Master's Theses

Date of Award

Fall 2007

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Advisor

Dr. Carol Moore

Abstract

Recent disclosure of the high number of avoidable patient deaths of hospitalized patients has focused attention on patient safety and stimulated exploration of processes to improve patient care. It has been shown that poor communication and physician verbal abuse contribute to preventable adverse events. Historically, little attention has been given to developing collaborative behaviors and effective communication skills in either medical or nursing education. Actions that create desirable change in patterns of communication, increase collaboration, and decrease intimidation in the work place are needed. The outcomes of this study could demonstrate the viability of an intervention that uses a communication technique to enhance professional collaboration between nurses and physicians. Advancing collaboration and focusing on achieving desired patient outcomes via skilled communication is an essential part of providing quality evidence based care. This proactive approach has the potential to not only improve collaboration between the professions but also improve patient safety. For this investigation, King’s Interacting Systems Framework and Theory of Goal Attainment were applied to the communication between nurse and physician. The purpose of this investigation was to examine whether a communication intervention would produce a significant difference in nurse participants' perceived level of nurse physician collaboration, and if the intervention would produce a significant difference in the occurrences of verbal abuse experienced by nurses. A quasi-experimental, pretest-posttest design was utilized with a convenience sample of nurses from one mid-west hospital who met the inclusion criteria. Informed consent was documented by the voluntary return of anonymously completed study instruments. The intervention was the Situation, Background, Assessment, and Recommendation (SBAR) method of communication for reporting critical information. The study instruments consisted of the Communication and Problem-solving subscales of the ICU Nurse-Physician Questionnaire and the Verbal Abuse Scale. Statistical analysis was performed using paired, two-tailed t-tests. The results of this investigation demonstrated no statistically significant increase on the dependent variable of nurses' perceptions of collaboration with physicians after instruction in the SBAR communication technique. Use of the SBAR technique did produce a statistically significant difference on the dependent variables of the frequency of verbal abuse and the perceived severity of the abuse by the nurse participants. This investigation was a first step in determining if use of the SBAR communication technique would enhance collaboration and foster respectful communication between nurses and physicians.

Rights

Copyright 2007 Barbara J. Starks

Comments

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