title: Developing and testing a tool to measure nurse/physician communication in the intensive care unit.
abstract: OBJECTIVE
  The purpose of this study, conducted in 3 intensive care units (ICUs) at 1 Department of Veterans Affairs Medical Center, was to develop tools and procedures to measure nurse/physician communication in future studies.
  
  
  METHODS
  We used mixed methods in a multistaged approach. Qualitative data came from 4 observations of patient care rounds and 8 interviews with nurses and physicians. Quantitative data came from anonymous surveys distributed to nurses in all 3 ICUs (n = 66). We administered the Safety Organizing Scale to measure nurses' self-reported behaviors that enable a safety culture. Analysis of variance was the main statistical test.
  
  
  RESULTS
  Qualitative data were used to create an observation data collection tool and a working protocol, to measure nurse/physician communication in a future study. Analysis of variance revealed significant differences between the 3 units (f = 4.57, P = 0.02). There also were significant differences on 4 of 9 items of the Safety Organizing Scale. Using mixed methods, we gained multiple perspectives that helped us to clarify and validate the context and content of communication. Quantitative analysis showed significant differences between the 3 ICUs in nurses' perceptions of a safety culture. According to qualitative analyses, nurses from the unit which reported the weakest safety culture also were the least satisfied in their communication with physicians. Qualitative analyses corroborated quantitative findings and demonstrated the importance of contextual influences on nurse/physician communication.
  
  
  CONCLUSIONS
  Through the tools and protocol we created, more realistic strategies to promote effective communication between nurses and physicians may be developed and tested in future studies.
authors.affiliation: University of Michigan School of Nursing Ann Arbor, Michigan 48109, USA. mmanojlo@umich.edu
authors.forename: Milisa
authors.initials: M
authors.lastname: Manojlovich
authors.forename: Sanjay
authors.initials: S
authors.lastname: Saint
authors.forename: Jane
authors.initials: J
authors.lastname: Forman
authors.forename: Carol E
authors.initials: CE
authors.lastname: Fletcher
authors.forename: Rosalind
authors.initials: R
authors.lastname: Keith
authors.forename: Sarah
authors.initials: S
authors.lastname: Krein
mesh_terms: D001291:Attitude of Health Personnel; D005240:Feasibility Studies; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D019370:Observation; D019555:Physician-Nurse Relations; D012107:Research Design; D012449:Safety / Q000592:standards*; D013223:Statistics as Topic / Q000379:methods / Q000592:standards; D000078329:Workforce