Barriers for nurse participation in multidisciplinary ward rounds: An integrative review
Abstract
Background & Aim: The purpose of this integrative literature review was to find, critically evaluate, and describe publications about barriers against nurse participation and collaboration in multidisciplinary ward rounds. Although multidisciplinary ward rounds are the right place for doctors and nurses to communicate, nurses’ attendance in these rounds is missed. The nurses' absence at the multidisciplinary ward rounding has apparent negative effects on the patients, their relatives, other team members, and patients’ care.
Methods: A systematic approach to searching, screening, and analyzing the literature was applied. The original and review papers were used. This study was an integrative review based on Whittemore and Knafl’s framework. Web of Science, PubMed, Scopus, Cochrane, Magiran, and SID were searched by time limitation for ten years (2009-2019). The search was conducted between February 2019–March 2019. The language was limited to English and Persian.
Results: After duplicate removal, title, and abstract review, 63 papers remained. After full-text control, finally, 7 papers chased for this review. Barriers for rounding were divided into 4 main categories: time limitation, reluctance to participate, ineffective communication, and infrastructure & administration. Nurse time limitation, feeling not being valued by MDs, lack of standard and structure, and nurse unawareness from time of round are the most repeated barriers.
Conclusion: Barriers may need to be removed until nurse participation in multidisciplinary ward rounds improves. Some study needs to take place about this issue in Iran to identify the situation, facilitators, and barriers specific to our country. Based on them, a relevant intervention can be chased.
1. Vietz E, März E, Lottspeich C, Wölfel T, Fischer MR, Schmidmaier R. Ward round competences in surgery and psychiatry-a comparative multidisciplinary interview study. BMC medical education. 2019;19(1):137.
2. Hodgson R, Jamal A, Gayathri B. A survey of ward round practice. Psychiatric Bulletin. 2018;29(5):171-3.
3. O'Hare JA. Anatomy of the ward round. European journal of internal medicine. 2008;19(5):309-13.
4. Shankar P. Ward rounds in medicine. RGUHS Journal of Medical Sciences. 2013;3(3):135-7.
5. Health Quality Council. Module 1–Interdisciplinary Rounding. Patient Flow Toolkit Saskatoon: Health Quality Council (Saskatchewan); 2017.
6. Jefferies H, Chan K. Multidisciplinary team working: is it both holistic and effective? International Journal of Gynecologic Cancer. 2004;14(2):210-1.
7. Savage L, Vyas V, Akerele E, Klein M. Surgical ward rounds: a missed opportunity for multidisciplinary working? The Bulletin of the Royal College of Surgeons of England. 2015;97(1):E9-11.
8. Sharma S, Peters MJ. ‘Safety by DEFAULT’: introduction and impact of a paediatric ward round checklist. Critical Care. 2013;17(5):R232.
9. Wershofen B, Heitzmann N, Beltermann E, Fischer MR. Fostering interprofessional communication through case discussions and simulated ward rounds in nursing and medical education: A pilot project. GMS J Med Educ. 2016;33(2):Doc28.
10. O'leary KJ, Boudreau YN, Creden AJ, Slade ME, Williams MV. Assessment of teamwork during structured interdisciplinary rounds on medical units. Journal of hospital medicine. 2012;7(9):679-83.
11. Malec A, Mørk A, Hoffman R, Carlson E. The care team visit: Approaching interdisciplinary rounds with renewed focus. Journal of nursing care quality. 2018;33(2):135-42.
12. Terra SM. Interdisciplinary Rounds. Professional case management. 2015;20(6):299-307.
13. Launer J. What's wrong with ward rounds? Postgraduate medical journal. 2013;89(1058):733-4.
14. Shaughnessy L, Jackson J. Introduction of a new ward round approach in a cardiothoracic critical care unit. Nursing in critical care. 2015;20(4):210-8.
15. Ndie EC, Ogwa E, Oko UJ, Emeh A. Assessment of nurses opinions on participation in ward round in Ebonyi State. International Research Journal of Public and Environmental Health. 2015;2(1):1-3.
16. Shokri A, Yazdan Panah A, Vahdat S. The Professional Relationship between the Nurses and Physicians from their Own Point of View. Journal of Health and Care. 2013;15(1):76-69.
17. Manias E, Street A. Nurse–doctor interactions during critical care ward rounds. Journal of clinical nursing. 2001 Jul 20;10(4):442-50.
18. Busby A, Gilchrist B. The role of the nurse in the medical ward round. Journal of advanced nursing. 1992;17(3):339-46.
19. Lees L. The nurse's role in hospital ward rounds. Nurs Times. 2013;109(12):12-4.
20. Walton V, Hogden A, Long JC, Johnson JK, Greenfield D. How Do Interprofessional Healthcare Teams Perceive the Benefits and Challenges of Interdisciplinary Ward Rounds. Journal of multidisciplinary healthcare. 2019;12:1023-32.
21. Kirthi V, Ingham J, Lecko C, Amin Y, Temple RM, Hughes S, et al., editors. Ward Rounds in Medicine: Principles for Best Practice: a Joint Publication of the Royal College of Physicians and the Royal College of Nursing, 2012. london: Royal College of Physicians
22. Muething SE, Kotagal UR, Schoettker PJ, Gonzalez del Rey J, DeWitt TG. Family-centered bedside rounds: a new approach to patient care and teaching. Pediatrics. 2007;119(4):829-32.
23. Aragona E, Ponce-Rios J, Garg P, Aquino J, Winer JC, Schainker E. A quality improvement project to increase nurse attendance on pediatric family centered rounds. Journal of pediatric nursing. 2016;31(1):e3-e9.
24. Whittemore R, Knafl K. The integrative review: updated methodology. Journal of advanced nursing. 2005;52(5):546-53.
25. Halcomb E, Stephens M, Bryce J, Foley E, Ashley C. Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing. 2016;25(9-10):1193-205.
26. Chew BH, Tang CJ, Lim WS, Yap JKY, Zhou W, Liaw SY. Interprofessional bedside rounds: Nurse-physician collaboration and perceived barriers in an Asian hospital. Journal of interprofessional care. 2019;33(6):820-2.
27. Sharma A, Norton L, Gage S, Ren B, Quesnell A, Zimmanck K, et al. A quality improvement initiative to achieve high nursing presence during patient-and family-centered rounds. Hospital Pediatrics. 2014;4(1):1-5.
28. Gonzalo JD, Kuperman E, Lehman E, Haidet P. Bedside interprofessional rounds: perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians. Journal of hospital medicine. 2014;9(10):646-51.
29. Lane D, Ferri M, Lemaire J, McLaughlin K, Stelfox HT. A systematic review of evidence-informed practices for patient care rounds in the ICU. Critical Care Medicine. 2013;41(8):2015-29.
30. Hendricks S, LaMothe VJ, Kara A, Miller J. Facilitators and barriers for interprofessional rounding: A qualitative study. Clinical Nurse Specialist. 2017;31(4):219-28.
31. Shetty K, Poo SXW, Sriskandarajah K, Sideris M, Malietzis G, Darzi A, et al. “The Longest Way Round Is The Shortest Way Home”: An Overhaul of Surgical Ward Rounds. World journal of surgery. 2018;42(4):937-49.
32. New South Wales. Department of Health. Multidisciplinary ward rounds: A resource. North Sydney, N.S.W: NSW Department of Health. 2011. Available from: http://www.health.nsw.gov.au/pubs/2011/multidiciplinary_ward_rou.html
33. Alcantara, Alma, "MDR Matters! Improving Primary Nurse Participation in Multidisciplinary Rounds". Master's Projects and Capstones. 852. 2018. Available from:
https://repository.usfca.edu/capstone/852
34. Henkin S, Chon TY, Christopherson ML, Halvorsen AJ, Worden LM, Ratelle JT. Improving nurse–physician teamwork through interprofessional bedside rounding. Journal of multidisciplinary healthcare. 2016;9(1):201.
35. Marshall CD, Fay ME, Phillips B, Faurote R, Kustudia J, Ransom RC, et al. Implementing a Standardized Nurse-driven Rounding Protocol in a Trauma-surgical Intensive Care Unit: A Single Institution Experience. Cureus. 2018;10(10) :e3422.
36. Jiménez RA, Swartz M, McCorkle R. Improving quality through nursing participation at bedside rounds in a pediatric acute care unit: a pilot project. Journal of pediatric nursing. 2018;43:45-55.
37. Licata J, Aneja RK, Kyper C, Spencer T, Tharp M, Scott M, et al. A foundation for patient safety: Phase I implementation of interdisciplinary bedside rounds in the pediatric intensive care unit. Critical care nurse. 2013;33(3):89-91.
38. Huang K, Minahan J, Brita-Rossi P, Aylward P, Katz JT, Roy C, et al. All together now: impact of a regionalization and bedside rounding initiative on the efficiency and inclusiveness of clinical rounds. Journal of hospital medicine. 2017;12(3):150-6.
2. Hodgson R, Jamal A, Gayathri B. A survey of ward round practice. Psychiatric Bulletin. 2018;29(5):171-3.
3. O'Hare JA. Anatomy of the ward round. European journal of internal medicine. 2008;19(5):309-13.
4. Shankar P. Ward rounds in medicine. RGUHS Journal of Medical Sciences. 2013;3(3):135-7.
5. Health Quality Council. Module 1–Interdisciplinary Rounding. Patient Flow Toolkit Saskatoon: Health Quality Council (Saskatchewan); 2017.
6. Jefferies H, Chan K. Multidisciplinary team working: is it both holistic and effective? International Journal of Gynecologic Cancer. 2004;14(2):210-1.
7. Savage L, Vyas V, Akerele E, Klein M. Surgical ward rounds: a missed opportunity for multidisciplinary working? The Bulletin of the Royal College of Surgeons of England. 2015;97(1):E9-11.
8. Sharma S, Peters MJ. ‘Safety by DEFAULT’: introduction and impact of a paediatric ward round checklist. Critical Care. 2013;17(5):R232.
9. Wershofen B, Heitzmann N, Beltermann E, Fischer MR. Fostering interprofessional communication through case discussions and simulated ward rounds in nursing and medical education: A pilot project. GMS J Med Educ. 2016;33(2):Doc28.
10. O'leary KJ, Boudreau YN, Creden AJ, Slade ME, Williams MV. Assessment of teamwork during structured interdisciplinary rounds on medical units. Journal of hospital medicine. 2012;7(9):679-83.
11. Malec A, Mørk A, Hoffman R, Carlson E. The care team visit: Approaching interdisciplinary rounds with renewed focus. Journal of nursing care quality. 2018;33(2):135-42.
12. Terra SM. Interdisciplinary Rounds. Professional case management. 2015;20(6):299-307.
13. Launer J. What's wrong with ward rounds? Postgraduate medical journal. 2013;89(1058):733-4.
14. Shaughnessy L, Jackson J. Introduction of a new ward round approach in a cardiothoracic critical care unit. Nursing in critical care. 2015;20(4):210-8.
15. Ndie EC, Ogwa E, Oko UJ, Emeh A. Assessment of nurses opinions on participation in ward round in Ebonyi State. International Research Journal of Public and Environmental Health. 2015;2(1):1-3.
16. Shokri A, Yazdan Panah A, Vahdat S. The Professional Relationship between the Nurses and Physicians from their Own Point of View. Journal of Health and Care. 2013;15(1):76-69.
17. Manias E, Street A. Nurse–doctor interactions during critical care ward rounds. Journal of clinical nursing. 2001 Jul 20;10(4):442-50.
18. Busby A, Gilchrist B. The role of the nurse in the medical ward round. Journal of advanced nursing. 1992;17(3):339-46.
19. Lees L. The nurse's role in hospital ward rounds. Nurs Times. 2013;109(12):12-4.
20. Walton V, Hogden A, Long JC, Johnson JK, Greenfield D. How Do Interprofessional Healthcare Teams Perceive the Benefits and Challenges of Interdisciplinary Ward Rounds. Journal of multidisciplinary healthcare. 2019;12:1023-32.
21. Kirthi V, Ingham J, Lecko C, Amin Y, Temple RM, Hughes S, et al., editors. Ward Rounds in Medicine: Principles for Best Practice: a Joint Publication of the Royal College of Physicians and the Royal College of Nursing, 2012. london: Royal College of Physicians
22. Muething SE, Kotagal UR, Schoettker PJ, Gonzalez del Rey J, DeWitt TG. Family-centered bedside rounds: a new approach to patient care and teaching. Pediatrics. 2007;119(4):829-32.
23. Aragona E, Ponce-Rios J, Garg P, Aquino J, Winer JC, Schainker E. A quality improvement project to increase nurse attendance on pediatric family centered rounds. Journal of pediatric nursing. 2016;31(1):e3-e9.
24. Whittemore R, Knafl K. The integrative review: updated methodology. Journal of advanced nursing. 2005;52(5):546-53.
25. Halcomb E, Stephens M, Bryce J, Foley E, Ashley C. Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing. 2016;25(9-10):1193-205.
26. Chew BH, Tang CJ, Lim WS, Yap JKY, Zhou W, Liaw SY. Interprofessional bedside rounds: Nurse-physician collaboration and perceived barriers in an Asian hospital. Journal of interprofessional care. 2019;33(6):820-2.
27. Sharma A, Norton L, Gage S, Ren B, Quesnell A, Zimmanck K, et al. A quality improvement initiative to achieve high nursing presence during patient-and family-centered rounds. Hospital Pediatrics. 2014;4(1):1-5.
28. Gonzalo JD, Kuperman E, Lehman E, Haidet P. Bedside interprofessional rounds: perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians. Journal of hospital medicine. 2014;9(10):646-51.
29. Lane D, Ferri M, Lemaire J, McLaughlin K, Stelfox HT. A systematic review of evidence-informed practices for patient care rounds in the ICU. Critical Care Medicine. 2013;41(8):2015-29.
30. Hendricks S, LaMothe VJ, Kara A, Miller J. Facilitators and barriers for interprofessional rounding: A qualitative study. Clinical Nurse Specialist. 2017;31(4):219-28.
31. Shetty K, Poo SXW, Sriskandarajah K, Sideris M, Malietzis G, Darzi A, et al. “The Longest Way Round Is The Shortest Way Home”: An Overhaul of Surgical Ward Rounds. World journal of surgery. 2018;42(4):937-49.
32. New South Wales. Department of Health. Multidisciplinary ward rounds: A resource. North Sydney, N.S.W: NSW Department of Health. 2011. Available from: http://www.health.nsw.gov.au/pubs/2011/multidiciplinary_ward_rou.html
33. Alcantara, Alma, "MDR Matters! Improving Primary Nurse Participation in Multidisciplinary Rounds". Master's Projects and Capstones. 852. 2018. Available from:
https://repository.usfca.edu/capstone/852
34. Henkin S, Chon TY, Christopherson ML, Halvorsen AJ, Worden LM, Ratelle JT. Improving nurse–physician teamwork through interprofessional bedside rounding. Journal of multidisciplinary healthcare. 2016;9(1):201.
35. Marshall CD, Fay ME, Phillips B, Faurote R, Kustudia J, Ransom RC, et al. Implementing a Standardized Nurse-driven Rounding Protocol in a Trauma-surgical Intensive Care Unit: A Single Institution Experience. Cureus. 2018;10(10) :e3422.
36. Jiménez RA, Swartz M, McCorkle R. Improving quality through nursing participation at bedside rounds in a pediatric acute care unit: a pilot project. Journal of pediatric nursing. 2018;43:45-55.
37. Licata J, Aneja RK, Kyper C, Spencer T, Tharp M, Scott M, et al. A foundation for patient safety: Phase I implementation of interdisciplinary bedside rounds in the pediatric intensive care unit. Critical care nurse. 2013;33(3):89-91.
38. Huang K, Minahan J, Brita-Rossi P, Aylward P, Katz JT, Roy C, et al. All together now: impact of a regionalization and bedside rounding initiative on the efficiency and inclusiveness of clinical rounds. Journal of hospital medicine. 2017;12(3):150-6.
| Files | ||
| Issue | Vol 8 No 2 (2021): Spring | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/npt.v8i2.5120 | |
| Keywords | ||
| physician-nurse relations; communication; nursing; review | ||
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How to Cite
1.
Zamanzadeh V, Orujlu S, Beykmirza R, Ghofrani M. Barriers for nurse participation in multidisciplinary ward rounds: An integrative review. NPT. 2020;8(2):96-102.
