Introduction and problem identification
It is impossible to imagine a competent medical system without adequate communication. Medical institutions whose leaders promote effective communication among their followers find it easier to solve emerging challenges and improve patient outcomes. Thus, the purpose of this project is to explain how to achieve effective communication between nurses, patients, and their family members, leading to better outcomes. The project will present background information on the issue, literature review, and proposed action plan.
Problem Statement
The problem statement is articulated with the help of the Johns Hopkins Question Development Tool as the guide (Johns Hopkins Hospital, n.d.). Effective communication is significant because it allows nurses to provide their patients with information on their health, treatment methods, and preventive measures. Furthermore, nurses should also address family members to contribute to better outcomes. If a medical establishment does not have effective communication strategies, possible issues are likely to emerge. It is a clinical problem with an educational focus that can result in effectiveness concerns, unsatisfactory patients, and variation in practice. The challenge of ineffective communication remains a significant problem in different units. Thus, it is necessary to formulate a PICO question and conduct a literature search to identify the most suitable solutions. The initial EBP question is whether effective communication between nurses, patients, and their family members can make a difference regarding the length of stay.
Problem Background
When individuals are unable to cooperate and pursue a common goal, the chances are high that they will ignore the effectiveness of the established care procedures and create room for medication errors. Portney (2020) argues that poor communication remains one of the major causes of poor health outcomes and preventable deaths in different medical facilities. Furthermore, Tulsky et al. (2017) admit that “poor communication by health care professionals contributes to physical and psychological suffering in patients” (p. 1361).
Stakeholders
This project involves several stakeholders whose roles can be instrumental in changing the situation. The first category of stakeholders is that of all medical professionals whose goals and experiences depend on the nature of communication. The second group is comprised of patients and community members who expect to receive high-quality services from their respective health units. Finally, medical units can also suffer from ineffective communication because unsatisfied patients can create a negative image of the health care establishment.
PICOT Question
The PICO(T) question formulated for the project is clear and concise. In patients suffering from a disease (P), does education on communication between nurse, patient, and family (I), compared with not communication (C), leads to lower length of stay (O) within the admission period (T)? This articulation stipulates that the proposed search terms include nursing, patient, and communication. The terms and the year of publication form the basis of a search strategy to use. The given question reflects the current evidence because it addresses a topical issue. Finally, the PICO(T) question shows that the project is aimed at determining how and whether education communication can contribute to a shorter duration of stay among hospital patients.
Literature support
Review of Literature
At this stage, it is necessary to find literature that can answer the question above. It was decided to look for the articles in the ScienceDirect, PubMed, Springer Link, and NCBI databases, and ten suitable studies have been found. The Johns Hopkins Individual Evidence Summary Tool demonstrates the analysis and the reliability of the sources (Johns Hopkins Hospital, n.d.). The following information will show how it is possible to address the problem under consideration.
On the one hand, one should state that ineffective communication between nurses and relatives of patients can result in sadness, anger, and anxiety (Chan, 2017). Furthermore, Crawford et al. (2017) argue that cultural differences resulting in communication inefficiencies can lead to adverse outcomes. At the same time, numerous patients admit that they appreciate the attention paid to them by nurses Chan et al. (2018). On the other hand, Curtis et al. (2016) stipulate that communication facilitators decrease family distress and reduce hospital length of stay. Furhermore, Wocial et al. (2017) also mention that effective communication is associated with reduced length of stay. That is why the following articles will explain how it is possible to improve nurses’ communication skills.
Blake and Blake (2019) and Bussard and Lawrence (2019) mention that nursing lab simulation and role modeling are sufficient ways to increase nurses’ communication skills. Donovan and Mullen (2019) stipulate that simulation programs result in higher nurses’ confidence while working with patients. In addition to that, Bullington et al. (2019) state that a phenomenologically-based communication training approach helps nurses train communication skills. Finally, Dittman and Hughes (2018) also say that nursing participation in multidisciplinary patient rounds increases communication proficiency.
Intervention description
Proposed Intervention
The proposed intervention is to organize regular simulation and role modeling rounds to contribute to communication excellence among nurses. It is necessary to develop a learning plan that will guide the rounds above. They will teach nurses how to include their patients and encourage family members in communication to offer proper support. This intervention will go further to allow key stakeholders to be involved in improving the level of communication.
Setting
The targeted setting for the proposed study is a healthcare unit. The hospital will have caregivers, practitioners, nurse leaders, and health managers. The facility will also identify patients who are expected to participate throughout the study period and benefit from effective communication. In this setting, it is necessary to make sure that patient length of stay is decreased, and their satisfaction can be an additional positive outcome.
Barriers
Several barriers have the potential to disorient or affect the success of the proposed project. Firstly, the introduction of the new educational program means that a change model will be necessary. Secondly, the issue of time might affect the nature and success of the proposed project. This outcome is possible since most stakeholders will be involved in critical processes aimed at improving the experiences and results of the targeted patients.
Outcomes
The given project is going to result in a few essential outcomes. Firstly, it is likely to increase the quality of care by reducing the length of stay. Secondly, patients and their family members will be satisfied with the work of nurses, which will combine their efforts to recover. Finally, it is more likely that improved communication between nurses and patients will result in better health outcomes of the latter.
Action Plan
It is reasonable to take some action to improve the situation, which implies a few milestones. Thus, Milestone 1 means that it is necessary to find general information and develop educational programs. Milestone 2 refers to organizing the educational environment, including the necessity to make sure that all nurses attend simulation and role modeling rounds that will occur once a week over 3 months. When it comes to Milestone 3, a critical task is to present the materials to the attendees. The rounds will explain the potential to improve communication skills to reduce patient length of stay and offer role modeling exercises to develop these skills. Finally, the assessment of knowledge is performed at Milestone 4, which is necessary to check whether nurses are ready to implement the theoretical information in practice. The details of this action plan are presented by the John Hopkins Action Planning tool (Johns Hopkins Hospital, 2017).
References
Blake, T., & Blake, T. (2019). Improving therapeutic communication in nursing through simulation exercise. Teaching and Learning in Nursing, 14(4), 260-264.
Bullington, J., Söderlund, M., Sparén, E. B., Kneck, Å., Omérov, P., & Cronqvist, A. (2019). Communication skills in nursing: A phenomenologically-based communication training approach. Nurse Education in Practice, 39, 136-141.
Bussard, M. E., & Lawrence, N. (2019). Role modeling to teach communication and professionalism in prelicensure nursing students. Teaching and Learning in Nursing, 14(3), 219-223.
Chan, E. A., Wong, F., Cheung, M. Y., & Lam, W. (2018). Patients’ perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study. PLoS ONE, 13(6), 1-17.
Chan, Z. C. Y. (2017). A qualitative study on communication between nursing students and the family members of patients. Nurse Education Today, 59, 33-37.
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural diversity in nurse-patient communication. Collegian, 24(1), 63-69.
Curtis, R., Treece, P. D., Nielsen, E. L., Gold, J., Ciechanowski, P. S., Shannon, S. E., Khandelwal, N., Young, J. P., & Engelberg, R. A. (2016). Randomized trial of communication facilitators to reduce family distress and intensity of end-of-life care. American Journal of Respiratory and Critical Care Medicine, 193(2), 154-162.
Dittman, K., & Hughes, S. (2018). Increased nursing participation in multidisciplinary rounds to enhance communication, patient safety, and parent satisfaction. Critical Care Nursing Clinics of North America, 30(4), 445-455.
Donovan, L. M., & Mullen, L. K. (2019). Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication. Nursing Education in Practice, 38, 126-131.
Johns Hopkins Hospital. (2017). John Hopkins nursing evidence-based practice. Appendix I: Action planning tool [PDF document]. Web.
Johns Hopkins Hospital. (n.d.). John Hopkins nursing evidence-based practice. Appendix B: Question development tool [PDF document]. Web.
Johns Hopkins Hospital. (n.d.). John Hopkins nursing evidence-based practice. Appendix G: Individual evidence summary tool [PDF document]. Web.
Portney, L. (2020). Foundations of clinical research: Applications to evidence-based practice. F.A. Davis Company.
Tulsky, J. A., Beach, M. C., Burtow, R. N., Hickman, S. E., Mack, J. W., Morrison, R. S., Street, R. L., Sudore, R. L., White, D. B., & Pollak, K. I. (2017). A research agenda for communication between health care professionals and patients living with serious illness. JAMA Internal Medicine, 177(9), 1361-1366.
Wocial, L., Ackerman, V., Leland, B., Benneyworth, B., Patel, V., Tong, Y., & Nitu, M. (2017). Pediatric ethics and communication excellence (PEACE) rounds: Decreasing moral distress and patient length of stay in the PICU. HEC Forum, 29, 75-91.