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Nursing communication occurs on a continuous basis whether it is between the patient and nurse,
nurse and patients family, nurse and physician, or nurse with co-workers. Being able to have
strong nursing communication skills is an asset to everyone involved in the healthcare system.
Studies continue to show that nursing communication is an area that has persistence for
improvement. Evidence-based practice shows that inefficient nursing communication can be
harmful to patient outcomes. Upgrading the workflow to boost nursing communication in all
areas of care is the long term goal for progress to combat the lack of nursing communication.
The most recent posted survey results took place in October 2012 through September
2013. In Michigan, 80% of discharged patients answered always to the nursing communication
questions. However, some states had a rate of 72%. This shows that 20-30% of patients feel that
their nurses did not communicate well with them during their hospital stay (HCAHPS, 2014).
This is where improvement can be made.
Interdisciplinary Team
The interdisciplinary team for this quality improvement team includes the clinical staff
and nursing managers. The clinical staff includes registered nurses, licensed practical nurses, and
certified nurse aides. The clinical staff plays the most important role, as this is who the patient is
evaluating. Nurse Managers have the responsibility of monitoring and encouraging the team.
Managers must act as leaders and ensure the staff is working effectively towards their goals.
Data Collection
Collecting data and sending out surveys to patients will always take place. This is
because quality improvement is constantly a goal for the multidisciplinary team (Yoder-Wise,
2011). Until the end of time, healthcare experiences constantly can be enhanced in some way,
shape, or form. To accomplish this there are many data tools that can be utilized for success by
the team. Some data tools could be flowcharts, line graphs, histograms, Pareto charts, and
fishbone diagrams (Yoder-Wise, 2011, p. 396). Nursing communication is a complex area of
healthcare as there are a variety of variables that can sway survey results. For difficult areas
requiring data collection a meticulous flowchart works the best (Yoder-Wise, 2011). The
flowchart can help staff understand the data better.
target goal from month end information was composed. Having the data presented in a bar graph
showing the overall percentage by month allows staff to have real time data. Knowing where
clinical staff ranks in regards to the current standards of care demonstrated with nursing
communication permits the staff to make adjustments as needed for improvement.
Outcomes
The overall goal is to improved patient responses to the three nursing communication
questions in the HCAHPS survey from 80% to 90%. Improving communication with patients in
turns improves the patients perceptions of the quality of nursing care they receive. Therefore the
goal is to make sure that nurses increase communication with the patient, even about the survey.
Strategies
Strategies identified to implement an improvement is nursing care are based on five key
areas identified in the HCAHPS survey (Rochin, 2012, p. 18). The five key areas identified in the
HCAHPS survey are nursing communication, staff responsiveness, pain management,
communication of medications, and discharge information (Rochin, 2012, p. 18). In order to
improve the patients perception of their health care experience the healthcare team must engage
and involve the patient in all aspects of their healthcare.
Nurses can increase communication in several ways. Nurses can assess patients pain by
doing a pain assessment with each patient encounter, educate patients on medication usage, and
inform patients of side effects with medication administration. They need to make sure that they
are answering call lights within three minutes, addressing care needs, introducing each nurse
with bedside nursing report, and indicating the primary nurses names on the communication
board in patients room. Discharge teaching should begin upon admission and continue until
discharge.
Surveys are extremely important to improve patient satisfaction. Yoder-Wise states that
consumer satisfaction with healthcare can be assessed through the use of questionnaires,
interview, focus group discussions, or observations (2011, p.394). In current nursing practice,
rehabilitation centers utilize post discharge postal mail surveys and telephone surveys. Also, the
day after admission, nursing management meet and greet to identify patients needs or areas for
improvement in the quality of nursing care. Once all the data from the surveys is compiled in a
graph or chart, it can be utilized to initiate strategies to improve patient care and attend to patient
needs.
The meet and greet strategy for improved communication can be used to improve the
quality of healthcare services by actively listening to the patient, finding and addressing any
misconceptions or short comings in patient cares needs to ensure a positive experience, and
rewarding experience for the patient. Post discharge surveys via mail and telephone can be
utilized to find areas of improvement in meeting patient care needs. Patients in the HCAHPS
survey are asked if they felt they were listened to, if they felt nursing explained care in a way
example, if the emergency room is lacking in their nursing communication to patient, it would be
important to target them to help them improve their communication. Management could tweak
this plan to work better for the emergency room in their area of weakness. Improving satisfaction
of the patients is a type of evidence-based practice to continue improving patient care. This is
extremely important for all staff members to realize.
the best possible care. Through surveys, communication issues can be addressed and the staff can
start making progress to fix their areas of weakness. Without communication, the system would
fall apart so it is vital to keep working on improving it.