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Improving Health and Nursing Practice Through Translational Research

Table of Contents

Introduction.

Communication issues in healthcare and understanding of proper medical communication by nurses

Formulation of question and its framework.

The search.

Identification of Research Articles.

Conclusion.

References.

Introduction to Clinical Issues in Today's Healthcare System

Medical communication is a relevant clinical issue for healthcare practice as a proper relationship between professionals and patients are needed for better treatment. Human beings are the smartest and the most adaptive creatures on this planet. Human body acts like a living machine by keeping every organ maintained by a single clutch but sometimes this "smart living machine" wears out, it is when one seeks the help of a healthcare system to recover.

Communication Issues in Healthcare and Understanding of Proper Medical Communication by Nurses

Issue

Good communication maintenance is an essential prerequisite for efficient, good and safe patient care. As reported by The Institute of Medicine, communication failures results in the worst outcomes in hospitals because incomplete treatment history of the patients can result in certain primary adversities. It includes care omissions, treatment delays; repeated testing whose data can be inefficient because health condition of the patient usually changes and lastly inappropriate treatment, which can cause minor or major misfortunes (Stewart, 2016). Secondary adversities such as patients' time span of staying in the hospital increases which can direct to two other pathways likely - expenditure rises up which is a serious blow to the family of the patient and secondly admission of another patient to the hospital is blocked which affects the society.

Many hospitals believe that a patient to receive proper care is more important than performing diagnoses. Accurate sharing of a patient's information with a group of doctors, nurses, specialists and other related hospital staff requires effective communication (Omura et al., 2017). Strong communication policies enrich patients' health, which is beneficial for both the patient and the health centre. Proper intrahospital and interhospital communication can increase day-to-day operating efficiencies with fewer chances of medical errors. Ethically this can lead to a good reputation of the healthcare system, which is much needed these days.

Clinical training of nurses is very beneficial because during periods of intense stress, nurses are responsible for relaying valuable information. Thus, their greatest challenge is communication in spite of having clinical expertise (Tulsky et al., 2017). Patient characteristics like hesitation or nervousness in speaking, upset mindset, which may be due to a lengthy conversation, can alter the situation, lengthening the process of treatment. Nurses thus should be mindful in tackling these by being kind, checking the location of the interaction while providing mental support to the patient. In return, the patient light heartedly discloses the symptoms and feelings much quicker. Nurses who intend to take time to understand the concerned patients are seen to address issues much faster.

This not only benefits the patient but also provides job satisfaction for the nurses for their best performance. Data from a 2014 research paper Communication in Nursing Practice states that nurses who display courtesy, kindness and security to their patients- through both action and words- are successful in establishing good merger because they act as communication bridges in relaying and illustrating information between physicians, caregivers, family members and patients (Foronda, MacWilliams & McArthur,2016).

Understanding of communication by nurses

Nursing care can be delivered by two means of communication, verbal and non-verbal. Facial expressions, gestures, posture and physical barriers express non-verbal communication. Analysing patient communications during stressful situations is important. A common ethical issue, which can cause communication breakdown, is hesitation due to difference in position and power of nurses (Müller et al., 2018). A hierarchy difference between nurses and physician exists. Thus, denial of any recommendation of a physician can be uncomfortable to a nurse which can leave a negative impact on the patient’s health. Thus, proper organizational culture and open communication should be maintained among health care workers.

Honesty and transparency of a nurse are very much required for understanding the social determinants of the patient. Unemployment, lack of housing can lead to psychological problems that can lead to mortality (Clarke et al., 2017). A nurse during these times, if becomes a good listener can reduce both physical and emotional distress. Taking care of personalized needs of the patient like specialized diets or maintenance of religious beliefs needs to be looked after by nurses. Nurses can be termed as frontline staffs bridging connection gaps between patients and the whole healthcare system.

Formulation of Question and Its Framework

Question

What are the negative impacts (O) of miscommunication (E) within healthcare centres (P) for both nurses and patients (P) towards ensuring proper patient safety (E) and security (E)?

Framework

PEO framework is used for making the above-mentioned question and this framework has three variables such as population, exposure and outcome. It is required for any medical research to produce a question under these three variables by which reliability of validity of data can be explored properly (Mao & Woolley, 2016). In case of this research on miscommunication in healthcare centres and its effect on the patient population has been accomplished by following the PEO framework and all these three criteria are met. On the other hand, ‘O’ has several parts for this study because of the diverse range of parts for this research and ‘E’ has also three different parts.

This question is helpful for further database searches from different websites and proper data analysis and systemic review of topic with the help of literature has been developed. Various components of PEO framework are described below with better justifications for this project and relevancy of work is projected in a suitable manner (Zhumadilova, Craig & Bobak, 2018).

Search for population 1: In this study, the selected professionals are more or less all medical officials such as doctors, nurses and patients are also considered as sample population for this study. Primarily, keywords such as physicians, nurses, patients are enlisted as searchable components for this study.

Search for population 2: Hospital, healthcare and nursing homes are used for this category of searches for justifying research question in a proper manner.

Search for exposure 1: This study is mainly focused on miscommunication issues within healthcare centres and this is the first set of exposure to be searched.

Search for exposure 2: Patient safety is related with proper communication within healthcare centres and for this study the above-mentioned key term is used to provide better exposure for this research (Hochman, 2017).

Search for exposure 3: Physical and mental security is needed for patients and nurses are responsible to accomplish such kinds of responsibilities. Therefore, patient security is categorised under exposure criteria and data are searched from NCBI, PubMed etc. websites.

Search for Outcome: Miscommunication within healthcare centre has several negative outcomes and it is analysed that all of them are responsible to reduce reputation of a hospital and patient safety and security are minimised due to this (Crawford, Candlin & Roger, 2017). Therefore, negative impacts of miscommunication for nurse-patient relationship are used as keyword for outcome for acquiring data from websites.

The Search

PICO framework

POPULATION

INTERVENTION

COMPARATOR

OUTCOME

Nurse- patient

Understanding of miscommunication issues within healthcare centre

Treatment issues like wrong medication.

Can prove fatal for the patient

Doctor -patient

Use of doctor-cantered language during workload periods, which can cause discomfort in patients

Unwanted medical tests

Can worsen the healthcare system, lowering reputation of the healthcare institution

Hospital staff – patient

Lack of medical education which can cause problems

 

Common people can lose faith in the healthcare system

Table 1: PICO framework

(Source: Created by researcher)

Database choice

Data added for framing this writing is collected from NCBI by directly looking for the research articles posted, from PubMed to get ideas from literature reviews associated and from CINAHL nursing journals.

NAME OF THE DATABASE

SEARCH ITEMS

RESULTS

NCBI

Communication breakdown, importance of communication, healthcare system and its issues, nurse-patient relationship

10

PubMed

Types of communication between nurse-patient, patient satisfaction, burn -patient care and their opinion on nurse care, effective communication, data analysis

16

CINAHL

Courses on effective communication of nurse-patient that provides satisfactory results on treatment. Years of nursing experience and its impact on communication

12

Table 2: Database searches

(Source: Created by researcher)

Search strategy

NCBI, PubMed and CINAHL are used to search all the data for this project and last five years articles are used to acquire better results for study purposes. On the other hand, most of the articles are based on various types of medical miscommunication between nurses and patients. Along with this, keywords such as miscommunication, nurse-patient relationship, patient safety and security and negative effects on healthcare are used to acquire better results (Howick et al., 2018).

Inclusion and exclusion criteria

Inclusion Criteria

● Human populations such as nurses, doctors and patients are included.

● Different types of medical journals are included.

● Healthcare centres and different types of nursing care systems are used in this study.

Exclusion Criteria

● Animals other than humans are rejected from this study.

● Journals before 2010 are also excluded from the study process.

● No non-medical staff and their communication process are included for this study.

Table 3: Inclusion and exclusion criteria

(Source: Created by researcher)

Identification of Research Articles

The following research articles provide an insight and clear evidence of the importance of communication between nurses and patients.

Article 1: Quality of Nurse Patient Therapeutic Communication and Overall Patient Satisfaction during their Hospitalization Stay

This research article enlightens the quality of nurse patient effective therapeutic communication and satisfaction of the patient during hospitalization by including patients who are seriously ill and willing to participate in this study. Sociodemographic studies on adults (both male and female) considering their educational qualification and occupational status was studied by taking help of various questions and points Likert scale. The study proved that nurse patient therapeutic communication had significant positive correlation with patient satisfaction but this correlation had no relation with age, gender, educational qualification, occupational status and patient health status, type of disease condition (Nisa et al. 2017). It can be approved from this article that effective therapeutic communication can improve the patient satisfaction level at any stage.

Article 2: Assessment of nurse-patient communication and patient satisfaction from nursing care

This research article deals with a special issue of establishing the importance of communication and patient satisfaction on nursing services at the burn wards of men and women at the Sina hospital of Tabriz. Data analysis showed a high level of dissatisfaction of service among patients (Lotfi et al. 2019). Nurses' communication with patients was weak and most of the patients were unaware of their respective nurses. Complaints arose that nurses were present only on patients' bedside when they were taking medicines and doing dressing. Moreover, Sina hospital is the only burn centre in the northwest of Iran so burn patients are obliged to be treated there. It is the duty of the hospital to train the healthcare staff, especially nurses to participate actively in satisfying patients and attend their needs on time.

Article 3: Quantitative exploration of the barriers and facilitators to nurse-patient communication in Saudi Arabia

This research article investigates the barriers and facilitators of nurse-patient communication in Saudia Arabia with the help of Nurses' Self- Administered Communication Survey (NSACS) ultimately promoting awareness to improve patient care. Saudi Arabian hospitals recruit nurses from diverse nationalities, which left an impact like coping up with Islamic religious beliefs of the patients, language importance that affected the wellbeing of the patients. During heavy workload, nurses were found to communicate in a nurse-centred style rather than patient centred approaches, which created a communication gap between the patients and nurses (Albagawi & Jones, 2017). The most important barrier that lighted up is the experience of nurses and whether they had training in specialist communication courses. These two parameters clearly differentiated nurses and assessed them respectively depicting the importance of medical communication.

Article 4: Nurse-patient communication: A quality assessment in public hospital

This research article establishes relations in medical communication with nurses, patients and situations. It was found that nurses who had long time exposure in this job have better communication abilities and are more skilled than freshers are. In turn, patients with a high level of education can more easily communicate with nurses irrespective of gender and age (Tran et al. 2020). It has also been found that morning shifts, fewer patients and less stressful conditions goes hand in hand with better communication between nurse and patient. In addition, effective communication was seen among nurses working in surgery division than internal medicine division.

Conclusion on Clinical Issues in Today's Healthcare System

Healthcare system includes the frontline warriors like nurses, doctors and other healthcare workers who fight selflessly. Several clinical issues bud out which can be stated as the bad side. It happens sometimes that health information of a patient gets transferred from one caregiver to another for greater safety of the patient. At the time of this process, some important information is overlooked and is not passed. This leads to various problems on treatment like deterioration of the health conditions of the patient, which can be fatal ultimately leading to unwanted chaos and loss of reputation of the healthcare system.

References for Clinical Issues in Today's Healthcare System

Albagawi, B. S., & Jones, L. K. (2017). Quantitative exploration of the barriers and facilitators to nurse-patient communication in Saudia Arabia. Journal of Hospital Administration, 6(1), 16. Retrieved from: https://www.researchgate.net/profile/Bander_Albagawi/publication/311505623_Quantitative_exploration_of_the_barriers_and_facilitators_to_nurse-patient_communication_in_Saudia_Arabia/links/5c144e7aa6fdcc494ff516cc/Quantitative-exploration-of-the-barriers-and-facilitators-to-nurse-patient-communication-in-Saudia-Arabia.pdf

Burns, M. I., Baylor, C., Dudgeon, B. J., Starks, H., & Yorkston, K. (2017). Health care provider accommodations for patients with communication disorders. Topics in Language Disorders, 37(4), 311-333. Retrieved from: https://alliedhealth.ceconnection.com/ovidfiles/00011363-201710000-00003.pdf

Clarke, J. L., Bourn, S., Skoufalos, A., Beck, E. H., & Castillo, D. J. (2017). An innovative approach to health care delivery for patients with chronic conditions. Population Health Management, 20(1), 23-30. Retrieved from: https://www.liebertpub.com/doi/pdfplus/10.1089/pop.2016.0076

Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural diversity in nurse–patient communication. Collegian, 24(1), 63-69. Retrieved from: https://www.academia.edu/download/54429058/jurnal.pdf

Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40. Retrieved from: https://bcpsqc.ca/wp-content/uploads/2018/03/Interprofessional-communication-in-health-care-an-integrative-review.pdf

Hassan, I. (2018). Avoiding medication errors through effective communication in healthcare environment. Movement, Health & Exercise, 7(1), 113-126. Retrieved from: http://mohejournal.com/index.php/mohe/article/viewFile/MoHE%20Vol7%281%29_9/87

Hochman, O. (2017). Patient-centered care in healthcare and its implementation in nursing. International Journal of Caring Sciences, 10(1), 596. Retrieved from: http://www.internationaljournalofcaringsciences.org/docs/64_merav_review_10_1.pdf

Howick, J., Moscrop, A., Mebius, A., Fanshawe, T. R., Lewith, G., Bishop, F. L., ... & Aveyard, P. (2018). Effects of empathic and positive communication in healthcare consultations: A systematic review and meta-analysis. Journal of the Royal Society of Medicine, 111(7), 240-252. Retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/0141076818769477

Lotfi, M., Zamanzadeh, V., Valizadeh, L., & Khajehgoodari, M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care. Nursing open, 6(3), 1189-1196. Retrieved from: https://onlinelibrary.wiley.com/doi/pdf/10.1002/nop2.316

Mao, A. T., & Woolley, A. W. (2016). Teamwork in health care: maximizing collective intelligence via inclusive collaboration and open communication. AMA Journal of Ethics, 18(9), 933-940. Retrieved from: https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/stas2-1609.pdf

Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: A systematic review. BMJ Open, 8(8), e022202. Retrieved from: https://bmjopen.bmj.com/content/bmjopen/8/8/e022202.full.pdf

Nisa, S. N. U., Hussain, M., Afzal, M., & Gilani, S. A. (2017). Quality of nurse patient therapeutic communication and overall patient satisfaction during their hospitalization stay. Retrieved from: https://www.researchgate.net/profile/Muhammad_Afzal91/publication/334225219_Quality_of_Nurse_Patient_Therapeutic_Communication_and_Overall_Patient_Satisfaction_during_their_Hospitalization_Stay/links/5d1dafc0458515c11c0f9c92/Quality-of-Nurse-Patient-Therapeutic-Communication-and-Overall-Patient-Satisfaction-during-their-Hospitalization-Stay.pdf

Omura, M., Maguire, J., Levett-Jones, T., & Stone, T. E. (2017). The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review. International Journal of Nursing Studies, 76, 120-128. Retrieved from: https://opus.lib.uts.edu.au/bitstream/10453/123620/4/Accepted%20version%20Omura%20et%20al.%20%20manuscript.pdf

Tran, T. V., Tran, T. D., Nguyen, A. Q., Dinh, T. T., Le, A. T. K., Tran, H. B., ... & Dang, L. V. P. (2020). Nurse–patient communication: A quality assessment in public hospital. International Journal of Healthcare Management, 1-7. Retrieved from: https://www.researchgate.net/profile/Thanh_Dinh5/publication/340847696_Nurse-patient_communication_A_quality_assessment_in_public_hospital/links/5ef2c678299bf1031f1f47e7/Nurse-patient-communication-A-quality-assessment-in-public-hospital.pdf

Tulsky, J. A., Beach, M. C., Butow, P. N., Hickman, S. E., Mack, J. W., Morrison, R. S., ... & Pollak, K. I. (2017). A research agenda for communication between health care professionals and patients living with serious illness. JAMA Internal Medicine, 177(9), 1361-1366. Retrieved from: https://escholarship.org/content/qt3p41t6tx/qt3p41t6tx.pdf

Zhumadilova, A., Craig, B. J., & Bobak, M. (2018). Patient-centered beliefs among patients and providers in Kazakhstan. Ochsner Journal, 18(1), 46-52. Retrieved from: http://www.ochsnerjournal.org/content/ochjnl/18/1/46.full.pdf

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