Nurses' perspectives on how an e-message system supports cross-sectoral communication in relation to medication administration: A qualitative study.

Abstract

To describe nurses' perspectives on how an e-message system supports communication between hospital and home care nurses in relation to medication administration. Medication administration is a complex process involving a high risk of error. Unclear communication and lack of updated information about medication have been identified as the leading cause of medication errors during care transitions. E-message systems are progressively being used to improve information exchange across sectors, yet little is known about their usage for exchange of medication information between nurses. A qualitative design using content analysis. Focus group interviews were conducted with nurses from eight hospital wards and six municipalities (n=79). Participant observations were conducted in three hospital wards and in three municipalities (165hr). The e-message system did not provide the information needed by the home care nurses to ensure safe medication administration after discharge due to (1) limitations of the system, (2) hospital nurses' lack of knowledge about home care nurses' information needs and (3) hospital nurses' lack of access to medication information. Due the home care nurses' perception of responsibility, they bypassed the e-message system to get the information. The home care nurses perceived themselves as the last link in the safety chain. As such, access to adequate information was essential for the nurses to ensure safe medication administration; however, the e-message system did not support exchange of the information needed. E-message systems must meet home care nurses' need for information to ensure that safe medication administration does not depend on the knowledge of the individual nurse. Moreover, other system factors that influence interprofessional collaboration and nurses' cross-sectoral communication must be addressed.