Nurse workload and Nurse-Physician Communication on medical and surgical wards.

Abstract: Background: An increasing volume of literature reports that ineffective or lack of interprofessional communication has a negative impact on patient outcomes. The Joint Commission reported in 2015 that two out of three reported incidents where based on ineffective communication between health care workers. In acute care settings, effective interprofessional communication is important to address challenges in healthcare such as increased complexity of clinical practice and heavy workload. High workload may affect patient safety because of a shortage of time to communicate with other health care workers. Objective: To exam nurse perceived workload and communication with physicians on medical and surgical wards. To describe types of interprofessional communication on nursing wards and identify which type of communication contributes most to optimize nurse-physician communication. How the workload and interprofessional communication affect the quality of care by staff nurses. Methods: Data collection was based on qualitative research methods through participative observations. A total of 150 nurses were observed in 13 wards during a period of 3 months (May to July 2016). The researcher observed how often and what types of interprofessional communication took place on the different units. Perceived workload was measured with the National Aeronautics and Space Administration Task Load Index (NASA – TLX) and six additional questions were used to understand the nurse-physician communication. Also the staff nurses reported the perceived quality of care and if any intervention was needed to improve the interdisciplinary communication. Results: Though the exam of 135 questionnaires an overall workload of 69.4 was measured with NASA – TLX. A communication score of 74.76 and a perceived quality of care 76.2. Staff nurses communicate with pysicians 5.49 per shift and mostly face-to-face contact. Was observed a negative correlation between workload and communication with younger nurses more sensitive to interprofessional communication which is a marked difference in medical and surgical wards (t=-2.9 P<.05.) A substantial contribution on the quality of care perceived by staff nurses is given by workload (r=-.228 P<.01) and communication (r=.306 P<.001)