TY - JOUR

T1 - Nurses' perspectives on how an e-message system supports cross-sectoral communication in relation to medication administration

T2 - A qualitative study

AU - Foged, Signe

AU - Nørholm, Vibeke

AU - Andersen, Ove

AU - Petersen, Helle Vendel

N1 - © 2017 John Wiley & Sons Ltd.

PY - 2018

Y1 - 2018

N2 - AIMS AND OBJECTIVES: To describe nurses' perspectives on how an e-message system supports communication between hospital and home care nurses in relation to medication administration.BACKGROUND: Medication administration is a complex process involving a high risk of error. Unclear communication and lack of updated information about medication have been identified as the leading cause of medication errors during care transitions. E-message systems are progressively being used to improve information exchange across sectors, yet little is known about their usage for exchange of medication information between nurses.DESIGN: A qualitative design using content analysis.METHODS: Focus group interviews were conducted with nurses from eight hospital wards and six municipalities (n = 79). Participant observations were conducted in three hospital wards and in three municipalities (165 hr).RESULTS: The e-message system did not provide the information needed by the home care nurses to ensure safe medication administration after discharge due to (1) limitations of the system, (2) hospital nurses' lack of knowledge about home care nurses' information needs and (3) hospital nurses' lack of access to medication information. Due the home care nurses' perception of responsibility, they bypassed the e-message system to get the information.CONCLUSIONS: The home care nurses perceived themselves as the last link in the safety chain. As such, access to adequate information was essential for the nurses to ensure safe medication administration; however, the e-message system did not support exchange of the information needed.RELEVANCE TO CLINICAL PRACTICE: E-message systems must meet home care nurses' need for information to ensure that safe medication administration does not depend on the knowledge of the individual nurse. Moreover, other system factors that influence interprofessional collaboration and nurses' cross-sectoral communication must be addressed.

AB - AIMS AND OBJECTIVES: To describe nurses' perspectives on how an e-message system supports communication between hospital and home care nurses in relation to medication administration.BACKGROUND: Medication administration is a complex process involving a high risk of error. Unclear communication and lack of updated information about medication have been identified as the leading cause of medication errors during care transitions. E-message systems are progressively being used to improve information exchange across sectors, yet little is known about their usage for exchange of medication information between nurses.DESIGN: A qualitative design using content analysis.METHODS: Focus group interviews were conducted with nurses from eight hospital wards and six municipalities (n = 79). Participant observations were conducted in three hospital wards and in three municipalities (165 hr).RESULTS: The e-message system did not provide the information needed by the home care nurses to ensure safe medication administration after discharge due to (1) limitations of the system, (2) hospital nurses' lack of knowledge about home care nurses' information needs and (3) hospital nurses' lack of access to medication information. Due the home care nurses' perception of responsibility, they bypassed the e-message system to get the information.CONCLUSIONS: The home care nurses perceived themselves as the last link in the safety chain. As such, access to adequate information was essential for the nurses to ensure safe medication administration; however, the e-message system did not support exchange of the information needed.RELEVANCE TO CLINICAL PRACTICE: E-message systems must meet home care nurses' need for information to ensure that safe medication administration does not depend on the knowledge of the individual nurse. Moreover, other system factors that influence interprofessional collaboration and nurses' cross-sectoral communication must be addressed.

KW - Focus Groups

KW - Health Knowledge, Attitudes, Practice

KW - Home Nursing/methods

KW - Humans

KW - Interprofessional Relations

KW - Medication Errors/nursing

KW - Nursing Staff, Hospital

KW - Patient Discharge

KW - Patient Transfer/methods

KW - Qualitative Research

KW - Text Messaging

U2 - 10.1111/jocn.14109

DO - 10.1111/jocn.14109

M3 - Journal article

C2 - 29048777

VL - 27

SP - 795

EP - 806

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 3-4

ER -