Interdisciplinary communication in the intensive care unit at the University Hospital of the West Indies
OBJECTIVE: To assess the perceptions of physicians and nurses working full-time in the Intensive Care Unit (ICU) at the University Hospital of the West Indies (UHWI) regarding interdisciplinary communication.
METHOD: A cross-sectional survey of all medical personnel working full-time in the ICU was conducted in January 2008 using a self-administered, validated questionnaire. Data on perceived communication, teamwork and leadership, comprehension of patient care goals, perceived effectiveness and satisfaction were collected and analysed using the SPSS Version 14. Internal reliability was tested using Cronbach's alpha score and differences and correlations were assessed using Pearson's Chi-square and correlation analysis.
RESULTS: Ninety-five per cent (105/111) of questionnaires were completed. More doctors than nurses experienced open communication with other staff members (73% vs 32%; p < 0.01), with less openness occurring with increasing seniority. More doctors (53%) than nurses (32%) reported receiving inaccurate information from doctors (p < 0.05), with 67% and 51% respectively receiving incorrect information from nurses (p < 0.05). Communication across shifts was felt to be better amongst doctors than nurses (73% vs 63%). Only 50% of doctors compared to 88% of nurses felt they received relevant information quickly (p < 0.05). More nurses than doctors (86% vs 63%; p < 0.01) felt that they had a good understanding of patient care goals. Negative perceptions of the leadership characteristics of consultants (62% amongst doctors and 74% of nurses) and sisters (79% and 73%, respectively) were high.
CONCLUSIONS: Communication within the ICU, UHWI, is unsatisfactory with an overall poor perception of senior leadership. Improvement in staff morale and leadership training may create a working environment where team members can communicate openly without fear of chastisement.
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