Communication Breakdowns in Nursing Care

Subject:	Nursing
Pages:	8
Words:	2122
Reading time:	9 min
Study level:	Master

Abstract

The paper focuses on analysing, discussing, and reviewing literature on the impact of communication breakdowns on the satisfaction of patients. 10 articles are chosen, analyzed in accordance with their eligibility, and used to present the impact and significance of communication in nursing, as well as the possible ways to decrease communication breakdowns. The goal of the work is to present available data in a quick and succinct manner, as well as to advance knowledge in the field of nursing.

Introduction

Communication is an especially important part of nursing. Nurses occupy a position of an intermediary between the doctor and their patients, being most directly involved in explaining and contextualizing healthcare strategies to the clients. This work involves finding correct pathways to understanding, and providing most relevant and important info to all concerned parties. In patient care, medical workers constantly need to act as mediator between distributing treatment and tending to a patient’s other needs. To provide a truly patient-centered, involved and effective care, nurses are required to communicate well with their clients. However, the process of communication is not always easy to uphold, and significant barriers exist to truly engaging with patients, connected with organizational, physical and psychological issues. The problem of communication is especially prevalent in older patients, where issues of hearing and other illnesses can affect patient’s ability to communicate with the healthcare delivery specialists. This review will focus on discussing the relevant literature on the effects of communication breakdowns on health outcomes, focusing on the elderly population and older patients in particular. The current body of work will be examined using publicly available materials on the internet. The main goal of this review is to answer the proposed PICO clinical question, as well as to promote a better understanding of communication as a factor in medical settings.

Relevant PICO clinical question

While examining the topic of communication breakdowns, one can formulate a specific clinical issue to talk about. Using the PICO process for better understanding, the question for this paper is: “In the elderly hospital patients, how does a communication breakdown compared with a normal communication case impact health outcomes and satisfaction?”. This PICO question identifies the main consideration of this paper, the demographics it will cover and the main comparison point that will be brought up.

Purpose or aim of review

The main purpose of the review is to see the current and most relevant pieces of literature in connection with patient care, as well as to examine a relevant contemporary issue in nursing. Such examination are a necessary part of advancing nursing as a profession, and making sure that the quality of care stays at a highest possible standard. The problems of communication are a persistent and important avenue of patient care to consider, as they cannot be remedied with changes in nursing practice or advancements in medicine. Communication will always depend on the human factor of medical care, as well as the systems that support it. Leadership and management efforts can be brought up to increase the effectiveness of communication, and proper teaching methods can be used to ensure the staff are prepared to handle their patients. However, any measure that is taken ultimately depends on the individual nurse or a group of nurses that oversee a client. It is impossible to fully eradicate cases of communication breakdowns, and that is exactly why the issue must be studied further and reviewed. Medical professionals have an obligation and an ability to make the process of healthcare and support as smooth and beneficial to the patients, and examining methods of communication, as well as the importance it has builds towards fulfilling that obligation.

Literature Search criteria and strategies

The main question of the discussion, as stated before, is “In the elderly hospital patients, how does a communication breakdown compared with a normal communication case impact health outcomes and satisfaction?”. To properly find data relevant to this review, a number of keywords and proper search terms needs to be highlighted. Some of the possible keywords and phrases include:

Communication breakdown
Communication barriers
Communication in nursing
Patient-nurse communication
Effects of communication on nursing care
Communication with elderly patients
Missed care
Missed Nursing care

These points will be used to find 10 or more relevant articles on the subjects of nursing communication, and communication issues with the elderly in particular. The scope of the review is the most recent 6 years. The materials reviewing the relevance of patient-nurse communication to maintaining, enhancing, or supporting patient health outcomes will be included. The main sources of the information are medical and nursing journals, published online in the recent years. All of the articles will be found using the relevant keywords in Google Scholar.

Comprehensive search and results

The comprehensive search was conducted using manual search methods, by individually reading through the list of results to highlighted keywords. The articles were selected based on their adherence to the topic of the review, year of publishing, and scientific focus. By the end of the comprehensive search, 10 relevant articles were selected among the available data. All of the papers range in publication date, sample sizes and specific research objectives.

Critical appraisal process and findings

Study	Appraisal Questions	Answers
Albsoul, R., FitzGerald, G., Finucane, J., & Borkoles, E. (2019). Factors influencing MISSED nursing care in public hospitals in AUSTRALIA: An exploratory mixed METHODS STUDY. The International Journal of Health Planning and Management, 34(4). Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Exploration of Missed Nursing care as a part of the nursing profession and the medical setting A convergent parallel mixed methods design, with secondary analysis Study has concluded that most prominent areas of missed nursing care include the provision of documentation, emotional support and patient ambulation
Boissy, A., Windover, A. K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R. M., Merlino, J., & Rothberg, M. B. (2016). Communication skills training for physicians improves patient satisfaction. Journal of General Internal Medicine, 31(7), 755–761. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	The impact of relationship-centered physician training on communication, patient satisfaction and physician experience. Observational Study using 1537 attending and 1951 and non attending physicians Communication skills training and a relationship-centered approach is likely to improve patient satisfaction
Burgener, A. M. (2020). Enhancing communication to improve patient safety and to increase patient satisfaction. The Health Care Manager, 39(3), 128–132. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Discussion of patient communication issues and their impact on patient safety, satisfaction, as well as some of the relevant communication protocols Descriptive research Addressing the problems of communication is crucial to enhancing patient health, wellbeing, and satisfaction. Communication can be improved through organization-wide policy and protocols
Cudmore, V., Henn, P., O’Tuathaigh, C. M., & Smith, S. (2017). Age-related hearing loss and communication breakdown in the clinical setting. JAMA Otolaryngology–Head & Neck Surgery, 143(10), 1054. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Effects of hearing loss connected with aging population on communication in hospital and primary care settings Qualitative analysis Loss of hearing has a significant negative effect on communication and must be addressed with proper hearing aid measures and tactics
Duffy, J. R., Culp, S., & Padrutt, T. (2018). Description and factors associated with missed nursing care in an acute care community hospital. JONA: The Journal of Nursing Administration, 48(7/8), 361–367. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Describe and evaluate the factors associated with missing nursing care in acute care community hospitals Cross-sectional correlational study Missing nursing care is consistent with existing data and is prevalent on medical-surgical and telemetry units
Fatima, T., Malik, S. A., & Shabbir, A. (2018). Hospital healthcare service quality, patient satisfaction and loyalty. International Journal of Quality & Reliability Management, 35(6), 1195–1214. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Analyze patient perception and attitudes towards private healthcare service providers 611 patients participated in a questionnaire survey. Descriptive statistics, common method variance, reliability, correlation and regression were used for analysis Communication, as well as other factors such as physical environment, responsiveness, safety and privacy were viewed as better in private hospitals, and enhanced patient satisfaction
Kalisch, B. (2016). Errors of omission: How missed nursing care imperils patients. Journal of Nursing Regulation, 7(3), 64. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	The impact of missed nursing care on patient safety and quality of patient care Research reports Communication between patients and nurses is inadequate, decreasing the quality of care and safety of patients
Moura, E. C., Lima, M. B., Peres, A. M., Lopez, V., Batista, M. E., & Braga, F. das. (2019). Relationship between the implementation of primary nursing model and the reduction of missed nursing care. Journal of Nursing Management, 28(8), 2103–2112. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Evaluate and predict the relationship of primary nursing model and the reduction of missed nursing care Predictive correlational study Missed nursing care and the was reduced by 78.5% with the use of nursing model
Tingle, J. (2018). Communication breakdown in healthcare settings. British Journal of Nursing, 27(20), 1204–1205. Web.	What is the research question? What is the study type (design)? What conclusions did the authors reach about the research question?	Influence of spoken communication on patient safety Descriptive research Failings in communication present a number of acute patient safety issues
Conclusion: Overall, all of the articles have been critically appraised and deemed to be sufficient for this paper

Results of findings (table and narrative format).

Relevant Questions	Findings
What is the relationship between communication breakdowns and missed nursing care?	Missed patient care as a overarching term to encompass errors in nursing care provision is in large part comprised of communication issues between the patients and nurses (Duffy et al., 2018)
How do communication breakdowns and missed nursing care impact patient safety?	The occurrence of communication breakdowns negatively impacts patient safety through the reduction of patient agency and possible creation of misunderstandings (Kalisch, 2016; Tingle, 2018)
How do communication breakdowns and missed nursing care impact patient satisfaction?	Communication breakdowns and the missed nursing care have been found to noticeably reduce patient satisfaction (Fatima et al., 2018)
What is the relationship between elderly patients and communication issues?	The elderly have been reported to suffer from an increased risk of communication breakdown, with their impaired hearing being the main reason
What are the contemporary ways of addressing nurse-patient communication problems?	Occurrence of communication issues and breakdowns, as well as missed nursing care can be addressed through relevant nurse education, training programs and effective nursing management (Moura et al., 2019, Marlow, 2017)

Discussion of findings—implications, limitations, conclusions

As it stands, most of the reviewed articles highlight the importance of communication as a facet of nursing care, as well as note it to be a major contributing factor to both satisfaction and safety of clients. In the elderly especially, poor communication can lead to worsened health outcomes and delivery of care (Cudmore et al., 2017). This work has reviewed and discussed the existing body of literature published in the recent 6 years, and surmised some of the major findings it has presented. The major limitation of this paper is the limited scope of the study, as well as the varied nature of original data. Many of the present data for different countries, impacting the focus and potential results of the review. From the conducted work, one can conclude that communication plays an extremely important role in the process of nursing healthcare, and proper strategies should be utilized to make sure the communication stays at a high level.

Conclusion

The work has analysed a number of existing articles on the topic of nursing mistakes, communication problems and missed nursing care as facets of patient care. In particular, the role of communication breakdowns on patient safety, satisfaction, and the quality of care were discussed. The research has found that all three can be negatively affected by cases of communication breakdowns, and are correlated with the quality of nurse communication (Albsoul et al., 2019). The elderly population was additionally noted to be even more susceptible to issues of communication, which presents an issue that needs to be combatted with modern intervention and improvement strategies. The application of various educational, training and regulatory frameworks was found to be effective in improving the quality of communication (Boissy et al., 2016; Burgener, 2020 ).

References

Albsoul, R., FitzGerald, G., Finucane, J., & Borkoles, E. (2019). Factors influencing MISSED nursing care in public hospitals in AUSTRALIA: An exploratory mixed METHODS STUDY. The International Journal of Health Planning and Management, 34(4). Web.

Boissy, A., Windover, A. K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R. M., Merlino, J., & Rothberg, M. B. (2016). Communication skills training for physicians improves patient satisfaction. Journal of General Internal Medicine, 31(7), 755–761. Web.

Burgener, A. M. (2020). Enhancing communication to improve patient safety and to increase patient satisfaction. The Health Care Manager, 39(3), 128–132. Web.

Cudmore, V., Henn, P., O’Tuathaigh, C. M., & Smith, S. (2017). Age-related hearing loss and communication breakdown in the clinical setting. JAMA Otolaryngology–Head & Neck Surgery, 143(10), 1054. Web.

Duffy, J. R., Culp, S., & Padrutt, T. (2018). Description and factors associated with missed nursing care in an acute care community hospital. JONA: The Journal of Nursing Administration, 48(7/8), 361–367. Web.

Fatima, T., Malik, S. A., & Shabbir, A. (2018). Hospital healthcare service quality, patient satisfaction and loyalty. International Journal of Quality & Reliability Management, 35(6), 1195–1214. Web.

Kalisch, B. (2016). Errors of omission: How missed nursing care imperils patients. Journal of Nursing Regulation, 7(3), 64. Web.

Marlow, C. (2017). Communication is key. Australian Nursing and Midwifery Journal, 24(8), 26. Web.

Moura, E. C., Lima, M. B., Peres, A. M., Lopez, V., Batista, M. E., & Braga, F. das. (2019). Relationship between the implementation of primary nursing model and the reduction of missed nursing care. Journal of Nursing Management, 28(8), 2103–2112. Web.

Tingle, J. (2018). Communication breakdown in healthcare settings. British Journal of Nursing, 27(20), 1204–1205. Web.