Poor physician-nurse communication linked to patient catheter problems

Poor communication between physicians and nurses can lead to catheters being left in too long and infecting patients, according to a study published in American Journal of Critical Care.

Ann Arbor-based University of Michigan researchers conducted individual and small group interviews with nurses, physician assistants, nurse practitioners and physicians in a progressive care unit of an academic hospital. The interviews focused on problems related to monitoring and communicating about patients' indwelling catheters.

The study shows that all respondents reported poor communication as the reason for the delay in removing unnecessary catheters. They cited several reasons for the breakdown in communication, including poor relationships between physicians and nurses, and hierarchical differences or workflow issues that resulted in nurses not being present for daily rounds.

EHRs also contributed to the communication issues, with some systems not updating fast enough. Sometimes there was a reliance on both paper and computer records, resulting in physicians and nurses having different information.

"People get catheters all the time, but meanwhile they cause lots of harm, so we need to talk about them," said Milisa Manojlovich, PhD, RN, a professor at University of Michigan's School of Nursing in Ann Arbor. "This study found a whole host of factors that affected the ability to discuss this issue."

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