Copying letters to children and parents: audit and survey of nurses' views.

Aim: To discover whether community children's nurses and other members of the multi-disciplinary team had changed their practice in the light of the 'copying letters' initiative recommended by the Department of Health and to seek their views on the process.

Method: A documentary analysis of the notes was undertaken on 30 sets of notes chosen at random from the community children's nursing team's caseload and the total number of letters in each child's notes was retrospectively recorded for periods before and after the implementation of the 'copying letter initiative'. In addition, 14 community children's nurses were interviewed about their communication practice.

Results: Letters accounted for 70 per cent of the total correspondence in the children's notes. Most of the 466 letters were from doctors (65 per cent) with nine per cent having been sent by community children's nurses. Before the initiative 70 per cent of letters from medical staff were copied compared to 74 per cent afterwards, with community children's nurses copying 19% of letters before and 47% afterwards. Only 13 were sent to the child. Nurses commented on changes to their practice since the copying initiative began and reported varying use of other forms of communication such as text messaging and email. CONCLUSION Professionals should be encouraged to copy letters to parents and children. A number of technologies are available to facilitate communication between patients, parents and other health care professionals. Careful consideration must be given to their introduction to ensure their use conforms to legal and professional codes and good practice principles.