HCAHPS- Nurse communication

klone, MSN, RN · Sep 4, 2015

AIDET

SummerGarden, BSN, MSN, RN · Sep 4, 2015

OP, it reads like your unit is implementing very good communication tactics. However, when you perform your management rounds (I am not talking about your rounds with IDT or with the nurses who perform bedside report), do you ask the patients directly how he/she is doing and if he/she has any concerns? Most of the time if I ask these two questions (although I am sure there are others I can ask) and I get an ear-full from the patients who do not think communication is going well on the unit. Being able to address his/her concerns in real-time, I think, will help your communication scores. Also, if your nurses are not providing hand-off by the bedside yet, you may want to look into doing that was well. Most patients find it helpful.

By the way, check back in and let us know how it goes. If you implement anything different and it works, we want to know that too. Good luck! :)

icuRNmaggie, BSN, RN · Sep 4, 2015

We dont know what goes on in your unit so you need to survey your staff in order to identify and fix the root causes.

1.What are the barriers that make it difficult to communicate well with the patients?

2. Are call bells answered promptly? Why not?

3. Do you explain medications and procedures thoroughly to your patients? What are the barriers to providing patient

medication preop and illness

teaching?

4. Have you ever observed a nursing coworker speak to a

patient with less than courtesy and respect? Describe what happened and how to prevent

this from happening again.

A nursing manager should have a brief conversation with each pt daily and ask "how are you finding are services" and promptly address any deficiencies as well as share any complementary comments.

icuRNmaggie, BSN, RN · Sep 4, 2015

Also ask your patients.

Banner Del Webb gives each pt a comment card in the morning and collects them each night at 11pm.

Compliments are posted behind the nurses station.

My family member wrote detailed notes of thanks to the staff every evening.

If there is a problem, a patient

should have several avenues he can use to express concerns about areas that need to improve.

The slow wifi, cold coffee, noisy

AC, rude XR tech or delay in

receiving codeine cough syrup

from the pharmacy are all out of

the nurses control yet it is the nurse who is blamed for "poor

service."

Nurse managers should take ownership for good communication as well and provide a number and email for direct communication in order to address your patients concerns in a timely manner.

Floridarn07 · Sep 7, 2015

I like the comment idea. I have a large unit and leadership rounds on every patient at which time we ask about care, if they have been offered a bath, change of sheets, we audit the communication board and question the patient to see if they are aware of their plan of care. If we get any complaints we address them right away.

I definitely take ownership for nurse communication; give a card to every patient with my cell phone on it as well as my e-mail.

Thought maybe someone had an idea we were not currently trying.

Floridarn07 · Sep 7, 2015

We dont know what goes on in your unit so you need to survey your staff in order to identify and fix the root causes.
1.What are the barriers that make it difficult to communicate well with the patients?
According to the staff they are communicating and when I round the patients are aware of their care and do not have many complaints. If I do have a complaint I immediately address it.
2. Are call bells answered promptly? Why not?
We monitor call bells daily and I post on a communication board at the nurses station the average length of time it takes to answer a light. The longest time it takes in a 12 hour shift. The amount of calls, average calls per patient, and the amount of time spent on answering call lights per 12 hour shift.
I break it up between night and day shift .Adds a little friendly competition to the mix.
By using these reports and bringing it to the staffs' attention the numbers have gone from an average of 300 calls per shift to less than 200. Usually an average of 3-4 calls per patient in a 12 hour shift.
3. Do you explain medications and procedures thoroughly to your patients? What are the barriers to providing patient
medication preop and illness
teaching?
This is actually the next step I was thinking of taking on. Via monitoring some med passes.
4. Have you ever observed a nursing coworker speak to a
patient with less than courtesy and respect? Describe what happened and how to prevent
this from happening again.
A nursing manager should have a brief conversation with each pt daily and ask "how are you finding are services" and promptly address any deficiencies as well as share any complementary comments.

jrt4 · Sep 8, 2015

It sounds like you are doing a lot of great things already. Have you taken the opportunity to evaluate your current processes to make sure that it is actually happening consistently. I find with my patients consistency is the key. Nurse A sees me every hour but Nurse B only comes in every couple of hours. Its not that nurse B is doing a bad job its just inconsistent to what the expectation was set out to be. I find its often the small things that patients do not mention that are having the biggest impact on scores. Just a thought!