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Bedside sitting improves patient–nurse communication
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Sitting at the bedside of patients with cancer improved patient–nurse communication, according to the results of a study presented at the Oncology Nursing Society Annual Congress.
Patients’ experiences, including their interactions with nurses, can lead to improvements in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Thus, nurses can have a direct impact on medical reimbursement, according to Lyn Zehner, MN, RN, AOCN, AOCNS, oncology nurse at Inova Alexandria Hospital in Alexandria, Virginia, and colleagues.
Lyn Zehner
“With a goal of implementing evidence-based practice, we assembled and implemented strategies to improve patient communication by sitting at the bedside with the focus being on the patient experience,” Zehner told HemOnc Today.
Zehner and colleagues sought to improve HCAHPS scores in the “communication with nurses” dimension by developing high-impact communication strategies between nurses and patients.
Based on a literature review of communication strategies, researchers developed interventions that included sitting at the bedside, use of body language and attention to eye contact that were then implemented on a 29-bed medical oncology unit. The staff received training and participated in role-playing exercises to implement these strategies.
Zehner and colleagues surveyed nurses and clinical technicians during the process to examine the effectiveness and practicality of the strategies.
Eighty-nine percent of patient visits involved bedside sitting.
The majority of RNs (94%) and clinical technicians (78%) reported being comfortable sitting at the bedside. Reasons for feeling uncomfortable included too many visitors, heavy patient load, and having a patient in isolation.
RNs and clinical technicians may also have felt uncomfortable due to cultural reasons, Zehner said.
“Some of the staff may have thought sitting at the bedside would be disrespectful to the patient or even that sitting down would have been looked down upon by their superiors,” she said. “We assured staff that bedside sitting was encouraged because it was certainly a change in behavior.”
Implementation of the new strategies led to an improved nurse communication HCAHPS score, increasing from 72% for the first quarter of 2015 to 88% for the third quarter of 2015. Other improved domains included pain management (61% vs. 84.6%), communication about medication (55% vs. 73%) and overall rating (54% vs. 71%).
“Relevant literature shows that when nurses sit at the bedside, patients tend to think that nurse is with them for a longer time than they are, and patients responded well, which is consistent with literature—making a connection with the patient improves patient outcomes,” Zehner said. – by Nick Andrews
Reference:
Zehner L, et al. Implementing an evidence-based practice approach to improve perception of nurse–patient communication at the bedside. Presented at: Oncology Nursing Society Annual Congress; April 28-May 1, 2016; San Antonio, Texas.
Disclos ure: The researchers report no relevant financial disclosures.