtz & Elizabeth Manias, 2015. "Challenges and opportunities of undertaking a video ethnographic study to understand medication communication," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(23-24), pages 3707-3715, December.
    3. Nugus, Peter & Greenfield, David & Travaglia, Joanne & Westbrook, Johanna & Braithwaite, Jeffrey, 2010. "How and where clinicians exercise power: Interprofessional relations in health care," Social Science & Medicine, Elsevier, vol. 71(5), pages 898-909, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Signe Foged & Vibeke Nørholm & Ove Andersen & Helle Vendel Petersen, 2018. "Nurses’ perspectives on how an e‐message system supports cross‐sectoral communication in relation to medication administration: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(3-4), pages 795-806, February.
    2. Noort, Mark C. & Reader, Tom W. & Gillespie, Alex, 2019. "Speaking up to prevent harm: a systematic review of the safety voice literature," LSE Research Online Documents on Economics 100774, London School of Economics and Political Science, LSE Library.
    3. Tiina Syyrilä & Katri Vehviläinen‐Julkunen & Marja Härkänen, 2020. "Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2466-2481, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Normand Carpentier, 2013. "Entry Into a Care Trajectory," SAGE Open, , vol. 3(2), pages 21582440134, June.
    2. Liberati, Elisa Giulia & Gorli, Mara & Scaratti, Giuseppe, 2016. "Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care," Social Science & Medicine, Elsevier, vol. 150(C), pages 31-39.
    3. de Kok, B.C. & Widdicombe, S. & Pilnick, A. & Laurier, E., 2018. "Doing patient-centredness versus achieving public health targets: A critical review of interactional dilemmas in ART adherence support," Social Science & Medicine, Elsevier, vol. 205(C), pages 17-25.
    4. Macinati, Manuela S. & Bozzi, Stefano & Rizzo, Marco Giovanni, 2016. "Budgetary participation and performance: The mediating effects of medical managers’ job engagement and self-efficacy," Health Policy, Elsevier, vol. 120(9), pages 1017-1028.
    5. Liberati, Elisa Giulia, 2017. "Separating, replacing, intersecting: The influence of context on the construction of the medical-nursing boundary," Social Science & Medicine, Elsevier, vol. 172(C), pages 135-143.
    6. Caronia, Letizia & Saglietti, Marzia & Chieregato, Arturo, 2020. "Challenging the interprofessional epistemic boundaries: The practices of informing in nurse-physician interaction," Social Science & Medicine, Elsevier, vol. 246(C).
    7. Keh Kiong Ong & Kit Cheng Ting & Yeow Leng Chow, 2018. "The trajectory of experience of critical care nurses in providing end‐of‐life care: A qualitative descriptive study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 257-268, January.
    8. Standing, Holly & Patterson, Rebecca & Dalkin, Sonia & Exley, Catherine & Brittain, Katie, 2020. "A critical exploration of professional jurisdictions and role boundaries in inter-professional end-of-life care in the community," Social Science & Medicine, Elsevier, vol. 266(C).
    9. Tit‐Chai Tan & Huaqiong Zhou & Michelle Kelly, 2017. "Nurse–physician communication – An integrated review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 3974-3989, December.
    10. Degeling, Chris & Carroll, Jane & Denholm, Justin & Marais, Ben & Dawson, Angus, 2020. "Ending TB in Australia: Organizational challenges for regional tuberculosis programs," Health Policy, Elsevier, vol. 124(1), pages 106-112.
    11. Skyberg, Henriette Lund & Innvaer, Simon, 2020. "Dynamics of interprofessional teamwork: Why three logics are better than one," Social Science & Medicine, Elsevier, vol. 265(C).
    12. Powell, Alison E. & Davies, Huw T.O., 2012. "The struggle to improve patient care in the face of professional boundaries," Social Science & Medicine, Elsevier, vol. 75(5), pages 807-814.
    13. Kuijper, Syb & Felder, Martijn & Clegg, Stewart & Bal, Roland & Wallenburg, Iris, 2024. "“We don't experiment with our patients!” An ethnographic account of the epistemic politics of (re)designing nursing work," Social Science & Medicine, Elsevier, vol. 340(C).
    14. Nugus, Peter & Greenfield, David & Travaglia, Joanne & Braithwaite, Jeffrey, 2012. "The politics of action research: “If you don't like the way things are going, get off the bus”," Social Science & Medicine, Elsevier, vol. 75(11), pages 1946-1953.
    15. Ludwig Kuntz & Stefan Scholtes, 2013. "Physicians in leadership: the association between medical director involvement and staff-to-patient ratios," Health Care Management Science, Springer, vol. 16(2), pages 129-138, June.
    16. Altomonte, Guillermina, 2022. "Coordinating illness and insurance trajectories: Evidence from a post-acute care unit," Social Science & Medicine, Elsevier, vol. 308(C).
    17. Graeme Currie & Charlotte Croft, 2015. "Examining hybrid nurse managers as a case of identity transition in healthcare: developing a balanced research agenda," Work, Employment & Society, British Sociological Association, vol. 29(5), pages 855-865, October.
    18. Miner, Skye A., 2019. "Demarcating the dirty work: Canadian Fertility professionals’ use of boundary-work in contentious egg donation," Social Science & Medicine, Elsevier, vol. 221(C), pages 19-26.
    19. Ranzani, Federica, 2024. "“Doing being a good parent” in the pediatric clinic: Parents' knowledge displays in advice requests on infants' everyday care," Social Science & Medicine, Elsevier, vol. 351(C).
    20. Tiina Syyrilä & Katri Vehviläinen‐Julkunen & Marja Härkänen, 2020. "Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2466-2481, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jocnur:v:25:y:2016:i:19-20:p:2943-2957. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1365-2702 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.