Nurse-Physician Communication and its impact on the health care process: A Literature Review

1. Nurse-Physician Communication and its impact on the health care process:A Literature Review Elham H. Othman, RN, MSN Student The University of Jordan Supervised by Mahmoud Al-Hussami, DSc., PhD

2. Introduction • Nurse-physician relationships and communication have been the focus of ongoing debate; • This communication has a major effect on workplace environment and patients' care and safety.

3. Introduction (Continue…) • The nurse-physician communication involves more than just the exchange of information. • Data must be transmitted in a clear and reliable way with mutual respect and satisfaction, to assure getting the job done right as well as getting the right job done. • It is not only what is said that matters, but also the way it is communicated between each others.

4. Introduction (Continue…) Nurse-physician communication can be conflictive to the point it is dysfunctional, this conflict arises from competition for status and power and different values and believes.

5. Purpose The purpose of the paper is to examine and describe the actual nurse-physician communication, the factors affecting this relationship, and its effect on the health care process.

6. Research Question What is the effect of Nurse-Physician communication on the health care process?

7. Significance A healthy nurse-physician communication is a key factor in the health care settings, it's been evidenced that it affects not only the nurse, but also the entire health care process.

8. Sampling • The sample consists of the primary studies that have addressed a similar research question. • Identification of the literature: including both quantitative & qualitative studies. • Computerized searching to find relevant research-based articles, • “MEDLINE, Ovid, EBSCO, and Direct Science research databases” were the primary database.

9. General inclusion criteria • full text articles • Written in English; • Any research articles published after 2000.

10. Methods • Integrative literature review (2000-2009) • Potential studies were (30) articles. • Resulting in (18) articles that met the inclusion criteria.

11. Results Nurse-physician communication can be conflictive and unhealthy. Many nurses report some disruptive physician behavior in their institutions. Many factors affect this communication such as experience, work environment, and empowerment.

12. Results (Continue…) A higher level of a collaborative nurse-physician relationship has a positive influence on the patient care, the nurse's, and the physician's satisfaction; A dysfunctional nurse-physician communication is linked to medication errors and unintentional patient injuries.

13. Results (Continue…) A higher level of a collaborative nurse-physician relationship has been associated with: • Higher patient satisfaction, • Better patient outcomes, • Lower length of stay, • Lower nurse turnover.

14. Results (Continue…) Barriers for Healthy Nurse-Physician Communication were related to : • Role misunderstanding; • Real and perceived differentials in power, position, and respect; • The different perceptions of decision-making and autonomy • Physicians' traits

15. Conclusion A healthy communication in health care settings is needed to assure health care excellence.

16. Recommendations many interventions were evidenced to enhance the Nurse-Physician communication: • The initiation of daily multidisciplinary rounds • The addition of nurse practitioners. • Introduced a systemic and clear daily goals work sheet that filled and reviewed daily by the assigned nurse, the resident and the fellow to determine the working pathway. • Further researches in Jordan are recommended.

17. References • Ashley Edwards, et al. (2009), Synchronous communication facilitates interruptive workflow for attending physicians and nurses in clinical settings, international journal of medical informatics, 7 8 : 629–637 • Milisa Manojlovich, Cathy L. Antonakos, and David L Ronis. (2009). Intensive care units communication between nurses and physicians and patients' outcomes. American Journal of Critical Care.18:21-30 • Brigita Skela Savic, Milan Pagon. (2008). Relationship Between Nurses and Physicians in Terms of Organizational Culture: Who Is Responsible for Subordination of Nurses? Croat Med J; 49:334-343. • Kyoko Morinaga, Yohsuke Ohtsubo, Keiko Yamauchi, Yasuhiro Shimada. (2008). Doctors’ traits perceived by Japanese nurses as communication barriers: A questionnaire survey, International Journal of Nursing Studies 45; 740–749 • Milisa Manojlovich, and Barry DeCicco, (2007). Healthy work environment, nurse-physician communication and patients' outcomes, American journal of critical care, 16 (6); 536- 543

18. References • Gollan PJ. (2006). High involvement management and human resource line sustainability. Handbook of Business Strategy :279-86. • Kathleen Rice Simpson , Dotti C . James , and G . Eric Knox, (2006). Nurse-Physician Communication During Labor and Birth: Implications for Patient Safety. Journal of Obstetric and Neonatal Nurses, 35 (4); 547-556 • Mangala Narasimhan, Lewis A. Eisen,, Christine D. Mahoney, Frank L. Acerra,, and Mark J. Rosen. (2006). Improving nurse-physician communication and satisfaction in the intensive care unit with a daily goals worksheet. American journal of critical care, 15 (2); 217-222. • Patricia H. Arford. (2005). Nurse-Physician Communication: An Organizational Accountability. Nursing Economics, 23 (2). • Sondra Vazirani, Martin F. Shapiro, and Marie Cowa, (2005). Effects of a Multidisplinary Intervention on Communication and Collaboration among physicians and nurses, American Journal of Critical Care.;14:71-77

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