Relational Quality of Registered Nurses and Nursing Assistants: Influence on Patient Safety Culture.

Amy Campbell,Elaine Scott,Diana Layne

doi:10.3390/healthcare9020189

Amy Campbell, Elaine Scott + Show 1 more

Open Access

https://doi.org/10.3390/healthcare9020189

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Abstract

Registered nurses (RNs) working within acute care hospitals have an incredible responsibility to provide safe care in a complex environment which requires trust, teamwork, and communication. Nursing assistants (NAs) play a critical role in working with RNs to meet these growing demands of inpatient care. Minimal evidence exists exploring the relational quality between RNs and NAs within hospitals. The aim of this study is to explore RN and NA behaviors and experiences that promote patient safety and teamwork and enhance communication between RNs and NAs within the hospital environment. Qualitative analysis was used, with two focus groups which included six participants within each group (three RNs and three NAs) from two separate inpatient units. Transcripts were reviewed and coded for themes. Collaborative teamwork and two-way communication were commonly reported as behaviors that promote patient safety. Trust between RNs and NAs was identified as a key component of positive relationships between RNs and NAs. Participants identified four common behaviors that build trust, which were accountability, effective conflict resolution, collaborative teamwork, and prioritizing patient needs. Finally, teamwork was identified as a common strategy to increase communication effectiveness between RNs and NAs. High relational quality (RQ) between the RN and NA is an important component of teamwork and patient safety culture.

Highlights

An Registered nurses (RNs) participant from the high group shared, “To me, it [team turns-turning the patient with an RN and Nursing assistants (NAs)]
An unintended consequence of poor relational quality between this dyad may be a lack of two-way communication
Relational quality is critical to patient safety [3]

Summary

Introduction

In today’s complex healthcare environment, the registered nurse has a tremendous responsibility to care for patients and manage the physical and emotional stress that accompanies their role. These stressors include increased acuity, short staffing, and working long hours away from their family [1,2]. Other typical responsibilities of the NA include collecting vital signs as well as other tasks delegated by the RN. In some cases, this decreases the job satisfaction for the RN [3]. The inability to communicate, delegate, and work as a team can lead to poor outcomes for the patient [3]

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