Barriers and Facilitators to Nurse-Provider Communication in the Emergency Department: A Scoping Review.

Abstract

BackgroundEffective nurse-provider communication in the emergency department (ED) is crucial but often hindered by hierarchical dynamics and high workloadsObjectivesThis review aimed to examine, systematically map, and identify gaps in existing literature concerning ED registered nurse-provider communication.Eligibility CriteriaStudies focused on direct communication between bedside registered nurses (RNs) and providers, including physicians, physician assistants (PAs), and nurse practitioners (NPs) in the ED, encompassing verbal, non-verbal and electronic communication. Non-direct patient care roles were excluded. Sources of Evidence: A search in CINAHL, MEDLINE and ProQuest Nursing & Allied Health identified 1978 sources, of which 37 studies were included: 15 qualitative, 9 quantitative, 4 mixed methods, 6 commentaries, 1 performance improvement project, and 1 scoping review.Charting MethodsData were extracted using Joanna Briggs Institute (JBI) guidelines and thematically analyzed according to Levac's framework.ResultsFour key themes emerged: (i) Interruptions hinder communication but can be reduced by electronic supports facilitating asynchronous communication, (ii) Power imbalances and high workload/communication load impede effective communication, emphasizing the need for structured communication tools and interprofessional communication training, (iii) Shared workspaces, electronic supports, and collaborative, respectful interactions enhance communication (iv) Timely updates and collaborative planning are valued, emphasizing the significance of consistent communication.ConclusionsThis review identified interventions that can improve ED nurse-provider communication, including electronic supports, shared workspaces, structured communication tools, and interprofessional communication training. Future research should evaluate these strategies' effectiveness and explore regional differences, particularly in Canada, where the literature is limited.