Nursing Notes

July 2, 2010

Nurse to Doctor Talk and Walk: How Interprofessional Communication Affects Patient Outcomes

Filed under: Nursing — Shirley @ 4:14 am
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Here’s an article that addresses communication in the healthcare setting and its effects on nursing satisfaction.  This was based on a research study done over a multi-year period which researched how disruptive behavior affected patient outcomes.  As a psychiatric nurse, I already know the outcome.  I sometimes wonder how the nurses on the medical floors ever get any information about outcomes and expectations for their clients when they don’t have access to the multi-discipline treatment team.

Please read this entire article and let me know if you feel this is important to your area of service or if your area has developed a way to communicate patient outcomes that help you provide good care.  To read the entire article you will need to go here…..


June 22, 2010 · 1 Comment | Category: Nursing Articles

Communication is always a buzzword being utilized in any profession, because of its influence on productivity and outcomes. Ineffective communication contributes to lost time, misunderstanding, strained relationships, and inhibits future communication. In health care communication is even more critical because it is not numbers, buildings, or sales targets that are the ultimate goal, it is people; patients and their health. Good, bad, or nonexistent communication has been shown to impact the patient’s outcome.

Research has proven what common sense already knows: That a positive workplace where nurses knew they could influence outcomes, were able to collaborate with doctors, and had access to conflict resolution skills led to greater nurse retention. Both doctors and nurses’ perception of the quality of the working environment was also positive.

Despite the knowledge that respectful, positive and productive communication will affect patient care what normally happens in communication between professionals in acute care settings? A study over a multi year period by Rosenstein and others(2002, 2005-6, 2008-9) researched how disruptive behavior affected patient outcomes. Disruptive behavior is defined as any inappropriate disrespectful action such as raising one’s voice, verbal abuse, to physical or sexual harassment. These actions impede progress towards a workplace goal.

The ramifications in patient care were very significant. The study showed that these disruptive behaviors were witnessed by more than 50% of respondents: raising one’s voice, disrespectful interaction, abusive language, scolding in front of peers, and condescension. These behaviors were exhibited by both doctors and nurses with doctors showing a slightly higher incidence than nurses, 77% versus 65%. RNs witnessed an even higher percentage. This negative communication was correlated with patient outcomes. 60-70% of negative patient events were a result of communication problems. Negative events included medical errors, increased mortality, decreased patient safety, quality of care, and patient satisfaction.

Among all personnel surveyed 18% were able to link a specific adverse occurrence in patient care to disruptive behavior. A negative clinical outcome could occur for example, if the nurses feel inhibited to contact a certain doctor and therefore did not, or if the doctor ignores the nurses’ observations of the patient.

Disruptive behavior also affects nurse job satisfaction which contributes to staff turnover and retention. One third of nurses leave hospitals because of disruptive behaviors from doctors. It goes without saying that negative communication contributes to stress, frustration and even decreases the probability of future professional collaboration and impacts relationships between all parties involved.

There are many reasons that less than effective communication occurs. Working in a care setting where pressure is constant and decisions must be made quickly is very stressful. Lack of respect is a definite contributor, as are lifelong communication habits, personality, emotional intelligence, among other reasons.

It is quite possible that the traditional hierarchical structure of hospital organization does not maximize the opportunity for effective professional collaboration. Could institutional leadership be more proactive in recognizing how disruptive behavior and poor communication affects the quality of medical care? The study even posed the question of how gender affects communication.

So what is the answer to improving communication between professionals? Various studies have focused on interprofessional education. Collaboration requires competence in one’s own discipline as well as mutual understanding and respect. Professionals must also understand the context and complexity…{more}

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1 Comment »

  1. […] Nurse to Doctor Talk and Walk: How Interprofessional Communication … […]

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