The Importance of Good Patient's Communication in Nursing

The profession of nursing has been referred to as one of the most trusted professions for many years. But, how did we get here? The central focus of the nursing profession has always been the patient, and how we accomplish patient centered care is with communication, collaboration, safety, quality improvement, and informatics. These five attributes are what drive patient-centered care and produce the best possible outcomes for our patients in the long and short term. The healthcare community has shared their initiatives among healthcare providers and the public to enhance these attributes.

Communication, Safety, Collaboration, Health Care Quality, and Informatics

Communication plays a huge part in the care of our patients. From patient hand-off to giving report to the specialists, nurses are responsible for communicating clearly and concisely to the healthcare team. In addition to in-network communication, there are also organizations outside the hospital that work hard to communicate changes or expectations of the nurses within their hospital. An example of this is the Joint Commission’s annually published National Patient Safety Goals which sets the standards for communication efforts and safety (2019). Two of these goals that focus primarily on communication are improving staff communication by reporting abnormal test results to the appropriate staff in a timely manner, and, preventing mistakes in surgery by pausing to communicate that the correct patient is present and the correct surgery will be performed (JCAHO, 2019). In addition to communication, and as the name suggests, this annual document is primarily used for safety goals and these goals may be met in different ways, such as communication (JCAHO, 2019). Some other safety goals include identifying patients correctly and using medications safely (JCAHO, 2019). Healthcare that is safe, well communicated, and collaborated on is quality healthcare. Each of these attributes to patient centered care.

Unfortunately, good communication does not always happen, and this is when we see stories such a Lewis Blackman’s where a life was lost because poor communication barred patient’s care. The QSEN Institute shares the story of Lewis Blackman, survived by his mother Helen, and how the lack of communication and collaboration lead to the deterioration and ultimate death of Lewis (2009). Helen recalls the many times she requested the attending provider come see her son, only to find out no one ever paged the provider (QSEN Institute, 2009). This lack of communication goes hand-in-hand with a lack of collaboration and safety concerns. Unfortunately, Lewis was the patient of a student doctor with a lack of oversight from the attending. He was continually given an unsafe dose of Ketorolac, which caused renal failure, shock, and death (QSEN Institute, 2009). If the healthcare team was attentive and collaborating in Lewis’s care, he would perhaps be alive today.

Collaboration can happen between the healthcare team and the patients served as well. However, many people are not active participants in their own care perhaps because of fear or maybe even lack of understanding. The Joint Commission Speak Up initiative aims to encourage the public to speak up about their healthcare especially in the cases when they do not understand or disagree with the decisions made about their care (2018). Another great program aiding in greater collaboration is the Campaign for Action which encourages nurses and other healthcare professionals to work within their communities to provide accessible healthcare (Campaign for Action, 2010). This campaign calls for nurses to be complete partners with other healthcare professionals to “redesign healthcare in the United States” (Campaign for Action, 2010). Collaboration and communication go well with safety because if we are collaborating and communicating well with our team members, our patients will have safe and productive outcomes.

Safety is the top priority of nursing care. How do we achieve safety outside of the Joint Commission’s safety goals, or in addition to collaboration and communication? There’s not a single correct answer, however, the prevention of illness exacerbation would be a great start. Healthy People 2020 (2010) is a guide to healthy living that aims to do exactly that: prevent and manage chronic illness and prevent the exacerbation of chronic illness. These guidelines are lifestyle oriented to those with conditions such as heart disease, hypertension, and diabetes (Healthy People 2020, 2010). In addition to treating these conditions medically, healthcare providers can prevent them from getting worse by following these guidelines and educating patients to follow them for preventative measures. Another important campaign is the 5 Million Lives Campaign which almost works in conjunction with the Joint Commission’s Patient Safety Goals. The 5 Million Lives Campaign aims to improve medical care in the US while reducing the mortality and morbidity rate (5 Million Lives, 2008). They outline things such as the prevention of pressure ulcers, reducing MRSA infections, preventing harm with high-alert medications, and reducing surgical complications (5 Million Lives, 2008). These specific issues are widely taught in nursing school and may be considered sentinel events. By being diligent with our assessments and nursing care, these issues can be prevented, and patient safety can be maintained. If an incident does occur, we rely on technology and informatics to analyze this data and present it along with potential solutions to the problem.

Technology and informatics are an integral part of healthcare today. Our charting is electronic, prescriptions are sent electronically, and even some education is web-based. The American Nursing Informatics Association (ANIA) is an organization that “uses informatics to improve the health of populations, communities, families and individuals by optimizing information management and communication” (ANIA, 2010). As the description states, this organization uses the technology to communicate and manage information, which includes the analysis of incident reports and the corresponding actions taken to prevent the event from reoccurring (ANIA, 2010). This not only affects the communication between providers but also affects the quality of healthcare provided.

Health care quality relies on the other 4 attributes very heavily. In a world without communication, collaboration, safety, or technology, is the healthcare received truly quality care? The Healthy People 2020 campaign along with Campaign for Action are both aiming to provide quality care indirectly. Healthy People 2020 (2010) aims to manage chronic illness in the least invasive way possible while the Campaign for Action aims to provide access to care among all people (2010). Quality healthcare is healthcare that is accessible, safe, and reliable to those who need it most.

Relationship of the Attributes

Each of these attributes is related. Specifically, communication, collaboration, and safety are all focused on improvement of patient outcomes and aim to prevent sentinel events. This can be accomplished with informatics and health care quality improvement. Suppose a safety incident occurs and a report is filed. This incident report would be reviewed by quality improvement teams and new measures would be implemented to alter communication, collaboration, and safety to prevent this event from occurring again. With the assistance of informatics, the implemented changes can be analyzed for effectiveness and adjusted as needed.

Reflection

The webpages explored all shared the same goal: patient centered care. Each webpage fell under multiple attributes and it was pretty difficult to narrow it down because it’s very subjective. It seems like most of these webpages and organizations have multiple goals in mind but it all circles back to the benefit of the patient and how we can do better as healthcare providers to ensure positive patient outcomes are achieved. As nurses, it’s great to be aware of these organizations and campaigns for ourselves and our patients to maintain a good nurse patient relationship but also to give patients something to look into if they have questions or concerns about what driving forces exist in the nursing profession. To conclude, the nursing profession continues to be one of the most trusted professions in the world and we wouldn’t be able to achieve that without communication, collaboration, safety, informatics, and quality care. With the five attributes working together, nurses, patients, and providers can continue their working relationship to achieve the goal of optimum health.