Influence of Multidisciplinary Collaboration on the Quality of Documentation of Nursing Care in Selected County Referral Hospitals in Kenya
Main Article Content
Abstract
A multidisciplinary care team comprises a range of healthcare professionals whose coordinated efforts result in high-quality, patient-centered care. However, communication challenges frequently undermine multidisciplinary teams, compromising the success and quality of team activities. Research has shown that physicians and nurses focus on different aspects of patient care, and that synergy between them improves outcomes. For nurses' contributions to patient care to be fully realized, nursing care activities must be clearly documented. Without team synergy, healthcare professionals often work in silos, with minimal consultation on documentation and limited opportunities for improvement. This study examined the influence of multidisciplinary collaboration on the quality of nursing care documentation. The study was anchored on the service delivery pillar of health systems strengthening and was conducted in Nyeri, Nyandarua, and Isiolo County Referral Hospitals. A stratified sampling technique was used to select the three counties, and a census approach was applied to nurse managers. A descriptive research design was employed, using questionnaires and key informant guides for data collection. The study collected both qualitative and quantitative data. Thematic and content analyses were used for qualitative data, while regression analysis in SPSS version 26.0 was applied to quantitative data. Findings were presented using frequency tables and charts. From the study, only 22% of documented nursing care was categorized as good. Several multidisciplinary factors influencing nursing care documentation were identified, including joint setting of clinical outcomes, joint evaluation of patient progress, limited multidisciplinary consultation, and joint clinical meetings that provide nurses with opportunities to contribute to patient care. Regression analysis yielded p-values <0.05. Enhancing these factors is recommended to improve nursing care documentation.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
I/We agree to transfer the copyright of this manuscript to the International Journal of Professional Practice (The IJPP) in the event that the manuscript is published in the Journal.
I/We give the undersigned authors of the manuscript have made the following declaration:
(a) That I/We have made substantial contribution during the conception and design, or acquisition of data, or analysis and interpretation of the data,
(b) That I/We have participated in drafting the article or revising it critically for important intellectual content,
(c) That I/We have read and confirm the content of the manuscript and have agreed to it,
(d) That I/We have participated sufficiently in the work to take public responsibility for appropriate portions of the content of the paper,
(e) That I/We give guarantee that the content of the manuscript is original, and has not beenvpublished elsewhere and is not currently being considered for publication by another journal.
References
Agom, C. (2015). Nurses’ participation in ward rounds: A critical analysis. Journal of Nursing Research, 20(4), 201–215. https://doi.org/10.15739/irjpeh.012
Al Khalfan, A. A., Al Ghamdi, A. A., De Simone, S., & Hadi, Y. H. (2021). The impact of multidisciplinary team care on decreasing intensive care unit mortality. Saudi Critical Care Journal, 5(2), 13–18. https://www.sccj-sa.org/text.asp?2021/5/2/13/319311 DOI: https://doi.org/10.4103/sccj.sccj_34_20
Asmirajanti, M., Hamid, A., & Hariyati, R. (2019). Nursing care activities based on documentation. BMC Nursing, 18(1), 1–5. https://doi.org/10.1186/s12912-019-0352-0 DOI: https://doi.org/10.1186/s12912-019-0352-0
Australian Government, Department of Health (2012). Multidisciplinary care. http://www.health.gov.au/internet/main/publishing.nsf/Content/multidisciplinary-care
Azhari, I., & Sukartini, T. (2021). The effect of nursing rounds on patient satisfaction in nursing services. https://doi.org/10.20473/fmnj.v4i1.27007 DOI: https://doi.org/10.20473/fmnj.v4i1.27007
Densash, A., Kassie S., Dubale A., Chereka A., Ngusie H., Hunde M., Emanu M., Shibabaw A., & Walle, A. (2023). Health professionals’ routine practice documentation and its associated factors in a resource-limited setting: a cross-sectional study. https://doi.org/10.1136/bmjhci-2022-100699 DOI: https://doi.org/10.1136/bmjhci-2022-100699
Fowler, A., Stephens, T., Partridge, J., & Dhesi, J. (2022). Surgery in older patients: Learning from shared decision-making in intensive care. https://doi.org/10.1016/j.bja.2022.08.002 DOI: https://doi.org/10.1016/j.bja.2022.08.002
Hickman, L. D., Phillips, J. L., Newton, P. J., Halcomb, E. J., Al Abed, N., & Davidson, P. M. (2015). Multidisciplinary team interventions to optimize health outcomes for older people in acute care settings: A systematic review. Archives of Gerontology and Geriatrics, 61(3), 322–329. https://doi.org/10.1016/j.archger.2015.06.021 DOI: https://doi.org/10.1016/j.archger.2015.06.021
Jepkosgei, J., English, M., Adam, M., & Nzinga, J. (2022). Challenges of patient care coordination in multidisciplinary healthcare teams. Journal of Global Health, 8(1), 145–160. https://doi.org/10.7189/jogh.08.01012
Jepkosgei, R., Mutai, J., Mwangi, A., & Chege, P. (2022). Evaluating nursing documentation practices in public hospitals: A case study in Kenya. African Journal of Health Systems Management, 14(2), 45–54. https://doi.org/10.4314/ajhsm.v14i2.4
Kallen, E., Niström, S., & Rosengren, K. (2021). Content and structure of ward rounds focusing on interprofessional collaboration on an internal medicine ward: An observational study of interprofessional collaboration. https://doi.org/10.1177/20571585211052757 DOI: https://doi.org/10.1177/20571585211052757
Kern, L., Safford, M., Slavin, M., Makovkina, E., Fudl, A., Carrillo, J., & Abramson, E. (2019). Patients’ and providers’ views on causes and consequences of healthcare fragmentation in the ambulatory setting: A qualitative study. https://doi.org/10.1007/s11606-019-04859-1 DOI: https://doi.org/10.1007/s11606-019-04859-1
Kuipers S., Cramm J., & Nieboer A. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research, 19(13). https://doi.org/10.1186/s12913-018-3818-y DOI: https://doi.org/10.1186/s12913-018-3818-y
Kvande, M., Lykkeslet, E., & Storli, S. L. (2017). ICU nurses and physicians' dialogue regarding patients’ clinical status and care options: A focus group study. International Journal of Qualitative Studies on Health and Well-being, 12, 1267346. https://doi.org/10.1080/17482631.2016.1267346 DOI: https://doi.org/10.1080/17482631.2016.1267346
Kyte, L., Sjursen, I., & Kleiven, O. T. (2020). The impact of pre-round meetings on quality of care: A qualitative study. Nursing Open, 7(2), 596–604. https://doi.org/10.1002/nop2.429. DOI: https://doi.org/10.1002/nop2.429
Licitra, L., Keilholz, U., Tahara, M., Lin, J., Chomette, P., Ceruse, P., Harrington, K., & Mesia, R. (2016). Evaluation of the benefit and use of multidisciplinary teams in the treatment of head and neck cancer. Oral Oncology. https://doi.org/10.1016/j.oraloncology.2016.06.002 DOI: https://doi.org/10.1016/j.oraloncology.2016.06.002
Mboineki, J., Chen, C., Gerald, D., & Boateng, C. (2019). The current status of nurse-doctor collaboration in clinical decision-making and its outcomes in Tanzania. https://doi.org/10.1002/nop2.360 DOI: https://doi.org/10.1002/nop2.360
Medaković, S. (2020). Communication in multidisciplinary teams. Journal of Multidisciplinary Healthcare Collaboration, 2(2), e105. https://doi.org/10.47363/JMHC/2020(2)105 DOI: https://doi.org/10.47363/JMHC/2020(2)105
Merriman, J., & Freeth, D. (2022). Understanding the role of ward rounds in modern healthcare. Journal of Hospital Management, 16(2), 89–103. https://doi.org/10.1111/jep.13670 DOI: https://doi.org/10.1111/jep.13670
Meyer-Kühling, J., Frankenberg, C., & Schroder, J. (2015). Professional boundaries and team communication in healthcare. European Journal of Health Communication, 9(3), 156–172. https://ejhc.org
Moleyar, P., Sharma, V., Noojibail, A., & Anupama, S. (2020). The role of interprofessional ward rounds in patient care coordination. Medical Journal of Dr. D.Y. Patil Vidyapeeth, 13(1), 79–81. https://doi.org/10.4103/mjdrdypu.mjdrdypu_65_19 DOI: https://doi.org/10.4103/mjdrdypu.mjdrdypu_65_19
Monica, R. (2018). Interdisciplinary collaboration in patient care: A case study analysis. Healthcare Research Publishing. https://healthcareresearchpublishing.org/article-url
Ndie, E. C., Ogwa, E. N., Oko, C. E., & Emeh, U. (2015). The role of nurses in multidisciplinary ward rounds: Challenges and recommendations. African Journal of Nursing Studies, 5(1), 22–35. https://doi.org/10.15739/irjpeh.012
Nursing Council of Kenya (2024). Documentation of care handbook for nurses and midwives in Kenya. https://www.nckenya.org/handbooks/documentation-care
Opia, J. (2018). Clinical meetings as a strategy for improving patient care outcomes. Journal of Healthcare Administration, 10(3), 142–156. https://journal.healthcareadmin.org/2018/vol10/issue3
Pierre, H., Herskovic, J. R., & Sepulveda, M. (2018). Complexity and adaptability in multidisciplinary healthcare teams: An overview. Journal of Health Informatics, 14(2), 112–125. Retrieved from https://journal.healthinformatics.org/2018/vol14/issue2
Ramukumba, M., & Amouri, S. (2019). Nurses' perspectives of the nursing documentation audit process. PMID https://10.4102/hsag.v24i0.1121 DOI: https://doi.org/10.4102/hsag.v24i0.1121
Redley, B., McTier, L., Botti, M., Hutchinson, A., Newnham, H., Campbell, D., & Bucknall, T. (2019). Patient participation in inpatient ward rounds on acute inpatient medical wards: A descriptive study. BMJ Quality & Safety, 28(1), 15–23. https://doi.org/10.1136/bmjqs-2017-007292 dro.deakin.edu.au+7 DOI: https://doi.org/10.1136/bmjqs-2017-007292
Reese, T., Johnson, M., Albright, K., & Torres, L. (2021). Improving nursing documentation through collaborative quality improvement initiatives. Journal of Nursing Management, 29(6), 1234–1242. https://doi.org/10.1111/jonm.13245 DOI: https://doi.org/10.1111/jonm.13245
Rosell, L., Alexandersson, N., Hagberg, O., & Nilbert, M. (2018). Clinical meetings as a tool for improving interdisciplinary collaboration and patient outcomes. Scandinavian Journal of Healthcare Management, 12(1), 112–130. https://doi.org/10.1186/s12913-018-2990-4 DOI: https://doi.org/10.1186/s12913-018-2990-4
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2019). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 74(4), 433–450. https://doi.org/10.1037/amp0000298 DOI: https://doi.org/10.1037/amp0000298
Schot, E., Tummers, L., & Noordegraat, M. (2019). Enhancing effectiveness of multidisciplinary teams in healthcare: A framework for best practices. Healthcare Leadership Journal, 9(2), 88–102. https://doi.org/10.1080/13561820.2019.1636007 DOI: https://doi.org/10.1080/13561820.2019.1636007
Studycorgie. (2022). The importance of teamwork in healthcare settings. https://www.studycorgie.com/articles/teamwork-healthcare
Suleiman, A. (2021). The role of structured nursing rounds in improving patient care. Journal of Nursing Practice, 15(3), 78–92. https://www.journalofnursingpractice.org
Tasew, H., Mariye, T., & Teklay, G. (2019). Nursing documentation practice and associated factors among nurses in public hospitals, Tigray, Ethiopia. BMC Research Notes, 12, 612. https://doi.org/10.1186/s13104-019-4661-x DOI: https://doi.org/10.1186/s13104-019-4661-x
Walker, L., & Selmanoff, H. (1964). The role of nursing documentation in healthcare delivery. Journal of Nursing Management, 2(1), 12–19. http://www.rcni.com/journal/nm
World Health Organization (2023). Patient safety and communication in multidisciplinary healthcare teams. Geneva: World Health Organization. https://www.who.int/publications/i/item/patient-safety-and-communication
Zajac S., Woods A., Tannenbaum S., Salas, & Holladay C. (2021). Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance. Health Communication, 6. https://doi.org/10.3389/fcomm.2021.606445 DOI: https://doi.org/10.3389/fcomm.2021.606445