Year of Publication

2015

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Nora Warshawsky

Clinical Mentor

Dr. Patty Hughes

Committee Member

Dr. Jan Forren

Abstract

Background: The history of nurse/physician communication is well documented. Although there is no universal definition of nurse-physician communication, an increasing body of evidence identifies this factor as an important component of organizing and delivering safe, quality care to patients. Communication has been identified as the root cause in 65% of sentinel events and noted as having significant effect on patient outcomes; contributing significantly to increasing care coordination, decreasing length of stay, and decreasing mortality rates. Purpose: To examine whether Crucial Conversations® training improves nurses’ self-efficacy scores and assess whether clinical nurse report improved ability to communicate with physicians. Methods: A one-group pretest, immediate posttest and 30-day posttest study design was conducted with 10 clinical nurses participating in Crucial Conversations® training. Crucial Conversations®, is a standardized communications training program for stressful interactions. The Crucial Conversations® training program provides specific tools to help manage conversations that include sensitive information to ensure positive outcomes for patients Results: Mean scores for each of the 10 items on posttest 1 and posttest 2 increased compared with pretest scores (Table 2). All participants’ scores increased following the skilled communication training. Baseline scores ranged from 4.60(SD) to 8.90(SD); posttest 1 scores ranged from 7.60(SD) to 9.30 (SD) and posttest 2 scores from 7.70(SD) to 9.70(SD). There were statistically significant improvements from baseline to posttest 1 and posttest 2 for each item with the exception of illegible orders and telephone calls and/or pages. From the repeated measures ANOVA, total scale self-efficacy (SE) scores significantly differed over time (F=7.54, p=.014). Post hoc analysis revealed a significant increase in total scale SE between baseline and posttest 1 (p= .003) and between baseline and posttest 2 (p=.004). There was no difference in SE from posttest 1 and posttest 2 (p=.80). Conclusion: Communication between nurses and physicians is vital to maintaining patient safety and has been linked to errors resulting in poor patient outcomes. Without skilled communication, patient care coordination is compromised thus leading to suboptimal patient outcomes. Communication skills training is one intervention strategy used to improve communication between nurses and physicians.

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