A DNP Evidence-based Quality Improvement Project to Improve Nurse-Patient Communication Process

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2020-05

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The Ohio State University

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Abstract

Problem: Standard nursing education includes professional communication content, but limited time is available for developing needed communication skills for work in a complex inpatient healthcare setting. Purpose: This DNP evidence-based quality improvement project developed, implemented, and evaluated a communication course in workshop format for new nurse residents in a large urban academic midwestern medical center to gain additional on-the-job professional communication skills. Methods: Nurse Residents completed pre-workshop and post-workshop questionnaires, including: pre-workshop Interprofessional Professionalism Assessment (IPA), pre/post confidence in physician and patient/family communication, pre/post knowledge of communication, and post-workshop extent of learning and most important thing learned. Data analyses included descriptive statistics, x2 analyses, paired t-tests, and Cohen’s d effect size estimation in the applicable analysis contexts. Findings: IPA results showed high interest of nurses in learning professional communication skills. Nurse-physician and patient/family communication confidence increased significantly and with large effect size changes from pre-course to post course, 64.6% to 81.7%, t (95) = - 9.458, p = .000, Cohen’s d = 0.966, and, 74.7% to 86.4%, t (95) = - 9.034, p = .000, Cohen’s d = 0.923, respectively. Knowledge gain from pre- to post-workshop was not statistically significant, implying the knowledge questions may need revision for future cohorts. A majority of nurse residents (73.5%) agreed to strongly agreed with increased learning from the workshop. Responses for the most important thing learned strongly endorsed the value of the communication and conflict management skills practice and tools provided in the workshop. Conclusions: New graduate nurses need and value opportunities for on-the-job professional communication skills practice and learning about specific tools to support effective communication. The workshop improved communication confidence and provided skills practice and tools that were well-received by nurse residents. Improved communication confidence and skills has significant potential to improve patient and healthcare system outcomes.

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communication, teamwork, conflict management, Nurse communication confidence

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