How 3 health systems promote nurse civility

The Joint Commission is working to change the way unprofessional issues are communicated between nurses using a report system and trained peer messengers.

A study, published in The Joint Commission Journal on Quality and Patient Safety, evaluated the feasibility and fidelity of a reporting system called Co-Worker Observation System (CORS) to address disrespectful behavior among staff nurses. CORS has been previously used among physicians and advanced practice providers, according to the Jan. 3 release from The Joint Commission.

CORS was implemented at three academic medical centers — Keck Medicine of the University of Southern California in Los Angeles, University of Iowa Health Care in Iowa City and Vanderbilt University Medical Center in Nashville, Tenn. — and received reports from Sept. 1 2019, to Aug. 21, 2021. A total of 590 reports of unprofessional behavior were submitted across the three organizations. Each report was screened through natural language processing software and referred to a trained peer messenger to share the observations with the nurse.

Most reports included more than one instance of unprofessional behavior, totaling 1,387 instances:

  • Clear and respectful communication — 48.8 percent

  • Responsibility — 33.3 percent

  • Appropriate medical care — 6.8 percent

  • Professional integrity — 5.9 percent

  • Report of concern/possibly egregious — 5.2 percent 

Researchers said the study shows CORS can be implemented with staff nurses when there is adequate nursing infrastructure.

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