Richards-Douglas, Marilyn (2016) Identifying learning needs to enhance communication skills between doctors (MDs) and nurses (RNs) in long-term care facilities (LTCFs) to deliver safe care to residents. Masters thesis, Concordia University.
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Abstract
ABSTRACT
Identifying learning needs to enhance communication skills between doctors (MDs) and nurses (RNs) in long-term care facilities (LTCFs) to deliver safe care to residents
Marilyn Richards-Douglas
The purpose of the study was to understand how nurses working in LTCFs perceive their communication with doctors in order to give safe care to residents and to identify learning needs to enhance communication skill between doctors and nurses. This qualitative study was based on narratives obtained through interviews with six nurse Team Leaders working in the same LTCF. The interdisciplinary team they lead includes nurses’ aides, licenced practical nurses, the team leader, the head nurse and the doctor and they work with occupational therapists, social workers, ergo-therapists, pharmacists, kitchen aids and nutritionists. Other individuals present on the floor on a continual basis are the family members and companions of the residents. All six team leaders expressed their desire to continue to work in the role of Team Leader and helped better define the following areas of concerns and needs to improve communication in their setting especially with the doctors. The insights gained are discussed under the following titles:
A. Preparedness for Team Leadership in LTCs: Education and Practice as Team Leaders.
--Nursing Education
--Challenges encountered as Team Leader
--Autonomy in Nursing Practice
--The Need To Be Recognized
B. RN Perception/Narratives of Working Relationship with the MD
--Communicating with doctors in LTC
--Perceived Barriers to Effective Communication
--Developing the Skill of Communication
--Strategies for Collaborative Practice
| Divisions: | Concordia University > Faculty of Arts and Science > Education |
|---|---|
| Item Type: | Thesis (Masters) |
| Authors: | Richards-Douglas, Marilyn |
| Institution: | Concordia University |
| Degree Name: | M.A. |
| Program: | Educational Studies |
| Date: | 14 September 2016 |
| Thesis Supervisor(s): | Hamalian, Arpi |
| Keywords: | Key Terms Centre Hospitalier Service Longe Durée [CHSLD]/ Long-term care facility [LTCF]: health care sites such as nursing homes that provide a home-like environment for residents who commonly receive care for the duration of their lives. CHF: Congestive heart failure Collaborative practice: “an inter-professional process for communication and decision making that enables the separate and shared knowledge and skills of care providers to synergistically influence the client/patient care provided” (Way, Jones, and Busing, 2000, p. 3 as cited in Donald, 2007). Externship: a student nurse who has completed two years of nursing school and is permitted by the OIIQ to work with a nurse during the summer. The student is paid a salary but her scope of practice is limited and she has to work with the same nurse or two nurses for that period. Intravenous [IV]: the infusion of liquids, fluids, nutrients, medication or blood products via a vein. LPN: Licensed Practical Nurse MD: Medical doctor OIIQ: Ordre des infirmières et infirmiers du Quebec/Order of Nurses of Quebec. PAB: Préposé aux bénéficiaires: Nursing assistant/orderly who provides basic hygiene care to patients. PEG: Percutaneous endoscopic gastrostomy: used to provide feeding to a patient who is incapable of taking food or sufficient food orally. RN: Registered nurse. SBAR: Situation-Background-Assessment-Recommendation: A tool used to enable the nurse to communicate information about a resident’s condition to the doctor by phone. Team leader: An RN within a LTCF who is responsible for ensuring that all members of a unit provide appropriate care to residents. All RNs referred to in this proposal are team leaders whether novice or experienced. |
| ID Code: | 981815 |
| Deposited By: | MARILYN DOUGLAS |
| Deposited On: | 04 Nov 2016 19:37 |
| Last Modified: | 18 Jan 2018 17:53 |
References:
ReferencesAdamson, B. J., Kenny, D. T., & Wilson-Barnett, J. (1995). The impact of perceived medical
dominance on the workplace satisfaction of Australian and British nurses. Journal of
Advanced Nursing, 21, 172-183.
Allen, D. E., Donham, R. S., & Bernhardt, S. A. (2011). Problem-based learning. New Directions
for Teaching and Learning, (128), 21-29.
Beck, C. T., (2009). Critiquing qualitative research. Aorn Journal, 90, 543-554.
Bogdan, R. C. & Biklen, S. K. (2007). (5th Ed). Qualitative research for education: An
introduction to theory and methods. Boston, MA: Pearson.
Brophy, K.E. (2000). Nursing students’ experiences of autonomy: A critical feminist approach.
(Unpublished master’s thesis). Memorial University of Newfoundland.
Bryant-Lukosius, D., Dicenso, A., Browne, G. & Pinelli, J. (2004). Advanced practice nursing
roles: development, implementation and evaluation Aim. Journal of Advanced Nursing,
48(5), 519–529.
Carr, D.D. (2003). Case management as a triad in long-term care: A collaborative approach.
Primary Health Care, 17 (7), 18.
Clement, E. (2010). Care-ing about patients: The construction, performance, and organization
of communication and care in medical education. Colorado: Colorado State University.
Donald, F. C. (2007). Collaborative practice by nurse practitioners and physicians in long-term
care homes: A mixed methods study. (Unpublished doctoral dissertation). MacMaster
University, Ontario, Canada.
Ehrenberg, A. C. & Häggblom M. (2007) Problem-based learning in clinical nursing education:
Integrating theory and practice. Nurse Education in Practice. 7, 67-74.
Employment and Social Development Canada, (2014). Addressing the challenges and
opportunities of aging in Canada. www.hrsdc.gc.ca
Fagermoen, M. S. (1997). Professional identity: values embedded in meaningful nursing
practice. Journal of Advanced Nursing, 25, 434-441.
Glesne, C. (2011). (4th Ed). Becoming qualitative researchers: An introduction. Boston, MA:
Pearson.
Hatch, J.A. (2002). Doing qualitative research in education settings. Albany, NY: State
University of New York Press.
Health Canada, & Interdepartmental Committee on Aging and Seniors Issues (2002). Canada’s
aging population. http//www.phac-
aspc.gc.ca/seniors:aines/pubs/fed.paper/pdfs/fedpager.e.pdf
Kogan, P., Underwood, S., Desmond, D., Hayes, M., & Lucien, G. (2010). Performance
improvement in managed long-term care: physician communication in managing
community-dwelling older adults. Home Healthcare Nurse, 28, 105-120. DOI:
10,1097/NHH.0b013e3181cb5a11.
Kramer, M., Schmalenberg, C. E. (2003). Magnet hospital staff nurses describe clinical
autonomy. Nursing Outlook, 51, 13-19.
Leonard, M., Graham, S., & Bonacum, D. (2004). The human factor : The critical importance of
effective teamwork and communication in providing safe care. Quality and Safety in
Health Care, 13 (Supplemental 1), i85-i90.
Leppa, C.J. (2004). The Nature of Long-Term Care Nursing Work. Journal of Gerontology
Nursing, 30 (3), 26-33.
Lindeke, L. L., Sieckert, A. M. (2005). Nurse-physician workplace collaboration. Online
Journal of Issues in Nursing, 10, 4.
MacDonald, C. J., Stodel, E. J., & Chambers, L. W. (2008). An online inter-professional learning
resource for physicians, pharmacists, nurse practitioners, and nurses in long-term care:
Benefits, barriers, and lessons learned. Informatics for Health & Social Care, 33, 21-38.
Martyn, J., Terwijn, R., Kek, M., Y.C.A., & Huijser, H. (2014). Exploring the relationships
between teaching, approaches to learning and critical thinking in a problem-based
learning foundation nursing course. Nurse Education Today, 3, 829-835.
Merriam, S.B. (2009). Qualitative Research. A Guide to Design and Implementation. San
Francisco, CA: Jossey-Bass Publishers.
Miller, G.P. (1977). From traditional to modern: Nursing education in transition in anglophone
Quebec. (Unpublished master’s thesis). Concordia University, Montreal, Canada.
Mlek, M. (2011). Nursing students’ learning experience in clinical setting: Stress, Anxiety and
Coping. (Unpublished master’s thesis). Concordia University, Montréal.
Morse, J. M., Barrett, M., Mayan, M., Olson, K., & Spiers, J. (2002). Verification strategies for
establishing reliability and validity in qualitative research. International Journal of
Qualitative Methods, 1, 13-22.
Mueller, C. A., Tetzlaff, B., Theile, G., Fleischmann, N., Cavazzini, C., Geister, C., Scherer…&
Hummers-Pradier E. (2014). Interprofessional collaboration and communication in
nursing homes: A qualitative exploration of problems in medical care for nursing home
residents – study protocol. Journal of Advanced Nursing 71, 451-457. doi:
10.1111/jan.12545
Nelson, D.S. (2012). The Hidden Curriculum : If our students are to change the world educators
need to partner them with inspiring effective individuals. Pulse, Spring/Summer 4-6.
O’Daniel, M. & Rosenstein, A.H. (2008). Chapter 33 : Professional communication and team
collaboration. Patient safety and quality: An evidenced-based handbook for nurses. [e-
book]. Rockville, MD : Agency for Healthcare Research and Quality.
Ordre des infirmière et infirmiers du Québec. [Website]. http://www.oiiq.org/admission-a-la-
Ouslander, J. G., Lamb, G., Tappen, R., Herndon, L., Diaz, S., Ross, B. A., … & Bonner, A., (2011). Interventions to reduce hospitalizations from nursing homes: Evaluation of the INTERACT II collaborative quality improvement project. JAGS, 59, 745-753.
Pijl-Zieber, E.M., Barton, S., Konkin, J., Awosoga, O. & Caine, V, (2014). Competence and
competency-based nursing education: Finding our way through the issues. Nurse
Education Today, 34, 676-678.
Ploeg, J., Kaasalainen, S., McAiney, C., Martin-Misener, M., Donald, F., Wickson-Griffiths, A.,
… & Taniguchi, A. (2013). Resident and family perceptions of the nurse practitioner role
in long term care settings: a qualitative descriptive study. BMC Nursing, 12 (24).
DOI: 10.1186/1472-6955-12-24
Quach, C., McArthur, M., McGeer A., Li, L., Simor, A., Dionne, M., Levesque, E., & Tremblay, L. (2012). Risk of infection following a visit to the emergency department: a cohort study. Canadian Medial Association Journal, 184, E232-239. DOI:10,1503/cmaj.110372.
Reynolds V. E. (March 2004). Improving clinical care through better communication. Long-Term
Living, 24-27.
Rolfe, G. (2006). Validity, trustworthiness and rigour: quality and the idea of qualitative
research. Methodological Issues in Nursing Research, 53, 304-310.
Ross, A. M., Fotheringham, D. & Crusoe, K. (2014). Re-evaluating nursing’s currency: shifting
away from hierarchical binary opposition. Nurse Education Today, 34, 687-690.
Ryden, M.B., Snyder, M., Gross, C.R., Savik, K., Pearson, V., Krichbaum, K., & Mueller, C.
(2000). Value-Added Outcomes: The use of advanced practice nurse in long-term care
facilities. Gerontologist, 40, 654-662.
Skar, R. (2010). The meaning of autonomy in nursing practice. Journal of Clinical Nursing, 19,
2226-2234. doi; 10.1111/j.1365-2702.2009.02804.x
Stein, L. I., (1967). The doctor-nurse game. General Psychiatry, 16, 699-703.
Stewart, C., (2007). Novice nurses’ perspectives on nursing education. (Unpublished
master’s thesis). Concordia University, Montreal, Canada.
Tjia, J., Mazor, K. M., Field, T., Meterko, V., Spenard, A. and Gurwitz, J. H. (2009). Nurse-
physician communication in the long-term care setting: Perceived barriers and impact
on patient safety. Journal of Patient Safety, 5, 145–152.
doi:10.1097/PTS.0b013e3181b53f9b.
Tschannen, D., Keenan, G., Aebersold, M., Kocan, M.J., Lundy, F. & Averhart, V. (2011).
Implications of nurse-physician relations: Report of a successful intervention. Nursing
Economics, 20, 127-135.
van Teijlingen, E. R., & Hundley, V. (2001). The importance of pilot studies. Social Research Update, 35, 1-4.
Vazirani, S., Hays, R. D., Shapiro, M. F. & Cowan, M. (2005). Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. American Journal of Critical Care, 14, 71-77.
Voyer, B.G. & Reader, T. (2013). The self-construal of nurses and doctors: Beliefs on
interdependence in the care of older people. Journal of Advance Nursing. 69, 2696-
2706. doi: 10.1111/jan.12157
Wade, G. H. (1999). Professional nurse autonomy: concept analysis and application to nursing
education. Journal of Advanced Nursing, 30, 310-318.
Whitson, H.E., Hastings, S.N., Lekan, D.A., Sloane, R., White, H.K. and McConnel, E.S. (2008).
A quality improvement program to enhance after-hours telephone communication
between nurses and physicians in a long-term care facility. Journal of American
Medicine, 56, 1080-1086.
Wilson, K., Coulon, L., Hillege, S. & Swann, W. (2005). Nurse practitioners’ experiences of
working collaboratively with general practitioners and allied health professionals in New
South Wales, Australia. Australian Journal of Advanced Nursing, 23, 22-27.
Winn, P., Cook, J. B. & Bonnel, W. (2004). Improving communication among attending
physicians, long-term care facilities, residents, and residents’ families. Journal of the
American Medical Directors Association, 5, 114-133.
Wood., D. F. (2003). ABC of learning and teaching in medicine: Problem based learning.
BMJ, 326, 328-330. doi:10.1136/bmj.326.7384.328.
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