Perceptions and Behaviors of Nurses and Physicians During Bedside Rounds in Medical-Surgical Units.

Communication and collaboration among health care professionals during bedside rounds improve patient outcomes and nurses' and physicians' satisfaction. To determine barriers to nurse-physician communication during bedside rounds and identify opportunities to improve nurse-physician collaboration at an academic medical center. A survey with Likert-scale and open-ended questions regarding professional attitudes toward nurse-physician communication was administered to 220 nurses and physicians in medical-surgical units to assess perceptions of participation in bedside rounds. After the survey was given, observational data from 1007 bedside rounds were collected via a standardized data collection tool. Nurses and physicians perceived different barriers to including nurses in bedside rounds. Nurses most often cited being unaware that bedside rounds were occurring (38 of 46 nurses [83%]); physicians most often cited nurse unavailability (43 of 52 physicians [83%]). Of 1007 observed rounds, 602 (60%) involved in-person contact of nurses and physicians; 418 (69%) of the 602 included a conversation between the nurse and physician about the nurse's concerns. Of 355 rounds with no in-person or telephone contact between nurses and physicians, the medicine team did not contact the nurse in 284 (80%). Conversations about nurses' concerns occurred more often after physician-initiated contacts (73% of 369 contacts) and nurse-initiated contacts (74% of 93 contacts) than after chance encounters (57% of 140 contacts). Initiating discussions of care between nurses and physicians and discussing nurses' concerns during bedside rounds have multiple benefits.

Natarajan A ，Venegas MG 3rd ，Mai D ，Dowling E ，Simon W ，Pessegueiro AM ，Vangala S ，Dermenchyan A ... -  《-》

Bedside interprofessional rounds: perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians.

Interprofessional collaboration improves the quality of care, but integration into workflow is challenging. Although a shared conceptualization regarding bedside interprofessional rounds may enhance implementation, little work has investigated providers' perceptions of this activity. To evaluate the perceptions of nurses, attending physicians, and housestaff physicians regarding the benefits/barriers to bedside interprofessional rounds. Observational, cross-sectional survey of hospital-based medicine nurses, attending physicians, and housestaff physicians. Descriptive, nonparametric Wilcoxon rank sum and nonparametric correlation were used. Bedside interprofessional rounds were defined as "encounters including 2 physicians plus a nurse or other care provider discussing the case at the patient's bedside." Eighteen items related to "benefits" and 21 items related to "barriers" associated with bedside interprofessional rounds. Of 171 surveys sent, 149 were completed (87%). Highest-ranked benefits were related to communication/coordination, including "improves communication between nurses-physicians;" lowest-ranked benefits were related to efficiency, process, and outcomes, including "decreases length-of-stay" and "improves timeliness of consultations." Nurses reported most favorable ratings for all items (P < 0.05). Rank order for 3 provider groups showed high correlation (r = 0.92, P < 0.001). Highest-ranked barriers were related to time, including "nursing staff have limited time;" lowest-ranked barriers were related to provider- and patient-related factors, including "patient lack of comfort." Rank order of barriers among all groups showed moderate correlation (r = 0.62-0.82). Although nurses perceived greater benefit for bedside interprofessional rounds than physicians, all providers perceived coordination/teamwork benefits higher than outcomes. To the extent the results are generalizable, these findings lay the foundation for facilitating meaningful patient-centered interprofessional collaboration.

Gonzalo JD ，Kuperman E ，Lehman E ，Haidet P ... -  《-》

Interprofessional bedside rounds: Nurse-physician collaboration and perceived barriers in an Asian hospital.

Chew BH ，Tang CJ ，Lim WS ，Yap JKY ，Zhou W ，Liaw SY ... -  《-》

The influence of effective communication, perceived respect and willingness to collaborate on nurses' perceptions of nurse-physician collaboration in China.

Nurse-physician collaboration is a critical prerequisite for high-quality care. Previous researchers have addressed multiple factors that influence collaboration. However, little of this research has explored the influence of interactional factors on nurses' perception of nurse-physician collaboration in China. To examine the influence of interactional factors (effective communication, perceived respect and willingness to collaborate) on nurses' perception of nurse-physician collaboration. A cross-sectional survey of 971 registered nurses in nine hospitals was conducted. An author-designed interactional factor questionnaire and the Nurse-Physician Collaboration Scale were used to collect data. Multiple regression analysis was used. Nurse-physician collaboration was identified as at a moderate level (mean = 3.93 ± 0.68). Interactional factors (effective communication, perceived respect and willingness to collaborate) were identified as relatively moderate to high (mean = 4.03 ± 0.68, mean = 3.87 ± 0.75, mean = 4.50 ± 0.59, respectively). The results showed that effective communication, perceived respect and willingness to collaborate explained 57.3% of the variance in nurses' perception of nurse-physician collaboration (Adjusted R2 = 0.573, F = 435.563, P < 0.001). Perceived respect (β = 0.378) was the strongest factor relevant to nurses' perception of nurse-physician collaboration, second was effective communication (β = 0.315), and the weakest factor among these three factors was willingness to collaborate (β = 0.160). Nurses' perceptions of collaboration were relatively positive, mainly in Sharing of patient information; however, improvements need to be made regarding Joint participation in the cure/care decision-making process. Effective communication, perceived respect and willingness to collaborate significantly affect nurses' perception of nurse-physician collaboration, with perceived respect having greater explanatory power among the three interactional factors. It is necessary for hospital managers to develop strategies to build professional respect for nurses, facilitate effective nurse-physician communication and improve nurses' willingness to collaborate.

Wang Y ，Wan Q ，Guo J ，Jin X ，Zhou W ，Feng X ，Shang S ... -  《-》

Communication during ward rounds in internal medicine. An analysis of patient-nurse-physician interactions using RIAS.

Weber H ，Stöckli M ，Nübling M ，Langewitz WA ... -  《PATIENT EDUCATION AND COUNSELING》