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Minimizing Harm From ADEs by Improving Nurse-Physician Communication (MED-COMM)
This study has been completed.
First Received: December 12, 2007   Last Updated: October 2, 2009   History of Changes
Sponsor: 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

Study Type: Observational
Study Design: 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
Study Completion Date: September 2009
Primary Completion Date: September 2009 (Final data collection date for primary outcome measure)
Groups/Cohorts
1
providers, nurses and pharmacists

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.

Objectives:

1.1 Specific Aim 1. Assess clinicians' 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 among 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 among 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 providers' beliefs and perceptions regarding barriers to 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:

We are preparing to begin the observational stage of the study.

  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

No publications provided

Responsible Party: Department of Veterans Affairs ( Weir, Charlene - Principal Investigator )
Study ID Numbers: NRI 05-275
Study First Received: December 12, 2007
Last Updated: October 2, 2009
ClinicalTrials.gov Identifier: NCT00574990     History of Changes
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 November 30, 2009