In specialized healthcare settings, communication between nurses and other members of the care team has never been more crucial. The types of patient care problems that care teams encounter are complex and everlasting making teamwork essential. Patients trust that all members of their care team are communicating with each other, each discipline providing input into the treatment regimen and proposing treatment plan.
Communication has a huge role on meeting the National Patient Safety Goals introduced by the Joint Commission in 2005. Improvement rests on effective communication between nursing and other disciplines of care.
So, how can this 'communication' be improved? The following is a list of proposed strategies:
- Discharge rounds. This is a chance for the patient’s assigned nurse to meet with other team members to discuss the patient’s progress. It is an opportunity to discuss the necessary patient care and needs and to assure that core measures related to in-patient status are addressed.
- Hospitalists. They are practitioners who are in-house and able to address the patient’s immediate needs and communicate it with the attending physician. Hospitalists are also readily available to answer questions cutting the hassle of a nurse calling the physician (who has his/her own out-patient practice) then awaiting call back.
- Objective data. When communicating with other team members, it is helpful if the nurse has objective data in hand to support the claim. For instance, if the patient is complaining of pain, offer a pain score or remedies that the patient uses at home. Similarly, when communicating with the dietician, state how much the patient ate or her food preferences.
- Round with the physician or team members. It is a helpful strategy to have the nurse be present in the patient’s room during a visit from other care discipline. This is an opportunity for each member to address his concerns or plans related to the nursing care plan and this assures that all players are on the same page.
- Computerized documentation. Computerized charting is now the standard of practice. It allows other members of the team to review the nurse’s notes and objective data related to the patient’s condition and the physician can review the chart from an off-site area and order interventions or medications.
- Effective documentation. When documenting, provide objective data. For example, if a nurse is recording a note related to a patient’s wound, provide measurements.
- Core measures. The Joint Commission has implemented a series of core measures related to common diseases and conditions. If the patient is on dialysis, it is a “core measure” to verify that a daily weight has been entered, and if she has a dialysis shunt, the status of the thrill and bruit should be documented. These core measures are objective data that give each member of the care team an understanding of the patient’s condition and progress.
- Effective communication. All members of the care team are busy, especially physicians. Therefore, it is important to contact them only for essential issues that cannot wait until they round. So, if you have several questions for dietary, respiratory or from a particular physician, consolidate them into one email or phone call versus several separate messages. Likewise, if a current nursing intervention is not working, propose a strategy that has worked in the past for the patient.
- Fulfill requested duties. Similarly, if a fellow member of the care team has requested a piece of information from you, follow through with answering the request. This shows your responsibility and dedication, and it builds trust between you both.
- Demonstrate leadership and a positive attitude. When working with your colleagues, it is important to keep in mind that you all have one common goal: to improve the health of the patient. It is important to show that you enjoy what you are doing, that you enjoy working with others, and that you are a nurse leader on your unit. This positive outlook goes a long way in professional relationships. And, the patients appreciate it.
Effective communication is an art, but in today’s fast-paced patient care arena, it is essential. Each member of the care team plays an integral role in patient outcomes, and building a comprehensive care plan demands that each discipline communicate her recommendations. No member acts in isolation and the patient trusts that her team is working as a whole to help her to achieve the best outcome.
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