Contextual Barriers to Communication Between Physicians and Nurses About Appropriate Catheter Use - PubMed

Contextual Barriers to Communication Between Physicians and Nurses About Appropriate Catheter Use - PubMed

Contextual Barriers to Communication Between Physicians and Nurses About Appropriate Catheter Use

Milisa Manojlovich 1, Jessica M Ameling 2, Jane Forman 2, Samantha Judkins 2, Martha Quinn 2, Jennifer Meddings 2

Affiliations 

• PMID: 31263012
 
• PMCID: PMC6760297 (available on 2020-07-01)
 
• DOI: 10.4037/ajcc2019372

Abstract

Background: Indwelling urinary and vascular catheters are a common cause of health care-associated infections. Interventions designed to reduce catheter use can be ineffective if they are not integrated into the workflow and communication streams of busy clinicians.

Objectives: To characterize communication barriers between physicians and nurses and to understand how these barriers affect appropriate use and removal of indwelling urinary and vascular catheters.

Methods: Individual and small-group semistructured interviews were conducted with physicians and nurses in a progressive care unit of an academic hospital. Common themes were identified, analyzed, and then organized using a conceptual framework of contextual barriers to communication: organizational, cognitive, and social complexity.

Results: Several barriers to communication between physicians and nurses contributed to inappropriate use and delayed removal of catheters. Workflow misalignment between clinicians was a barrier associated with organizational complexity, issues with electronic medical records and pagers were associated with cognitive complexity, and strained relationships between clinicians and rigid hierarchies were associated with social complexity.

Conclusions: Communication is contextual, and improving physician-nurse communication about appropriate catheter use may require innovations that address the identified contextual barriers.

© 2019 American Association of Critical-Care Nurses.

Conflict of interest statement

Conflict of Interest Disclosures: Dr. Meddings has reported receiving honoraria for lectures and teaching related to prevention and value-based purchasing policies involving catheterassociated urinary tract infection. The remaining authors report no conflicts of interest.

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