Nursing Staff Communication Research Articles

Development and Validation of the Companion's Satisfaction Questionnaire of Patient's Hospitalized in Intensive Care Units.

The current study aimed to develop and validate of companions' satisfaction questionnaire of patients hospitalized in ICUs. This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability. In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability. The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs.

Patient-healthcare worker communication in emergency departments: patient perspectives

Background: Effective communication between healthcare practitioners and patients in the emergency department (ED) is crucial for patient satisfaction and quality of care. This study explored patients' perspectives on communication with nurses and physicians in the ED. Methods: A cross-sectional study was conducted using a sample of 159 patients to assess the type of information relayed by nurses and doctors. The interview data were analyzed to examine nursing staff communication, physician communication, and communication difficulties. Results: Nurses were found to be less likely to inform patients about their results or disposition. While 81.2% of physicians introduced themselves to patients, only 51.6% stated their status level. Approximately 68.6% of subjects were offered analgesia or treatment, and 60% reported no communication difficulties with medical staff. Empathy was demonstrated by 54.2% of healthcare practitioners, and nearly 80% of patient encounters were conducted in understandable language. Conclusion: The study highlights the importance of effective communication in the ED, including empathy, information provision, and language barriers. To improve patient satisfaction and healthcare quality, medical organizations should develop comprehensive work plans, provide communication skills workshops, and enhance the ED work environment. Future research should focus on the perspectives of medical staff and explore communication in larger samples and various contexts.

Nursing staff communication with pediatric patients and families in a pediatric transitional care unit: a best practice implementation project.

The objective of this project was to promote evidence-based practices regarding nursing communication with pediatric patients/families. Effective communication between healthcare providers and patients/families is an essential component of patient care and plays a vital role in patient outcomes. Ineffective communication among the healthcare team and patient families has been described as a significant factor contributing to adverse events and poor health outcomes. The project used JBI's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for encouraging evidence-based practices. A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine change in practice. Three evidence-based practices were utilized as audit criteria for the project. The baseline audit on the three audit criteria revealed an average compliance of 30%. After providing communication skills training to nursing staff and education and visual aids to patients/families and nursing staff regarding the use of white boards, follow-up audits revealed an average compliance of 62%, an increase of 32%. These implementation strategies will continue to be utilized on the unit and will be implemented in other areas of the hospital to further improve communication between patients/families and their healthcare team.

Perceptions of Long-Term Care Nurses and Nursing Assistants about Communication Related to Residents’ Care

<strong>Context:</strong> Research shows ineffective healthcare team communication is linked to sentinel and adverse healthcare events (Gooch 2016; Robson 2016; Wagner et al. 2018). Long-term care (LTC) facilities face unique challenges of caring for frail elderly (Young 2003), who are at increased risk for cascading negative health events beginning with functional decline (Lakshmi 2014). Frequent, effective nursing team communication is essential to providing safe care for these individuals. (Castle 2007; Cortes et al. 2004; Foulkes 2011; Griffin et al. 2016; Howe 2013; Madden et al. 2017; Siegel &amp; Young 2010). <strong>Objective:</strong> The purpose of this study was to use findings from a survey of staff to inform a quality improvement initiative (Appendix A) to enhance nursing team communication. The study explored the perceptions of LTC nursing staff (i.e., registered nurses (RNs), licensed practical nurses (LPNs), and unlicensed assistive personnel (UAPs) about their communication related to resident care. <strong>Methods:</strong> A cross-sectional, descriptive survey design was used to explore perceptions of nursing staff working in a LTC setting about their communication. <strong>Findings:</strong> All levels of nursing staff contributed useful information regarding nursing staff communication, including their contributions, their communication, the frequency of communication, and the methods of communicating. <strong>Limitations:</strong> This study was done at one LTC facility, which limits the generalizability of the findings, though the study can be replicated easily at the city, state, regional, or national level to explore LTC nursing team communication in public and private facilities, including government LTC facilities (i.e., for veterans). <strong>Implications:</strong> Evidence-based standardized communication tools succinctly implemented for communication between nursing staff will bridge patient care communication barriers and positively impact teamwork, leadership, and workplace culture while improving resident and facility outcomes.

The Relationship between Nursing Staff Communication Skills and Quality of Nursing Care in A Pediatric University Specialized Hospital

Abstract Background: Studies were done all over the world related to communication skills and quality of nursing care but most of studies were done in that context based on others perspec-tives'. Nursing staff are the dominant hand in health care system, their skills development particularly communication skills could improve quality of care especially when dealing with children. Aim of Study: The aim of this study is to assess the relationship between nursing staff communication skills and quality of nursing care in Pediatric University Specialized Hospital. Subjects and Methods: A descriptive correlational design was utilized to collect data which was conducted in 4 Icu units in a Pediatric University Specialized Hospital affiliated to Cairo University Hospitals in Egypt. The sample was equated of 40 nurses of nursing staff and their assigned 40 patients who meet criteria. Data were collected through Glasgow coma scale; demographic data, medical and nursing datasheet was reviewed. It was also collected by utilized two observational checklists used in data collection were developed by the researcher. Developed tools are Communication Skills (CSOC) and quality of nursing care (QOC), these tools were validated by experts' opinions and pilot-tested. The time framework of the study was April 2018 to February 2019. Result: The study revealed that (67.5%) of the studied sample had unsatisfactory communication skills and (75%) of the studied sample had unsatisfactory quality of nursing care. Also there was a highly statistically significant relation between communication skills and quality of nursing care. Conclusion: A strong positive relationship between nursing staff communication skills and quality of nursing care in the selected pediatric hospitals is what current study resulted in. Recommendations: The study recommended that training courses on communication skills for nursing staff should be conducted, studies should be encouraged in the field of communication in nursing career as it is an important element in quality of care.

Nursing Unit Communication During a US Public Health Emergency: Natural Experiment.

BackgroundIn the second half of 2014, the first case of Ebola virus disease (EVD) was diagnosed in the United States. During this time period, we were collecting data for the Measuring Network Stability and Fit (NetFIT) longitudinal study, which used social network analysis (SNA) to study relationships between nursing staff communication patterns and patient outcomes. One of the data collection sites was a few blocks away from where the initial EVD diagnosis was made. The EVD public health emergency during the NetFIT data collection time period resulted in the occurrence of a natural experiment.ObjectiveThe objectives of the NetFIT study were to examine the structure of nursing unit decision-making and information-sharing networks, identify a parsimonious set of network metrics that can be used to measure the longitudinal stability of these networks, examine the relationship between the contextual features of a unit and network metrics, and identify relationships between key network measures and nursing-sensitive patient-safety and quality outcomes. This paper reports on unit communication and outcome changes that occurred during the EVD natural disaster time period on the 10 hospital units that had data collected before, during, and after the crisis period.MethodsFor the NetFIT study, data were collected from nursing staff working on 25 patient care units, in three hospitals, and at four data collection points over a 7-month period: Baseline, Month 1, Month 4, and Month 7. Data collection was staggered by hospital and unit. To evaluate the influence of this public health emergency on nursing unit outcomes and communication characteristics, this paper focuses on a subsample of 10 units from two hospitals where data were collected before, during, and after the EVD crisis period. No data were collected from Hospital B during the crisis period. Network data from individual staff were aggregated to the nursing unit level to create 24-hour networks and three unit-level safety outcome measures—fall rate, medication errors, and hospital-acquired pressure ulcers—were collected.ResultsThis analysis includes 40 data collection points and 608 staff members who completed questionnaires. Participants (N=608) included registered nurses (431, 70.9%), licensed vocational nurses (3, 0.5%), patient care technicians (133, 21.9%), unit clerks (28, 4.6%), and monitor watchers (13, 2.1%). Changes in SNA metrics associated with communication (ie, average distance, diffusion, and density) were noted in units that had changes in patient safety outcome measures.ConclusionsUnits in the hospital site in the same city as the EVD case exhibited multiple changes in patient outcomes, network communication metrics, and response rates. Future research using SNA to examine the influence of public health emergencies on hospital communication networks and relationships to patient outcomes is warranted.

Nursing Unit Design, Nursing Staff Communication Networks, and Patient Falls: Are They Related?

Purpose:The purpose of this research is to (1) investigate the impact of nursing unit design on nursing staff communication patterns and, ultimately, on patient falls in acute care nursing units; and (2) evaluate whether differences in fall rates, if found, were associated with the nursing unit physical structure (shape) or size.Background:Nursing staff communication and nursing unit design are frequently linked to patient safety outcomes, yet little is known about the impact of specific nursing unit designs on nursing communication patterns that might affect patient falls.Method:An exploratory longitudinal correlational design was used to measure nursing unit communication structures using social network analysis techniques. Data were collected 4 times over a 7-month period. Floor plans were used to determine nursing unit design. Fall rates were provided by hospital coordinators.Results:An analysis of covariance controlling for hospitals resulted in a statistically significant interaction of unit shape and size (number of beds). The interaction occurred when medium- and large-sized racetrack-shaped units intersected with medium- and large-sized cross-shaped units.Conclusion:The results suggest that nursing unit design shape impacts nursing communication patterns, and the interaction of shape and size may impact patient falls. How those communication patterns affect patient falls should be considered when planning hospital construction of nursing care units.

Abstract TP375: Strength in Numbers: Enhancing Bedside Shift Report with an Advanced Registered Nurse Practitioner

Background and Purpose: According to research, bedside shift report has a direct correlation with improved nursing communication, patient satisfaction, patient safety and quality of care. Exploring the addition of an advanced practice provider, this innovative quality improvement initiative was implemented on a 47 bed neuroscience unit at a trauma level one hospital. Stroke related patients were targeted with cognitive functioning in mind. The purpose of this evidence based nursing practice and quality enhancement initiative was to improve the patient satisfaction, experience and outcomes as well as improving nursing communication by the involvement of an advanced nurse practitioner. Methods: The reengineered plan of care was implemented by incorporating an advanced nurse practitioner to bedside shift report. Stroke patients where the nurse practitioner was the primary provider joined the nurse to nurse communication team during bedside shift report to improve quality measures. Results: This interdisciplinary initiative contributed to a steady increase in patient’s ratings of communication with nurses and advanced practice providers. There was also some increase in patients’ better understanding of their plan of care which encouraged participation with active decision making. As a result, nursing staff communication improved and satisfaction as well as enhanced professional relationships among providers and nurses was demonstrated. Conclusions: Reengineering of the interdisciplinary team approach incorporating an advanced practice provider with bedside shift report increased patient satisfaction, patient experience, improved nursing communication and overall improvement of professional relationships. This quality enhancement initiative was vital in increasing patient satisfaction, expediting the plan of care, providing betterdecreasing length of stay and quality of care and a collegial relationship with nurses in the stroke population.

How does the length of day shift affect patient care on older people's wards? A mixed method study

BackgroundInternationally, studies have focused on whether shift length impacts on patient care. There are also ongoing concerns about patient care for older people in hospital. The study aim was to investigate how length of day shift affects patient care in older people’s hospital wards. Objectives1) To explore how length of day shift affects patient care in older people’s wards; 2) To explore how length of day shift affects the quality of communication between nursing staff and patients/families on older people’s wards DesignA mixed method case study. SettingsThe study was based on two older people’s wards in an acute hospital in England. One ward was piloting two, overlapping 8h day shifts for 6 months while the other ward continued with 12h day shifts. Participants and methodsQualitative interviews were conducted with 22 purposively recruited nursing staff (17 registered nurses; 5 nursing assistants). An analysis of patient discharge survey data was conducted (n=279). Twenty hours of observation of nursing staff’s interactions with patients and families was conducted, using an adapted version of the Quality of Interaction Schedule (301 interactions observed), with open fieldnotes recorded, to contextualise the observations. ResultsThere were no statistically significant differences in patient survey results, or quality of interactions, between the two wards. There were three overall themes: Effects of day shift length on patient care; Effects of day shift length on continuity of care and relationships; Effects of day shift length on communication with patients and families. Nursing staff believed that tiredness could affect care and communication but had varied views about which shift pattern was most tiring. They considered continuity of care was important, especially for older people, but had mixed views about which shift pattern best promoted care continuity. The difficulties in staffing a ward with an 8h day shift pattern, in a hospital that had a 12h day shift pattern were highlighted. Other factors that could affect patient care were noted including: ward leadership, ward acuity, use of temporary staff and their characteristics, number of consecutive shifts, skillmix and staff experience. ConclusionsThere was no conclusive evidence that length of day shift affected patient care or nursing staff communication with patients and families. Nursing staff held varied views about the effects of day shift length on patient care. There were many other factors identified that could affect patient care in older people’s wards.

The Spirit and Intent of Motivational Interviewing.

To describe an educational program to improve inpatient psychiatric nursing staff communication skills to better provide patient-centered care throughout patient hospitalization. Delivered and evaluated an educational program to increase inpatient staff knowledge and use of communication skills during patient encounters. Emphasizing the spirit and intent of motivational interviewing in a training program results in a translation of the newly obtained knowledge into nursing practice, as evidenced by observed use of motivational interviewing skills during which patient encounters to strengthen the therapeutic alliance. Advanced Psychiatric Nurse Practitioners can provide an important role of coaching/mentorship for inpatient psychiatric nursing staff to further develop communication skills that are meaningful, patient-centered, and may lead to improved treatment adherence.

Linking Resident Behavior to Dementia Care Communication: Effects of Emotional Tone

Care for older adults with dementia is complicated by behaviors such as verbal and physical aggression and withdrawal that disrupt and increase the costs of providing care. These behaviors, referred to as resistiveness to care (RTC), have been linked to staff elderspeak communication, measured by behaviorally coded explicit behaviors. This study examined videotapes of nursing home (NH) residents with dementia interacting with staff during bathing to explore the relationships between implicit messages communicated by nursing staff and resident RTC behavior. Implicit messages in nursing staff communication were rated using the Emotional Tone Rating Scale by naïve coders. Associations between implicit ratings of care, respect, and control were analyzed in relation to RTC scale scores. Highly controlling communication was significantly correlated with increased resident RTC ( r = .49, p < .05). Associations between the care and respect dimensions of communication were not significantly correlated with RTC; however, trends in hypothesized directions were identified. The association between emotional tone and RTC found in this study suggests that it is an important factor in care. Understanding affective messages is a first step in modifying these implicit messages conveyed during staff-resident communication. Research is needed to confirm these findings and to identify and test interventions to teach staff to reduce controlling messages that will to reduce RTC and improve care.

Nursing staff's communication modes in patient transfer before and after an educational intervention

The objective was to explore and describe nursing staff's body awareness and communication in patient transfers and evaluate any changes made after an educational intervention to promote staff competence in guiding patients to move independently. In total, 63 nursing staff from two hospitals wrote weekly notes before and after the intervention. The topics were: A) reflect on a transfer during the last week that you consider was good and one that was poor; B) reflect on how your body felt during a good and a poor transfer. The notes were analysed with content analysis. The results showed five different communication modes connected with nursing staff's physical and verbal communication. These communication modes changed after 1 year to a more verbal communication, focusing on the patient's mobility. The use of instructions indicated a new or different understanding of patient transfer, which may contribute to a development of nursing staff's competence. Statement of Relevance: The present findings indicate that patient transfer consists of communication. Therefore, verbal and bodily communication can have an integral part of training in patient transfer; furthermore, the educational design of such programmes is important to reach the goal of developing new understanding and enhancing nursing staff's competence in patient transfer.

Antidepressant Treatment of Depression in Rural Nursing Home Residents

Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by their primary care provider than women. Depression detected by nurses through the Minimum Data Set was treated at a lower rate with antidepressants, which generates issues related to interprofessional communication, nursing staff communication, and the need for geropsychiatric role models in nursing homes.

Emergency Department Communication Links and Patterns

We characterize and describe the communication links and patterns between and within emergency department (ED) practitioner types. This is a prospective, observational study of emergency physician and nursing staff communication patterns in an academic ED using link analysis techniques. Twenty ED staff members were observed in the pediatric and adult acute areas of the ED, including attending physicians, residents, nurses, and charge nurses. Data were recorded for each communication event, including duration, mode, partner, location, and interruptions. Because this study was intended to focus on professionally related communication between staff, social interactions and direct patient interactions were excluded. Frequency percentage and duration were calculated for each measure, and link analysis graphs were prepared to assist in interpretation of the data. One thousand six hundred sixty-five total communication events were recorded during a total of 39 hours 12 minutes of observation. Face-to-face communication was the most common mode. Communication links and patterns were described and graphically represented using a link analysis technique. Communication gaps were found between ambulance providers and the providers who would ultimately take care of the patient during their ED stay. Attending physicians communicated often despite caring for separate patients, and the charge nurse seemed to be the hub for communication, linking ED personnel with non-ED staff. In the adult area, interruption rates ranged from 6.9 per hour (attending physician) to 0.5 per hour (bedside nurse), and in the pediatric area they ranged from 3.6 per hour (attending physician) to 0.3 (bedside nurse). Distinct patterns are identified. These results will be helpful in designing future communication adjuncts in the ED.

Communication enhancement: nurse and patient satisfaction outcomes in a complex continuing care facility

This paper presents an evaluation of a communication enhancement intervention on staff and patients in a complex continuing care facility. The importance of effective communication as a fundamental element of nursing has been emphasized and is regarded as integral to the provision of quality patient care. For people residing in complex continuing care (similar to long-term care facilities), opportunities for socialization occur primarily during interactions or communication with staff, and these interactions have been found to be limited. One way to improve nursing staff communication is through a communication enhancement intervention. Twenty-one nursing staff members (Registered Nurses, Registered Practical Nurses and healthcare aides) working in a complex continuing care environment and 16 patients participated in this study, conducted in the summer of 2003. A repeated measures design was used to evaluate the effects of the communication enhancement intervention on outcomes. Data were collected from patients and nurses at baseline, 5 weeks into the intervention and at 10 weeks after the intervention. Nurse outcome variables included nurses' job satisfaction and their relationships with patients; patient outcome variables included two measures of patient satisfaction with care. Nursing staff felt closer to their patients (F(2,40) = 3.0, P = 0.045) following the intervention and reported higher levels of job satisfaction (F(2,40) = 4.1, P = 0.02). No changes were found in the level of patient satisfaction with care. Our results suggest that nursing staff can feel better about their job and about their patients as they enhance their communication skills. Understanding the barriers to finding time to talk with patients for a few minutes a day, outside of direct hands-on caregiving, requires further exploration.

Patterns of medical and nursing staff communication in nursing homes: implications and insights from complexity science.

Complexity science teaches that relationships among health care providers are key to our understanding of how quality care emerges. The authors sought to compare the effects of differing patterns of medicine-nursing communication on the quality of information flow, cognitive diversity, self-organization, and innovation in nursing homes. Two facilities participated in 6-month case studies using field observations, shadowing, and depth interviews. In one facility, the dominant pattern of communication was a vertical "chain of command" between care providers, characterized by thin connections and limited information exchange. This pattern limited cognitive diversity and innovation in clinical problem solving. The second facility used an open communication pattern between medical and frontline staff. The authors saw higher levels of information flow, cognitive diversity, innovation, and self-organization, although tempered by staff turnover. The patterns of communication between care providers in nursing facilities have an important impact on their ability to provide quality, innovative care.