Nurses, docs need to improve communication, ISU survey finds

By: ISU Communications and Marketing Staff, ISU Communications and Marketing Staff
October 13, 2010

Health care providers and administrators in western Indiana hospitals and nursing homes say they need to improve communication with one another and with patients.

They also see a need to brush up on clinical skills, especially for managing patient care during a crisis or event such as a seizure, a "code blue" or a psychiatric emergency.

Those are some of the major findings from an Indiana State University survey of more than 300 nurses and administrators. Respondents represent all 10 hospitals and 30 of 35 long term care facilities in 11 largely rural counties.

"Healthcare staff and administration reported that they perceived a need for more professional communication and teamwork, both among and between nurses and also between nurses and physicians. Recent studies have shown that if you're not communicating clearly and effectively, you are likely to make more mistakes," said Roseanne Fairchild, assistant professor of nursing at Indiana State and lead researcher on the survey.

The research was done to help guide continuing education programs offered through collaboration between ISU's continuing nursing education program and the West-Central Indiana Area Health Education Center.

Two out of three respondents said nurses need to enhance teamwork and relationships with co-workers and engage in lifelong learning while 58 percent identified a need for improved communications skills and to serve as stronger advocates for patients and families.

Staff communication is a frequent issue in similar surveys nationwide, Fairchild said, but the clinical skills issue was "a bit of a surprise." However, it is one the Area Health Education Center and partner institutions Indiana State, Ivy Tech Community College and Union Hospital can help address, she said.

Louise Anderson, director of the Area Health Education Center, said research also shows communication may be hampered by a misunderstanding of the role and scope of practice of the variety of persons involved in patient care.

"Much of that starts at the student level where teaching takes place in silos; students in medicine, nursing, radiology technology, respiratory therapy, social work, etc. learn with their peers but when they get into a patient care setting, they must work in teams to care for the same patients," Anderson said. "To assist in solving that problem, more inter-professional education needs to be done both at the student and professional levels."

An interdisciplinary learning day for senior nursing students, third-year medical students and students in allied health fields is scheduled for Nov. 19 at the Landsbaum Center for Health Education in Terre Haute.

Improving communications is essential - especially when teaching "self care" practices for rural patients who may live many miles from a health care facility, and for those with chronic illnesses, Fairchild said.

"Several nurse administrators also expressed a need to return to the ‘caring ethic', a concept considered to be the hallmark of the nursing profession. This tells me that we need to find ways to bring nurses back to community- and patient-centered care," she said.

Fairchild said expanded use of electronic healthcare records can save time and free nurses from paperwork so they can concentrate more on care and providing patients and families with instructions for follow-up care at home. However, there is a learning curve to using new technology, so this may, at first, pull providers away from the bedside as they learn to use new electronic documentation systems.

Fairchild has submitted the survey results to support an application for an $870,000 grant from the Agency for Healthcare Research and Quality. The grant would provide financial support for staff-driven quality initiatives in rural hospitals in the region, and allow development of continuing education programs for rural healthcare providers based on the needs assessment study results.

Indiana State University and Union Hospital's Richard G. Lugar Center for Rural Health are partners in the Rural Health Innovation Collaborative, which seeks to build on Terre Haute's reputation as a leader in education and delivery of health care to meet the unique needs of rural residents.

"We want to start an excellent program of rural health research at Indiana State and the Lugar Center," Fairchild said.

The initial goal is to adopt "Transforming Care at the Bedside," a patient-care quality delivery model developed by the Robert Wood Johnson Foundation, to serve as a national model for smaller, lower volume rural hospitals, Fairchild said.

Other continuing education needs identified by survey respondents:
• Drug therapy/drug interactions - 76 percent
• Assessing patients' physical status - 69 percent
• Medication administration - 68 percent
• Treating cardiovascular problems - 68 percent
• Engage in lifelong learning - 67 percent
• Meeting standards of patient care in facilities - 66 percent
• Treating diabetes - 65 percent
• Treating infectious diseases - 64 percent
• Maintaining patient safety - 63 percent
• Treating pulmonary problems - 63 percent
• Managing multiple chronic illnesses - 61 percent
• Protecting patients' rights - 61 percent
• Assessing patients' mental status - 58 percent
• Advocate for patients and families - 58 percent

Photo: http://isuphoto.smugmug.com/photos/1046275327_oAHxT-L.jpg - Roseanne Fairchild, assistant professor of nursing at Indiana State University, presented findings from a survey of the continuing education needs of health care professionals in 11 most rural counties of western Indiana. (ISU/Tony campbell)

Contact: Roseanne Fairchild, assistant professor, advanced practice nursing, College of Nursing, Health, and Human Services, Indiana State University, roseanne.fairchild@indstate.edu

Writer: Dave Taylor, media relations director, Office of Communications and Marketing, 812-237-3743 or dave.taylor@indstate.edu