Abstract P158: A Training Program for Nursing Staff on Communicating Adverse Outcomes and Errors

Abstract

Background: Nursing professionals are confronted with situations where adverse events (AEs) or errors occur, and communication and disclosure principles are required to manage these challenging situations ethically and effectively. We adapted and taught hospital cardiovascular nurses an established program at Vanderbilt for training “the how and when of communicating unexpected AEs and errors.” Methods: The two-hour communication skills training program was presented to inpatient nurses in the Vanderbilt Heart and Vascular Institute (VHVI) and was evaluated using participant surveys. Obvious errors require full disclosure communications, and a “balance beam” approach was taught to weigh alternatives in situations involving uncertainty. We used live case-based interactive training with exercises requiring application of key content. Key elements included: early identification of unexpected AEs and errors, advocating for “huddles” among healthcare team members to consider how to handle unexpected outcomes, and supporting consistent communication to patients and families by team members. Surveys assessed participant satisfaction and intentions to change behavior based on program content. Results: 57 nurses completed the intentions survey and indicated 164 intentions to change (mean 2.9 intentions/respondent). These were grouped into 5 categories (Table). Results on standard participant satisfaction questions were positive for content and teaching methods. Conclusions: We conclude that disclosure training provided relevant information and resulted in nurses’ intentions to change consistent with program objectives. We believe this program can enhance communication, promote a just culture among unit professionals, and facilitate doing the right things for patients and families. Response Categories for Post-Program Intentions to Change Intent Response Category N intentions (%) Use “balance beam” tool in situations of uncertainty re errors and AEs 19 (11.6) Employ “huddles” when health team needs to think through alternative approaches to disclosure 38 (23.2) Improve ability to analyze complex situations 56 (34.1) Fully evaluate patients’ unexpected outcomes 3 (1.8%) Pursue further information and share information on this topic 48 (29.3%)