The impact of interprofessional communication safety in medication administration processes: A mixed methods systematic review.

Introduction: Medication-related harm remains an important patient safety concern in acute hospital settings, with communication recognised as an important factor in safe medication processes. Effective interprofessional communication supports the exchange, interpretation and clarification of medication-related information across healthcare professionals and clinical contexts. The world health organization identifies medication safety as a global patient safety priority, emphasising the importance of healthcare professionals, medicines, and systems and practices of medication. communication challenges may occur across professional boundaries, during medication transitions and within complex hospital environments.

Aim: This systematic review aimed to identify communication factors associated with medication errors in acute hospital settings and to explore the factors that influence safe interprofessional communication during medication-related processes. The findings will inform further exploration of communication practices in clinical practice.

Methods: A mixed-methods systematic review was undertaken to identify empirical research examining communication and medication safety in acute hospital settings. Searches were conducted across cinahl, medline/pubmed, cochrane library, scopus, sciencedirect, web of science and proquest central. Studies were screened against predefined eligibility criteria using JBI SUMARI for screening, critical appraisal and data extraction. Methodological quality was assessed using relevant Joanna briggs institute critical appraisal tools. The review was reported in accordance with the 2020 preferred reporting items for systematic reviews and meta-analyses (Prisma) guidelines.

Results: Twenty 26 studies were found. Fourteen studies were excluded. Twelve studies were included. Facilitators of effective communication included open and respectful interprofessional relationships, recognition of professional roles and expertise, clear responsibilities, and opportunities to clarify, question, and confirm medication-related information. Barriers included unclear roles, professional hierarchy, differences in professional status or seniority, intimidation, workload, time pressures, interruptions, and fragmented communication processes. Communication occurred through formal and informal channels, including medication charts, electronic medication management systems, clinical documentation, structured communication tools, telephone and face-to-face communication, and bedside discussions. Electronic and structured systems supported the recording, access, and transfer of medication-related information but did not replace interpersonal communication. Healthcare professionals continued to use discussion to interpret information, resolve ambiguity, challenge potentially unsafe decisions, and establish shared understanding.

Discussion: The findings indicate that safe interprofessional communication extends beyond the transmission or documentation of medication-related information. Communication was a relational and contextual process involving clarification, questioning, confirmation, and opportunities to raise concerns. Professional relationships, role clarity, hierarchy, workload, time pressures, interruptions, and organisational processes influenced how communication occurred. The quantitative and qualitative evidence complemented one another by demonstrating both measurable medication-related outcomes and the interpersonal and organisational factors influencing communication practices. Communication technologies and structured systems appeared complementary to, rather than substitutes for, interpersonal communication

conclusion: Safe interprofessional communication in medication administration is a complex process shaped by interpersonal, professional, technological, and organisational factors. Creating conditions that enable healthcare professionals to clarify information, question decisions, confirm understanding, and raise medication-related concerns may be important to medication safety. The findings provide a foundation for further investigation and the development of a communication framework or tool to support safer medication-related communication.