Bridging Gaps in Communication: Family Members' Involvement and Understandings about Their Relatives' Prescribed Medications in Hospital

Thursday, 2 August 2012: 1:35 PM

Elizabeth Manias, RN, MPharm, MNS, PhD
Melbourne School of Health Sciences, The University of Melbourne, Parkville Victoria 3010, Australia

Learning Objective 1: The learner will be able to understand facilitators and barriers underlying family membersí involvement with health professionals about how patientsí medications are managed in hospital.

Learning Objective 2: The learner will be able to identify strategies to address barriers impacting on family membersí involvement with health professionals about how patientsí medications are managed.

Purpose: To explore family members’ involvement with health professionals and patients about how patients’ medications are managed in hospital.

Methods: Qualitative interviews were conducted with family members of patients who were admitted to hospital for a surgical or medical reason. A purposive sampling approach was used for recruitment. Interviews took place in a quiet room of four surgical and four medical wards of two Australian hospitals.

Results: Forty interviews were conducted with family members in relation to their respective relative’s medications. A median of nine medications were prescribed per patient, ranging from 5 to 17 medications. Family members’ understandings about the purpose of patients’ medications prescribed in hospital ranged from 14 to 100%. In all cases, changes were made to medications prescribed, either in terms of the dose, or removal or initiation of medication during the hospital stay at the time when interviews were conducted. Family members generally showed extensive involvement with patients in managing medications, and they contributed actively in negotiating medication management activities in hospital and in addressing problems relating to continuity of care. Communication with doctors, nurses and pharmacists was generally insufficient, despite family members’ keenness to speak with them. With respect to family members’ interactions with nurses, communication about medications involved nurses informing patients about the medications being administered. According to family members, this communication was often brief, with few details offered about the purpose, action or side effects of medications.

Conclusion: Improved communication is highly needed between family members, health professionals and patients in medical and surgical wards. Greater attention should be played by nurses in their interactions with patients and family members at the bedside, to initiate communication proactively. Family members possessed valuable, unique information about patients’ medications that could easily be utilised to facilitate patient safety.