Ashley Deal University of Central Florida Improving Nurse-Physician Communication Through collaborative communication Ashley Deal University of Central Florida

Background Nurse Physician communication in the acute care setting is one of the key components of a healthy work environment and allows for improved patient care and nursing satisfaction

Background One of the AACN’s Standards for creating a health work environment is Skilled Communication. “Nurses must be as proficient in communication skills as they are in clinical skills” (AACN, 2005) One of the elements of skilled communication focuses on seeking to “protect and advance collaborative relationships among colleagues” including physicians (AANP, 2005).

“Communication between nurses and physicians is the one factor that is most associated with excess hospital mortality” (Manojlovich & DeCicco, 2007).

Background Nurse physician communication is vital to ensuring safe and quality patient care Effective nurse physician communication improves nursing job satisfaction and also decreases burn out syndrome among nurses (Kadda, 2013) Also allows for decreased job stress.

What are the barriers to effective communication between nurses and physicians?

Barriers Communication involves two parities and in this case nurses and physicians are the parties being examined There are barriers on both the nurses side and the physicians side that hinder effective communication

Barriers Hierarchical authority structure Sexism Experience Support from management lack of formal training or education on effective communication Ineffective leadership

Role of the Nurse Leader The nurse leader needs to be proficient at skilled communication in order to set an example for their team The nurse leader should allow for education or training sessions for staff in skilled communication and effective nurse-physician communication The nurse leader needs to provide support to staff and act as a liaison between staff nurses and physicians

Nurse Leader Nurse leaders and management play in an important role in providing information and communicating to allow for effective care coordination and to avoid unsafe care and errors (Huber, 2010).

Role of the Nurse Leader Improve the leadership team’s ability to exercise shared leadership in promotion of collaborative relationships among all nurses and physicians Enhance or modify individual and team collaborative communication behaviors and processes, including open, timely, and accurate communication; enhanced team coordination; improved interdisciplinary problem (Boyle & Kochinda, 2004).

Alternative Solutions Utilizing the SBAR communication tool Situation Background Assessment Recommendation Research shows that SBAR dose not allow for complete communication of key information (Joffe, 2013)

Solution Collaborative communication nursing and physician leaders create the environment for collaborative communication among healthcare providers, and collaborative communication is associated with positive patient, nurse, and physician outcomes ((Boyle & Kochinda, 2004))

Solution Collaborative communication allows for nurses and physicians to effectively communicate with one another Collaboration allows nurses to have a voice in their patients care

Implementation Multidisciplinary rounds Allows for nurses and physicians to discuss patients together and provides nurses a voice in patient care “Nurse-physician rounds have the potential to improve relationships between caregivers, and positively affect communication and perception of patient care. Greater understanding may contribute to safer medical care and more satisfied patients” (Burns, 2011)

Implementation Collaborative meeting Allowing a time for nurses and physicians to meet in an organized and professional manner to address concerns of communication between nurses and physicians Nurse leaders and management should also be involved to assist in facilitating positive communication and outcomes Review negative communication situations and create plans to avoid repeating the same mistakes

Evaluation Evaluation would be based on nursing satisfaction of communication between nurses and physicians Improved communication should also yield improved patient care and decreased errors

References American Association of Critical-Care Nurses (2005). AACN STANDARDS FOR ESTABLISHING AND SUSTAINING HEALTHY WORK ENVIRONMENTS. Retrieved March 30, 2014, from http://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf Boyle, D., & Kochinda, C. (2004). Enhancing collaborative communication of nurse and physician leadership in two intensive care units. The Journal Of Nursing Administration, 34(2), 60-70. Burns, K. (2011). Professional Issues. Nurse-Physician Rounds: A Collaborative Approach To Improving Communication, Efficiencies, and Perception of Care. MEDSURG Nursing, 20(4), 194-199. Joffe, E., Turley, J. P., Hwang, K. O., Johnson, T. R., Johnson, C. W., & Bernstam, E. V. (2013). Evaluation of a Problem-Specific SBAR Tool to Improve After-Hours Nurse- Physician Phone Communication: A Randomized Trial. Joint Commission Journal On Quality & Patient Safety, 39(11), 495-501.

References Kadda, O. (2013). Effective Physician - Nurse communication. Health Science Journal, 7(4), 237-238. Manojlovich, M., & DeCicco, B. (2007). Healthy work environments, nurse-physician communication, and patients' outcome. American Journal Of Critical Care, 16(6), 536-543. Robinson, F., Gorman, G., Slimmer, L., & Yudkowsky, R. (2010). Perceptions of effective and ineffective nurse-physician communication in hospitals. Nursing Forum, 45(3), 206-216. doi:10.1111/j.1744-6198.2010.00182.x