Nursing Commons^™

Improving Clinical Communication And Collaboration Through Technology, Michelle Machon

Doctor of Nursing Practice (DNP) Projects

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.

Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …

Chief Nurse Executive Work Engagement: System Leadership Through A Natural Disaster, Strike, And Pandemic, Ryan Fuller

Doctor of Nursing Practice (DNP) Projects

Problem. In a 21-hospital region of a 39-hospital integrated health system, CNE turnover peaked at 63% (12 CNEs) in 2015. Interviews were conducted in 2019 with 12 CNEs across the region to understand potential issues related to CNE job satisfaction. Responses revealed concerns regarding empowerment, alignment, work-life balance, information transparency/sharing, and recognition. While identifying a solution to address CNE concerns, the organization experienced successive crisis events during a 12-month period that included a record-setting wildfire, multiple labor union strikes, and a novel pandemic. The regional leadership team (RLT) required new approaches to facilitate effective communication during a crisis between the …

Standardizing The Bedside Shift Report: Improving Nurse-To-Nurse Communication, Deepi Sahota

Master's Projects and Capstones

PROBLEM: The Community Living Center (CLC) reveals an immense concern on shift-to-shift handoff report. Shift-to-shift report is done in the report room, often times unclear information is given and critical information is not appropriately conveyed.

CONTEXT: The project was implemented on a 50-bed unit at the Veterans Affairs. The improvement project was focused on collaborative partnerships, standardized bedside shift report, and utilization of the SBAR tool. in the prevention of communication errors.

INTERVENTIONS: The SBAR tool was utilized to provide a framework for effective communication between nurses. The CNL facilitated an hour in-service on bedside shift report to nurses …

Impact Of Technological Communication Devices, Joshua George

MSN Capstone Projects

Nurses, family members, and other medical professionals have always found it difficult when communicating with patients who have impaired communication. Those who fall under the category of impaired communication include those who are mechanically ventilated and those who have a tracheostomy. Ineffective communication skills on both ends of the spectrum have led to negative patient outcomes. According to Aslani, Niknejad, Maghaddasi, & Akbari (2017), ineffective communication in patients with impaired communication have led to numerous physical and mental complications. Discovering an effective communication method to implement has been of great importance in the nursing field.

The current practice of communicating …

Patient Participation Strategies: The Nursing Bedside Handover, Irene Decelie

Patient Experience Journal

Patient participation is an important goal in today’s health care and considered necessary to achieve safe and quality patient care. The purpose of this paper is to discuss the historical and theoretical background surrounding the concept of patient participation in health care and specifically to examine patient participation strategies which have been reported to be of influence when employed during the nurse to nurse and patient to nurse activities encompassed in the bedside handover. The bedside handover is the nursing activity of transferring primary nursing responsibility of care from one nurse to another. Encouraging patients to participate during this process …

Conversations With Health Care Providers And Parents Before Autism Diagnosis: A Qualitative Study, Norah L. Johnson, Wendy Krueger, Elizabeth Jilek, Kristin Haglund

College of Nursing Faculty Research and Publications

Introduction

The purpose of this study was to explore communication with health care providers from the perceptions of parents before their child's diagnosis of autism spectrum disorder and provide some examples of how communication may contribute to the autism diagnosis.

Method

This study used a qualitative descriptive design with multiple individual structured in-person interviews.

Results

Three themes captured parents’ (n = 8) descriptions of the phases of communication during their children's diagnoses including, (1) anguished questioning, (2) urgently seeking help, and (3) expecting a diagnosis. In addition, three themes characterized the communication style that parents needed, although not always …

Is This Really Happening? Family-Centered Care During Covid-19: People Before Policy, Terri Savino, Karri Crispino

Patient Experience Journal

In the middle of a global pandemic, hospitals created policies for visitor restrictions to reduce the transmission of coronavirus to protect patients and staff and developed protocols allowing only one support person to call the critical care unit for patient updates. Late on a Tuesday afternoon, the Manager of Patient Experience received a phone call asking her to call Karri, the wife of one of our patients who was on a ventilator. Karri was struggling with updating her mother-in-law because she was very upset with the news she received, making it difficult to call her husband’s mom. Karri asked the …

Dnp Final Project: Implementing Teamstepps Training: Using Evidence To Impact Teamwork In An Acute Care Hospital, Nana Baah Adjei

DNP Final Reports

Background: Medical errors are the third leading cause of death in the United States. Patient morbidity and mortality will decrease when institutional efforts result in the implementation of action plans which reduce medical errors. Teamwork, education, and training through structured initiatives are the most effective mechanism to improve patient safety. Purpose: The project aims to impact the perception of communication among newly hired medical surgical nursing and support staff. The acute care hospital is a 200-bed tertiary care hospital. Intervention: The intervention consists of the registered nurses and support staff participating in an innovative, six-hour, interactive TeamSTEPPS fundamentals course. Results: …

Patient-Centered Emr Communication, Christi Lynn Camarena

Doctoral Projects

The electronic medical record (EMR) has become the standard in health care documentation. The EMR has been shown to improve the availability of medical records, provide tools to facilitate communication, and improve patient safety. Because of the absence of standardized training and EMR research, there is a gap in understanding the relationship between the EMR and the provider-patient relationship. The EMR requires the provider to use purposeful and deliberate patient-centered EMR communications behaviors to facilitate a meaningful, engaging, and educational dialogue with patients. These behaviors have been studied in physician populations and standardized tools have been developed to assist in …

Crna To Cvicu Rn: Implementation Of A Standardized Patient Handoff Checklist For Post-Surgical Heart Patients, Ashley Mcgrath

Doctor of Nursing Practice Projects

Patient handoffs occur when the information and responsibility of the patient is transferred from one health professional to another. Ineffective communication during the critical postoperative phase of the transfer of care (TOC) has been associated with extended hospital stays, increased healthcare costs and patient dissatisfaction. In 2007, the Joint Commission National Patient Safety Goals proclaimed the importance of a standardized handoff process for effective handoffs. The purpose of this quality improvement doctoral project was to assess if the utilization of a standardized TOC checklist from the operating room to the cardiac intensive care unit (CVICU) for post-heart patients improved communication …

Development And Validation Of A Scale To Measure Nurse/Medical Resident Physician Collaboration, Bruce St. Amour, W. Brady Dehart

HCA Healthcare Journal of Medicine

Introduction: The purpose of this pilot study is to investigate the reliability of an interprofessional collaboration measurement scale used for nursing interactions with resident physicians. To date, the collaboration between nurses and residents has not been adequately investigated and a validated tool specifically for this purpose is not yet available. Our objective is to adapt a previously validated interprofessional scale for health care settings to the specific nurse/resident physician collaboration.

Methods: In 2019, nurses from two hospitals were contacted via email and were invited to complete an anonymous survey that asked about the nurses’ interaction and collaboration with resident physicians. …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Facilitating Communication With Diverse Teams, Maryjane Lewitt

Academic Chairpersons Conference Proceedings

Non- hierarchical communication structures are associated with greater clarity across all levels. These structures can be implemented in a variety of ways under different circumstances. A variety of communication processes should be implemented to improve communication with individualizing the technique to the type of information being communicated.

Improving Patient And Provider Engagement By Utilizing Ask Me 3®, Joseph G. Smith, Msn, Arnp, Fnp Bc

Doctor of Nursing Practice Projects

Background: Patient and provider engagement in healthcare has an impact on health outcomes.

Purpose: To study the implementation of the Ask Me 3 (AM3) tool, a tool that encourages patients to ask three questions about their health to their care provider. The aim of the project is to explore the level of patient and provider engagement by patients` reports of their perception of engagement with their provider and in understanding their diagnosis.

Methods: The setting was a small urban family practice in the Pacific Northwest. Every patient that checked in for their appointment, excluding pediatric and younger than 18 years …

The ‘Human Factor’… Worth Considering?, Geoff Hay

Journal of Perioperative Nursing

On any given day, be it in our professional or personal lives, our predominant thought processes are geared towards outcomes. How often, though, do we allow ourselves time to pause and reflect on the human factors involved in our decision making? This article examines lessons we can learn from human factors training and systems used in aviation and how they can be applied in the perioperative environment.

Was That In An Email? An Electronic Tool To Improve Nursing Communication Satisfaction, Jennifer A. Morgan

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Nursing communication satisfaction impacts engagement and turnover as well as patient care which affects organizational profits. Although direct care nurses report dissatisfaction with nurse manager communication methods, organizations and nurse managers do not utilize best practice strategies. In addition, there is a lack of high-quality implementation studies of best practice communication methods, specifically on obstetrics units, to assist managers in improving communication methods. Methods: An electronic communication tool was implemented on an inpatient obstetrics unit at a large tertiary hospital in the Upper Midwest. The tool was accessible on all unit computers on the SharePoint site. The project leader …

Reducing Nurses' Communication Anxiety During End Of Life Care, Susan Dunbar Wolfrom

Master of Science in Nursing Theses and Projects

End of life (EOL) conversations are meaningful discussions pertaining to the patient’s disease trajectory, symptom management, and the patient’s goals at end of life. End of life care discussions have been associated with many benefits for the patient including: decreased healthcare costs, less aggressive treatments at EOL, and a good death. These sensitive discussions must occur over the course of several interactions or spontaneously in the moment in order to support the patient during delicate moments. This makes the nurse the prime candidate to help facilitate and harbor these discussions. However, barriers to communication exist, leading to the omission of …

Communication Within The Perioperative Department, Leah Quinn

Master of Science in Nursing Theses and Projects

No abstract provided

Cultural Communication For New Nurse Residents: K.I.N.D Communication Toolkit, Jennifer Caraballo

Doctor of Nursing Practice (DNP) Projects

Background: Microaggressions can create a hostile work environment and decrease rapport and functioning in clinical and personal relationships. Exposure to micro aggression and implicit bias results in micro trauma and possible compassion fatigue by medical staff. Symptoms can include headaches, poor sleep, depressions, and anxiety, similar to compassion fatigue.

Purpose: To develop a toolkit for healthcare staff to use as educational material to facilitate for cultural communication and cultural humility.

Methods: Nurses that were enrolled in a nurse residency program at a level 1 trauma center participated in the education of a communication toolkit related to K.I.N.D …

Kind Communication: An Educational Intervention To Raise Nurse Resident's Awareness Towards Decreasing Implicit Bias Through Effective Communication Strategies, Khadijah Tuitt

Doctor of Nursing Practice (DNP) Projects

Background: There is an increasing need for healthcare institutions to become more aware of how provider biases can affect patient outcomes and contribute to health care disparities for Black and other diverse populations. Implicit biases can result in poor patient outcomes and a breakdown in trust between patients and health care providers.

Purpose: To educate nurse residents on the use of the Kinesics, Inclusive, Non-biased and Deliverable KIND, Communications technique to decrease biases during interactions.

Methods: Nurses enrolled in the institutions Nurse Residency program participated in the training session during their monthly educational meeting. Education was provided using …

Effectiveness Of End Of Shift Bedside Report, Glory Abuajah

Walden Dissertations and Doctoral Studies

AbstractNursing shift reports are the primary communication mechanism for outgoing nurses to transfer information about a patient to oncoming nurses. Nurse shift reports and nurse handovers are two of the most critical patient care processes that can support patient safety and reduce medical errors. But many nurses do not recognize the evidence supporting the practice of bedside reporting (BSR). In response to this practice problem, this project involved education on the importance of BSR on a telemetry unit in line with the best available evidence. The goal of the staff education project was to educate the staff on the value …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson

Walden Dissertations and Doctoral Studies

Patient perception of care has become a main priority in the delivery of high-quality health care. The creation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a nationally standardized method of evaluating patient perception to be incorporated in the reimbursement process defined by the Centers for Medicare and Medicaid Services (CMS). The purpose of this study was to examine the relationship between HCAHPS scores and readmission rates in 2 states in the South Atlantic region of the United States. Using social construction theory, this quantitative study utilized multiple regression analysis to analyze HCAHPS scores (independent …

Tool Kit To Address Communication On A Mental Health Unit, Carol L. Barclay

Walden Dissertations and Doctoral Studies

Effective communication by newly graduated, hired nursing staff is a significant issue affecting patient care on mental health units. The rising prevalence of mental illness in the United States has not only increased the healthcare burden, but has also affected the overall economy. The lack of training of new nursing staff regarding communication diminishes the effective recovery rate of patients, further increasing the burden to the healthcare field and the economy. A tool kit for newly graduated mental health nurses working on mental health units may help to improve communication skills and enhance patient safety and quality of care. Therefore, …

Evaluation Of Nurse-To-Nurse Handoff With The Use Of A Tablet, Maria Bessie Ziegenfuss

Walden Dissertations and Doctoral Studies

According to recent studies, many medical errors are caused by ineffective hand-off communication, which leads to patient harm and poor outcomes. Researchers have demonstrated that accurate and timely communication improves patient outcomes. The purpose of this quality improvement project was to evaluate the necessity, planning, implementation, outcomes, and transferability of the site quality improvement project, “Improving Nurse-to-Nurse Handoff With the Use of a Tablet.” The context/input/process/product model was used to provide a systematic approach to the evaluation of the site quality improvement project. A paired t test was used to analyze the pre- and post-survey results and demonstrated improvement in …

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …