4 tips for improving communication and helping nurses get back to the patient's bedside

Nurses are one of the most important assets to a hospital. They can reduce the likelihood of falls, infections and medication errors, and improve patient satisfaction. That said, the more hospitals can do to keep nurses at the patient's bedside, the better.

Studies have shown nurses may spend as little as two hours of a 12-hour shift on direct patient care. Other studies have found nurses face numerous interruptions while caring for patients, increasing the likelihood of procedural failures by 12 percent and clinical failures by 13 percent.

Frequently, nurses are busy paging physicians, copying and faxing documents, tracking down test results, searching for supplies, completing paperwork and a whole variety of other tasks, according to Molly Gamble, Editor-in-Chief of Becker's Hospital Review.

"Nurses are very, very busy and they work really hard, but many hospitals are realizing their nurses are not spending enough time with patients, and this is problematic because that's the time that matters the most," said Ms. Gamble.

To combat this problem, many clinicians try to streamline the communication processes, even if it's not always through channels that are up to regulation standards. For instance, 96 percent of physicians with smartphones use unsecure SMS to communicate about patient care and, while 89 percent of hospitals do not allow nurses to use their personal smartphones, 67 percent do anyway.

In a recent webinar, Rhonda Collins, RN, CNO for Vocera Communications, highlighted one of the goals of communication, saying, "The vision is that communication doesn't start with a device or technology platform; it starts with the patient. Likewise, caregivers all have to be talking to each other in a secure, seamless environment."

Mary Beth Mitchell, RN, CNIO for Arlington-based Texas Health Resources, outlined four tactics hospitals should employ to bring the communication pieces together so nurses can spend more time at patients' bedsides.

1. Establish a clear strategy for communication. For instance, THR created a unified communication program to eliminate subpar workflows, examine the best communication strategies and practices and hardwire those across the system's hospitals and facilities.

2. Transition from a person-specific to a role-specific method of communication. Sometimes it is difficult to leave a contact or callback for a specific person since that can change with breaks and shift changes and whatnot. Having contacts based on hospital roles instead of people could improve communication.

3. Maintain flexibility when managing escalations, changes in staff and emergencies. Things can change in the blink of an eye at a hospital and someone who was acting as a contact may become unavailable at a moment's notice. There should be a system in place to make sure messages from either patients or clinicians are continuously passed up the hierarchy until the matter is addressed to avoid having messages fall through the cracks.

4. Have the ability to integrate various technologies. In a hospital's communication plan, managing various kinds of technologies — including wireless nurse badges, smartphones, shared devices with secure messaging and EHRs — is an important issue to address.

"If we have a strategy and we have the right tools and way to communicate, we can conquer this beast and really make a difference and show good outcomes," said Ms. Mitchell.



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