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Minimizing Harm From ADEs by Improving Nurse-Physician Communication (MED-COMM)

This study is ongoing, but not recruiting participants.

Sponsored by: Department of Veterans Affairs
Information provided by: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00574990
  Purpose

The purpose of this research study is to examine the clinical processes of care involved with the sharing and communicating of medication management information in the inpatient setting between nurses, pharmacists and physicians. The study is unique in that few studies have examined communication content and processes in depth and in relation to specific clinical care. The study will be conducted in two phases. The first phase involves using three focus groups across three sites (a total of nine) each involving between 7-10 individuals to examine perceptions regarding role and procedures associated with medication management. The focus group discussions will be tape-recorded and analyzed using qualitative methods. The information gleaned will assist us in identifying patterns of problems in enhancing the sharing of information, to develop better measures for assessing communication as well as designing effective interventions to enhance communication.

In the second phase of the study, 400 2-hour time slots will be randomly selected over about a 5-week period for nursing staff and 500 events over a 6-week period for physicians to conduct ethnographic observations during which specific communication events will be recorded and coded. Every effort will be made to minimize interruptions during clinical care. Information gleaned in this phase will help us measure the types of communication patterns, content and characteristics. This research has not been done in terms of medication management content in the inpatient setting (non-ICU).


Condition
Interdisciplinary Communication
Management, Medication Therapy

U.S. FDA Resources

Study Type:   Observational
Study Design:   Other, Prospective
Official Title:   Minimizing Harm From ADEs by Improving Nurse-Physician Communication

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Qualitative information [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Biospecimen Retention:   None Retained

Biospecimen Description:

Estimated Enrollment:   50
Study Start Date:   January 2008
Estimated Study Completion Date:   September 2009
Estimated Primary Completion Date:   September 2009 (Final data collection date for primary outcome measure)

Groups/Cohorts
1
providers

Detailed Description:

Background:

The purpose of this study is to explore the role that inter-provider communication plays in the management of medications in the inpatient setting. Tasks associated with medication management include prevention of error, monitoring of therapeutic response, early detection of adverse drug events (ADE) and appropriate response once they have occurred. At all steps in the process, harm can be significantly mitigated by effective communication between provider roles. Communication in this study refers specifically to the sharing of medical management information. We propose to do a series of three interconnected studies to triangulate on how, when, and what information content regarding medication management is shared in an acute care hospital setting.

1.1 Specific Aim 1. Assess clinician's beliefs and concerns regarding the role of communication in preventing, detecting and managing ADEs in elderly inpatients.

1.2 Specific Aim 2. Evaluate communication events between nurses, physicians and pharmacists in an inpatient medicine setting. (ethnographic observation) Characterize communication events for timing, source, recipient, channel and content.

Assess the incidence rate of communication events between nurses, pharmacists and physicians, for both topics in general and related to medication management.

Identify and categorize prevalent communication goals of nurses, pharmacists, and physicians.

Identify and categorize role expectancies associated with communication events. Assess perceived communication satisfaction at the event level. Identify existing barriers and facilitators to effective communication.

Methods:

In the first study, we will conduct a series of focus groups to examine provider's beliefs and perceptions regarding barterers and issues surrounding communication of this kind of information. The second study will use ethnographic techniques to directly observe patterns and forms of communication.

Status:

Ongoing

  Eligibility
Ages Eligible for Study:   18 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample

Study Population

VA nurses, pharmacists and physicians


Criteria

Inclusion Criteria:

  • Providers who are working in the VA on the inpatient setting, including pharmacists, nurses, and physicians.

Exclusion Criteria:

  • Staff who have worked at the VA less than 1 year.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00574990

Locations
United States, California
VA Medical Center, San Francisco    
      San Francisco, California, United States, 94121
United States, North Carolina
VA Medical Center, Asheville    
      Asheville, North Carolina, United States, 28805
United States, Utah
Salt Lake City    
      Salt Lake City, Utah, United States, 84148

Sponsors and Collaborators

Investigators
Principal Investigator:     Charlene Raye Weir, PhD RN     Salt Lake City    
  More Information


Responsible Party:   Department of Veterans Affairs ( Weir, Charlene - Principal Investigator )
Study ID Numbers:   NRI 05-275
First Received:   December 12, 2007
Last Updated:   May 16, 2008
ClinicalTrials.gov Identifier:   NCT00574990
Health Authority:   United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Interdisciplinary Communication  
Safety Management  
Management, Medication Therapy  
Cooperative Behavior  
Drug Therapy Management  
Physician Nurse Relationships
Side Effects
Hospital Information Systems
Documentation
Quality Assurance, Health Care

ClinicalTrials.gov processed this record on October 10, 2008




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