Nursing Commons^™

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 …

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 …

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 …

Primary Care And Behavioral Health Provider Communication: Strategy For Improvement, Kathleen J. Matthews

Nursing Capstones

Communication in health care is essential. Limited communication between primary care and behavioral health providers was identified as a barrier access to care and effective collaborative care of patients seeking behavioral health treatment in the Matanuska-Susitna (Mat-Su) Borough, Alaska. A one-group pre- and post-test design quality improvement project was created to develop and implement a standardized communication template to facilitate communication and collaboration between behavioral health and primary care providers in the project group. The theory of relational coordination with an emphasis on the mutually reinforcing interaction between relationships and communication served as the theoretical framework for the project. Objectives …

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

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. …

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 …

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, …

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 …

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 …

Seven Steps To Successful Change: How A Large Academic Medical Center Prepared Patients For Organizational Change, Brian Carlson, Madison Agee, Terrell Smith, Paul Sternberg Jr, Jason Morgan

Patient Experience Journal

Vanderbilt University Medical Center (VUMC) launched a new electronic health record (EHR) in a “big bang” implementation that saw the new software go live across multiple hospitals, clinics and geographic locations in a single morning. The organization rightly focused most of its energy on preparing its nearly 25,000 employees for the impacts of the transition, but it also considered the effects that would be felt by its patients and families. Survey data indicate that patient satisfaction scores demonstrably dip before, during and after an EHR implementation, and take approximately a year to recover. A team at DMC employed a seven-step …

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth

Doctoral Dissertations and Projects

The AACN has identified in their QSEN competencies that collaborative teamwork and patient-centered care are two qualities that skilled nurses must exhibit to provide high-quality care. The IOM has made a call to action that healthcare professionals must exhibit patient-centered care in interdisciplinary team settings to achieve high-quality care. At a community resource program in the mid-Atlantic region, a recent qualitative job satisfaction survey revealed that employees identified issues with interprofessional collaboration and a lack of teamwork at the facility. Using the Iowa Model, this EBP project involves the use of a cohort study with a pretest-posttest design, where the …

Intensive Care To Intermediate Care Bridge Program, Natasha Bartlett, Sally Langerak, Lindsey Lucas, Jonathan Archibald, Tayla Robbins, Miranda Thompson, Patrice Tetu, Calla Hastings, Megan Garland, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operations Transformation

To deliver the highest quality of care across the continuum, a large academic tertiary medical center envisioned a project that would provide an internal source of cross trained nurses for their medical intensive care unit (SCU2) and their medical intermediate care unit (R4/IMC/AVU). The hope for this program was to improve communication and collaboration between nurses and enhance the care that they provide to patients and their families.

A highly qualified team of nurses was established to create a performance improvement project. The overall goal of this endeavor was to build a more collaborative relationship between the units and ultimately …

Improving Nurse-Physician Collaboration: Building An Infrastructure Of Support, Marshall Blue

Doctor of Nursing Practice (DNP) Projects

Abstract

Healthcare organizations have come to realize the 21st century brings many challenges. First and foremost is the challenge of improving patient satisfaction with their health care and their associated experience accessing this complex system. Other challenges are incorporating the patient perceptions of delivering high quality, safe, equitable care to the surrounding community while demonstrating cohesive teamwork. Healthcare professionals and organizations must find an effective and efficient pathway to provide excellent care to the patient within an extremely competitive market. Current research demonstrates a patient perceives they are receiving exceptional care when interdisciplinary conversations are noticed between the nurse and …

A Literature Review On Improving Nurse-Patient Communication Manuscript, Irene Gabbedon

DNP Qualifying Manuscripts

Effective communication happens when the sender of the message sends it, and it is conveyed and understood by the receiver (Gilbert & Hayes, 2009). Medical errors are the third leading cause of death in the United States alone (McMains, 2016). The Joint Commission (TJC) (2019) implemented National Patient Safety Goals (NPSG) in 2002, and improving communication among caregivers has been a goal that has been frequently revised. Due to ineffective communication, life-threatening errors are created among healthcare workers. Nurses play an important role in the communication channel and barriers can be created when there is a lack of health literacy. …

A Qualitative Study Into The Communication Surrounding The Initiation And Withdrawal Of Non-Invasive Ventilation (Niv) In People With Motor Neurone Disease, Charlotte Chapman

Theses: Doctorates and Masters

Introduction

Motor neurone disease (MND) is a degenerative disease that adversely affects the nervous system and muscular control. Eventually respiratory muscles weaken, causing breathing, communication and swallowing difficulties, and ultimately, respiratory failure and death. Improved quality of life and potentially a short extension of life can be provided with non-invasive ventilation (NIV), which is offered to people with MND when symptoms of respiratory distress become evident.

It is recommended that end-of-life communication, encompassing the benefits and burdens of symptom-relieving interventions (NIV and percutaneous gastrostomy tube to assist with nutrition), NIV withdrawal (proposed when continued use is considered futile) and other …

Problem Based Learning With Teamstepps®, Dana Clairmont

Nursing Capstones

No abstract provided.

Clarifying Model For Continuity Of Care: A Concept Analysis, Sarah J. Bahr, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Aim

The aim is to clarify the use of the term continuity in the specific context of acute care hospitalization and discharge.

Background

The meaning of “continuity” is often co‐mingled with other concepts, specifically coordination and communication. To increase usefulness for contemporary concerns with the hospitalization‐postdischarge continuum, continuity of care is examined from the specific context of acute hospitalization and discharge.

Design

Concept analysis.

Data Sources

Medline via Ovid, Cochrane Library, Cinahl, and Google Scholar. Search years encompassed 2001–2016.

Review Methods

Rodgers evolutionary concept analysis method.

Results

A total of 50 papers were included in this concept analysis. Synthesis of …

Strategies To Improve English As An Additional Language (Eal) Nursing Student Communication, Kellie Ann Quesada

All Electronic Theses and Dissertations

Background: The demand for diverse nurses to care for an increasingly diverse population in the United States is growing. Nursing programs need to have strategies in place to support nursing students who a speak English as an Additional Language (EAL). Adequate communication skills are an essential part of the nurse- patient relationship and can be complicated by language barriers. Strategies to improve this communication need to be evaluated to ensure that resources are dedicated to the most efficient strategies. Purpose: The purpose of this review is to determine the most effective strategies to improve communication skills in nursing students who …

Policy Knowledge Communication In Nursing, Curtiss John Vavra

Walden Dissertations and Doctoral Studies

Evidence-based practices in nursing improve patient outcomes, decrease healthcare costs, and can be implemented with policies and procedures. However, there is limited literature describing how nurses acquire policy knowledge, the dissemination of which may require a significant investment of resources by a hospital. The purpose of this study was to learn more about how nurses obtain policy knowledge. Rogers's diffusion of innovations theory guided the examination of communication channels and how they relate to the formation of policy knowledge. The research questions were designed to gather information on the relationship of policy communication channels, demographic factors, and the frequency of …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Validation Of Communication Simulation Scenarios For Nurse Preceptors, Karie Thurston

Walden Dissertations and Doctoral Studies

An expectation of the nurse preceptor role includes the ability to evaluate, deliver feedback, and coach new graduate nurses. A gap in nurse preceptors' communication skills can affect the safety-related behaviors and quality of care provided by new graduate nurses, thus affecting patient outcomes. To bridge this gap, robust training on delivering feedback and coaching is needed for preceptors. The purpose of this staff education project was to develop and validate 5 communication simulation scenarios for preceptor training. Mezirow's transformative learning theory and the National League for Nurses-Jeffries simulation theory were used to guide the project. A panel of nurse …

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

A Simulated Learning Experience In Advanced Care Planning Conversations, Brandy Ellis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: The CDC (2012) reports that 1/3 of Americans have no advance care planning (ACP), which is essential for maintaining autonomy when people are no longer able to communicate wishes directly. IOM (2014) reports that providers have limited training in communication techniques and low confidence in holding advanced care planning conversations. Nursing simulation is an effective method of teaching clinical skills in a safe environment. The development of a high fidelity (HF) standardized patient simulation, using the Jeffries Simulation Framework, combined with evidence-based practice classroom curriculum, may increase knowledge and confidence in holding ACP conversations for nurse practitioner students.

Methods: …

Can The Implementation Of Interprofessional Rounds Improve Hospital Throughput Efficiency?, Rebecca Howdyshell

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

Efficient throughput processes are a vital part of providing cost effective, safe, quality patient care. Research has shown interprofessional rounds can have success at improving throughput processes. A rural, not-for-profit, 255 bed hospital in a Mid-Atlantic State was experiencing issues with throughput/patient flow. The aims of this quality improvement project were 1). to implement Interprofessional Rounds on the Progressive Care Unit (PCU); 2). To design and build a working Interprofessional Rounds template into meditech to guide Interprofessional Rounds and streamline discharge documentation; 3). to increase the amount of discharge orders entered between 0700 and 1300 by ten percent; and …

Nursing Partnership With Patients, Parents And Families For Safety Through Simulation, Courtnay Caufield

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The importance of communication between nurses, patients, and their family members with respect to treating each other as partners in safety cannot be overstated. It is imperative that families and patients feel empowered to speak up and report clinical errors at any time and be able to communicate effectively to prevent harm and encourage communication.

Context: This is especially important in the acute care setting, where patients may be in contact with multiple people and processes daily. Attention to this safety partnership can be established through improvements in patient satisfaction scores, which are usually collected from patients and …