DEVELOPMENT OF AN INSTRUMENT TO UNDERSTAND NURSE-PYSICIAN RELATIONSHIPS

摘要

US healthcare faces a variety of complex challenges as pressure builds to lower costs while simultaneously improving care quality. These challenges have drawn many researchers seeking ways to improve healthcare delivery. Two key issues commonly identified in these efforts are: 1) The need to reduce adverse patient outcomes caused by medical errors, and 2) The need to reduce staffing shortages that lead to lower levels of direct patient interaction. Several studies have shown that disruptive behavior, especially within nurse-physician interactions, can be a material contributor to both of these issues because it can lead to turnover and create additional stress and cognitive loading for those who remain. While researchers have investigated the nature of nurse-physician interaction, these studies tend to focus on the perception of nurses and not physicians. In addition, studies generally do not investigate the underlying culture that supports these behaviors. Social Norms Theory (SNT) presents a novel approach to investigate behavioral norms in the healthcare workplace. SNT suggests that people tend to behave in the way they believe is most typical of and accepted by their peers. Unfortunately, perceptions of behaviors are frequently inaccurate, with views of problematic behaviors overestimated and healthy behaviors underestimated. This disconnect may lead individuals to believe that disruptive behavior is an acceptable norm, when the true norms disagree. This study leveraged SNT as a means to address both gaps by developing a new survey instrument that involves both nurses and physicians to measure norms. This paper discusses the development and validation of the instrument.