Importance of Communication in Nursing

Importance of Communication in Nursing

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FOUR MAJOR HEADACHES IN NURSING COMMUNICATION

Communication is one of the most critical aspects of providing care, especially for seniors. If nurse to nurse communication or communication with other care team members (primary care, specialists, therapists, etc. ) doesn’t occur in a timely manner, it may result in  delayed critical decisions for the patient and the patient my end up in an ER. More specifically, nurses are at the forefront of healthcare delivery and play a pivotal part in a patient’s path to well-being.

Behind the scenes, nurses work in dynamic teams that are changing by the hour due to shifts and availability. They are responsible for relaying masses of detailed information to fellow nurses during shifts and importantly between shifts as well as to various other healthcare professionals. The burden of sharing large volumes of accurate and timely communication can be very stressful.

Yet, effective timely nursing communication is critical to ensure that everyone is on the same page. Nurses also serve as voices for patients who may not be able to communicate, hence,  open and clear interaction in nursing is vital to ensure that a patient is getting the right care.

Challenges Facing Nurses in Improving Communication

Implementation of Electronic Health Records (EHR) has not helped much, primarily because EHRs are built and used to get insurance billed and providers paid. They are not optimal tools for patient related timely communication. No wonder text messaging, phone calls, voicemails, and faxes are still the most standard communication tools in healthcare. Accordingly, many challenges still exist among nurses when it comes to timely communication about patients.

There are several factors driving delayed communication in nursing.
  1. Extraordinary workload: ‘Workload’ does not necessarily mean the number of patients, it rather means the needs of the patients (medications, precautions, length of stay, etc). A research study in Finland assessed 732 patient reports from 2 acute care hospitals. They wanted to see if there is a correlation between patient safety and nurse workload. The results confirmed that fewer patients-to-nurse ratio resulted in fewer incident reports. It can be inferred that a patient’s outcome is dependent on the communication and collaboration of the healthcare team. One cannot control the number of patients in a hospital, however, what can be controlled is how patient information is being delivered.
  2. High turnover of nurses and other employees: especially in post acute care, depending on the region, staff turnover can be between 40% to over 80%. There are multiple factors contributing to this issue, which we will cover in another blog so make sure to subscribe to our blog if you would like to learn more about reducing turnover. High turnover results in bringing new team members on-board and getting them trained on existing nurse protocols and processes, only to do the same all over again when the hired  nurse leaves. On the flip side, new nurses and employees also bring their own past training and experiences around nurse protocols and processes, which may contradict and conflict with the current facility’s existing processes. All of this creates confusion around taking care of patients and further complicates the critical communication among nurses. 
  3. Limited one-to-one communication: 1-1 communication is widely prevalent in healthcare, whereas there are usually many different care team member usually involved in caring for a single patient. This means that 1-1 communication is highly ineffective because it only allows two people to get on the same page while leaving all the others out of sync.
  4. Use of old communication methods: 1-1 communication is further delayed and exasperated by the use of text messaging, voicemails, phone calls, hallway conversations and faxes. Important information can easily fall through the cracks created by these old tools.  
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Communication Techniques in Nurse to Nurse Communication

It is estimated that by 2050, nurse practitioners will comprise 1/3 of the workforce (Troxel et al., 2018). This means increased responsibility and liability. Therefore, focusing on ‘how nurses can improve communication’ to improve timely care delivery, better outcomes, and reduce malpractice  is important. A research study conducted by the Doctors Company assessed medical malpractice claims among nurse practitioners, family medicine and internal medicine practices from 2011-2016. It was found that 10% of nurse practitioner claims were related to lack of proper communication among providers. In addition, the frequency of nurse practitioner claims have gradually increased and are expected to rise.

The data showed that there is a discrepancy between the convenience of EHR and malpractice. Many claims have been for the following factors which can be prevented with improved collaboration (Troxel et al., 2018):

  • Failure to adhere to SOP (standard operating procedures).
  • Inadequate physician supervision.
  • Absence of written protocols.
  • Deviation from written protocols.
  • Failure or delay in seeking physician collaboration or referral.

The study concluded by providing 13 risk mitigation strategies that can help nurse and physicians to decrease injuries by bridging the communication gap.

  1. Collaboration agreements. Nurse and physicians should agree on the level of supervision that will be used.
  2.     Complete a thorough clinical history and physical examination for each patient.
  3.     Physicians, NPs, and office staff should take the time to explore patient complaints, especially when similar complaints are made on return visits.
  4.     If there is uncertainty about a diagnosis or about the appropriate testing to establish a diagnosis, the NP should ask the supervising physician to evaluate the patient.
  5.     Clinicians should consider new and unrelated illnesses when patients with chronic illnesses present multiple times for treatment.
  6.     Thoroughly evaluate all age groups of patients presenting with chest pain.
  7.     Train office staff to recognize complaints from patients or families that warrant immediate follow-up.
  8.     Document the details of telephone calls, including any recommended follow-up.
  9.     Have a clear policy and procedure in place for tracking diagnostic test results and referrals and verifying that reports are received and reviewed.
  10. Use read-back or repeat-back techniques to confirm that patients understand discharge instructions, follow-up care, and medication plans.
  11. Document patient non adherence to treatment plans, medication plans, and follow-up appointments.
  12. Provide a list of community resources that can help the patient receive needed treatment and services if he or she has a limited ability to pay for medications
  13. A physician cannot delegate responsibility for obtaining informed consent to an NP if the procedure will be performed by the physician.
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Although, the above list of actions are clear, however, they are not so easy to implement. Primarily because most of these are dependent on logging patient information in silo solutions (EHRs, etc.) across different care settings. 
This is why Hucu.ai ( a FREE person-centered, HIPAA compliant messaging network with real-time risk ratings and staff appreciation) was developed to simplify and streamline many of the above complex workflows and related requirements.

Conclusion – Vision of Communication Among Nursing Teams

Nurses are becoming more vocal for the need of improved communication which leads to better delivery of care. In a recent article by Arthur L. Davis Publishing Agency (ALD), a Certified Hospice and Palliative Care registered Nurse (CHPN) shared that in New Jersey there is a need to improve end-of-life-care planning for seniors. For this reason, a steering committee has been created, Hospice and Palliative Nursing Association (HPNA), to address this issue. HPNA believes that the nurse care is a combination of science and skillful communication to provide the best care for their patients.

To address nursing issues, New Jersey has already taken the step by forming the Nursing Workplace Environment and Staffing Council Commission. “This Commission worked on the development, education, and implementation for hospital-based Nursing Workplace Environment and Staffing Councils (NWESC) throughout New Jersey.” (Caruso and Edwards, 2020). The leaders of these councils are the Chief Nursing Officer and the direct RN staff of a healthcare facility. The purpose of this is to create a model to address health work environment issues (Caruso and Edwards, 2020). Already this shows staff empowerment and team work. The future is improved collaboration and communication amongst health leaders while providing compassionate care to patients.
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The Office of Disease Prevention and Health Promotion provides interactive eLearning courses that highlight effective communication strategies within a healthcare setting. These trainings are geared to help health professionals broaden their skillset. Also, they provide lessons/ examples of what other states and counties are doing in promoting effective communication in nursing and other community leaders. 
Lastly, and most importantly, Hucu.ai is primarily developed to help various nurses and other care staff to effectively communicate with each other using a simple and Free tool. Hucu.ai is the best HIPAA compliant text messaging application for the healthcare industry. Nurses and other staff (irrespective of their employer organization) are able to communicate with each other via 1-1 direct messages, via specific channels developed for certain discussion topics, and via patient-centered messages with the entire care team in one place. Do you want to overcome communication challenges in nursing and within your care teams? Let us help you get started on Hucu.ai. Sign up now.

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