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Running head: NURSE TO NURSE COMMUNICATION

Nurse to nurse communication

Student Name: Navjyoti Suri
Student No: N01031326
Date of Submission: March 22, 2016
NURS 250: Practical Nursing Leadership
Humber College, North Campus ITAL

Nurse to Nurse Communication

NURSE TO NURSE COMMUNICATION

In nursing an alignment of knowledge, clinical skills and interpersonal communication is

essential. Nursing is two things; the care of the sick and the inclining to the environment within
which care happens (Chapman, 2009). Good communication among nurses is essential for
successful outcome of individualized nursing care of each patient. Patient safety always comes
first (Schuster, 2010). Ineffective hand-off communication is recognized as a critical patient
safety problem in health care; in fact, an estimated 80% of serious medical errors involve
miscommunication between caregivers during the transfer of patients (Patterson, 2013).
Identifying the problem
Current research indicates that ineffective communication among nurses is one of the
leading causes of medical errors and patient harm. According to Joint Commission of
Accreditation of Health Care Organizations (JCAHO, 2005) 65% of medical errors are due to
communication breakdowns among healthcare providers (Hillier, Regan & Gordan, 2012). First
identified problem is while giving change of shift report in backrooms; nurses are usually
interrupted during their communication. Patterson (2013) in his study determined that one third
of all communication among nurses is interrupted while giving reports and 10% of all
communications involve discussing multiple patients at the same place. The reason for
interruption in communication may be due to noise in the surrounding and lack of structure in
giving report. If communication among nurses breaks down at any point, patient safety is
compromised resulting in serious consequences (Carrington, 2012). Treatment planned will be
inappropriate and can cause harm to patients if the clinical decisions are made on misinterpreted
or wrong information communicated (Carrington, 2012). Most nurses lack guidance on the

NURSE TO NURSE COMMUNICATION

proper format in giving handovers and their importance. It is essential for all nurses to determine
that another team member has interpreted her message accurately.
Alternatives to deal the issue
Instead of giving report in closed rooms, patients report should be given at bedside,
involving patient while giving report (Hysong, 2009). This gives opportunity to patients to be
involved in their care by sharing their concerns and goals with incoming nurse (Hysong, 2009).
Using communication tools such as situation-background assessment-recommendation (SBAR)
communication ensures messages are clear, precise and straightforward. This can prevent
misinterpretations and patient harm (Chapman, 2009). Patients who feel uncomfortable with
having their care discussed are free to decline. In order to respect clients privacy and
confidentiality in shared rooms, the nurse can take permission of patients for bedside rounds.
Another way to increase safety du e to miscommunications in patient care is to have a
team huddle at shift change that includes other health care professionals as well. Both shifts can
gather at nursing station and outgoing staff can report the critical information about each patient
that everyone needs to know, including code status, diagnosis, tests scheduled for the day, fall
risks and safety issues and plan for the day. The advantage of having an idea of all patients on a
busy high acuity unit can be a great help at time of emergency. Safety huddle also facilitates
collaboration among nurses of various levels of experience. In a pilot project at large medical
center, SBAR communication, multidisciplinary shift report and situational awareness were
instituted. After one year the improved communication and team work lead to improved patient
safety outcomes (Hillier, Regan & Gordan, 2012).

NURSE TO NURSE COMMUNICATION

Implementation of the alternatives

In order to implement these alternatives there should be multiple teaching strategies to
introduce concepts, reinforce learning, and facilitate these ideas into practice and methods to
manage practice challenges. The education system should focus on concepts of teamwork,
psychological safety, open effective communication and its impact on patient safety. This should
also assimilate safe communication strategies into that organizational culture. Consistency and
high quality should be maintained in all educational efforts. Educational tools should include
video presentations, communication education note books, practice scenarios, SBAR practice
worksheets, visual reminders such as posters, cards, bookmarks etc. A feedback got by research
done indicates 61.8% health care workers strongly agreed that using SBAR can decrease
communication problems (Dingley, 2007).They should be allowed for flexibility in use and
application in diverse practice. Nurses can be taught by web based training and tables of
communication forms on units in strategic locations. In the safety huddles they can give brief
bullet statements. Clinical nurse educators, managers and resource nurse can use the posters to
review concepts and reinforce previous teachings in safety huddles or on individual basis.
Evaluation
In order to evaluate the implementations; a brief self-report survey on patients plan of care
can be done by unit manager or educators for evaluation of staff understanding of patient daily
goal. There can be focus group interviews with hospital staff. An anonymous hospital survey or
audit can be conducted on patient safety culture. To build a safer health care system, it is critical
that nurses develop high level of proficiency in communication and use patient safe
communication strategies provided by the leading professionals. Patient safety net (PSN) reports

NURSE TO NURSE COMMUNICATION

can be reviewed on regular basis by the nurse managers and evaluations can be done effectively.
Nurses communicate patient status using various communication systems, the Electronic Health
Record (EHR), audio recorded, written or verbal handovers (Carrington, 2012). Verbal report
using nursing handovers and patient records is generally considered an effective method of
exchange in information and tape recordings can be done to review the effectiveness of the
alternative.

NURSE TO NURSE COMMUNICATION

References:
Carrington, J. M. (2008). The effectiveness of electronic health record with standardized nursing
languages for communicating patient status related to a clinical event (Order No.
3297974). Available from ProQuest Nursing & Allied Health Source. (304685769).
Retrieved from http://search.proquest.com/docview/304685769?accountid=11530
Carrington, J. M. (2012). Development of a Conceptual Framework to Guide a Program of
Research Exploring Nurse-to-Nurse Communication. CIN: Computers, Informatics,
Nursing, 30(6), 293-299.
Chapman, K. B. (2009). Improving Communication Among Nurses, Patients, and Physicians.
AJN, American Journal of Nursing, 109, 21-25.
Dingley, C., (2007). Improving patient safety through provider communication strategy
enhancements. American Nursing Association (ANA).
Hysong, Sylvia J., et al. "Improving outpatient safety through effective electronic
communication: a study protocol." Implementation Science 4 (2009): 62. Academic
OneFile. Web. 19 Mar. 2016.
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df098797e6ad34a951dce2f919cb
Patterson, P. D., Pfeiffer, A. J., Weaver, M. D., Krackhardt, D., Arnold, R. M., Yealy, D. M., &
Lave, J. R. (2013). Network analysis of team communication in a busy emergency
department. BMC Health Services Research, 13, 109. doi:http://dx.doi.org/10.1186/1472-

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6963- 13-109Schuster, P. M., & Nykolyn, L. (2010). Communication for nurses: How to
prevent harmful events and promote patient safety. Philadelphia.
Fay-Hillier, T. M., Regan, R. V., & Gordon, M. G. (2012). Communication and Patient Safety in
Simulation for Mental Health Nursing Education. Issues in Mental Health Nursing,
33(11), 718-726.