Clinical decision making on the ward round
Research type
Research Study
Full title
An ethnographic study investigating intra- and inter- disciplinary team dynamics in antimicrobial decision making on the ward round
IRAS ID
173068
Contact name
Esmita Charani
Contact email
Sponsor organisation
Imperial College London and Imperial College London Healthcare NHS Trust
Research summary
Antimicrobial drugs are used to treat infections, and their inappropriate use can render them ineffective. Across the globe initiatives are underway in hospitals to improve antimicrobial prescribing behaviours. Little is known about the influence of local cultural factors such as team dynamics and influence of senior colleagues and patients on the prescribing decisions made by individual doctors.
In hospitals, the diagnosis and treatment pathway of infection in any individual patient is complex and may involve input from multiple teams. Antimicrobial prescribing and management decision making is made by multiple individuals for the duration of the infection for any given patient episode. One regularly occurring activity in hospitals that provides an opportunity for multidisciplinary decision making is the ward round. The hospital ward round is a key event, where healthcare professionals follow the lead surgeon or consultant and go to each patient bedside and review the patient. This routine ward round is where the patient medical/surgical problems are discussed, diagnoses made and treatments planned. The ward round provides one of the few occasions where the patient can participate in the communication and decision making process of their care. To date no research has been conducted on the culture of antimicrobial decision making on the ward round.
In this study, I aim to investigate the influence of different healthcare professionals and patients on antimicrobial decision making in ward rounds. I propose to conduct a study where I observe medical and surgical ward rounds and conduct face to face interviews with participants of these ward rounds to understand what influences antimicrobial decision making. Understanding how antimicrobial decision making is made on the ward round will enable development of better interventions to improve infection related outcomes for individual patients.
REC name
Yorkshire & The Humber - Leeds East Research Ethics Committee
REC reference
15/YH/0139
Date of REC Opinion
2 Apr 2015
REC opinion
Further Information Favourable Opinion