title: Nurse-physician communication during labor and birth: implications for patient safety.
abstract: OBJECTIVE
  To describe communication between nurses and physicians during labor within the context of the nurse-managed labor model in community hospitals and its relationship to teamwork and patient safety.
  
  
  METHODS
  Multicenter qualitative study involving focus groups and in-depth interviews.
  
  
  METHODS
  Labor and birth units in 4 Midwestern community hospitals.
  
  
  METHODS
  54 labor nurses and 38 obstetricians.
  
  
  METHODS
  Focus groups and in-depth interviews were conducted using open-ended questions. Data were analyzed using inductive coding methods to gain understanding from the perspective of those directly involved.
  
  
  METHODS
  Description of interdisciplinary interactions during labor.
  
  
  RESULTS
  Nurses and physicians shared the common goal of a healthy mother and baby but did not always agree on methods to achieve that goal. Two clinical situations critical to patient safety (fetal assessment and oxytocin administration) were frequent areas of disagreement and sources of mutual frustration, often leading to less than optimal teamwork. Minimal communication occurred when the mother and fetus are doing well, and this seemed to be purposeful and considered normal. Physicians and nurses had distinct opinions concerning desirable traits of members of the other discipline.
  
  
  CONCLUSIONS
  Interdisciplinary communication and teamwork could be improved to promote a safer care environment during labor and birth.
authors.affiliation: St. John's Mercy Medical Center, Doisy College of Health Sciences School of Nursing, Saint Louis University, MO 63141, USA. krsimpson@prodigy.net
authors.forename: Kathleen Rice
authors.initials: KR
authors.lastname: Simpson
authors.forename: Dotti C
authors.initials: DC
authors.lastname: James
authors.forename: G Eric
authors.initials: GE
authors.lastname: Knox
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D016903:Drug Monitoring / Q000451:nursing; D005260:Female; D005323:Fetal Monitoring / Q000451:nursing; D017144:Focus Groups; D006040:Goals; D006764:Hospitals, Community; D006801:Humans; D007751:Labor, Induced / Q000451:nursing; D007743:Labor, Obstetric / Q000523:psychology*; D019300:Medical Errors / Q000451:nursing / Q000517:prevention & control / Q000523:psychology; D008505:Medical Staff, Hospital / Q000523:psychology; D015146:Midwestern United States; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology; D009773:Obstetric Nursing / Q000458:organization & administration; D010120:Oxytocics / Q000008:administration & dosage; D010819:Physician's Role / Q000523:psychology; D019555:Physician-Nurse Relations; D011247:Pregnancy; D011361:Professional Competence / Q000592:standards; D036301:Qualitative Research; D017751:Safety Management / Q000458:organization & administration*; D011795:Surveys and Questionnaires
chemical_list: D010120:Oxytocics