EXAMINING THE IMPACT OF NURSES' EFFECTIVE COMMUNICATION

SKILLS ON IMPROVING PATIENT CARE

A Requirement for the Subject

Purposive Communication

By:

Kurt Steven S. Reyes

to:

Alvin Sanico, LPT

MAY 2024
 Chapter 2
Review of Related Literature

International

Providing patient care and ensuring recovery requires efficient communication between
patients and healthcare practitioners. According to Madula et al. (2015), in a study of
maternal care in Malawi, patients are happier when nurses and midwives communicate
effectively and demonstrate warmth, empathy, and respect. Some patients, however, reported
that poor communication by nurses and midwives, such as verbal abuse, disdain, or refusal to
ask questions, negatively affected their experience. Similarly, Joolaee et al. (2015)
investigated patients' perceptions of caring interactions in an Iranian hospital and concluded
that communicating effectively with nurses was more important than physical care to patients.

Healthcare systems that experience an increase of culturally and linguistically diverse patients
and practitioners need to understand language's role in creating barriers to healthcare. In
addition to contributing to the development of policy and practical solutions for
communication training, the study will provide an agenda for future research and extend
theoretical understanding of health communication (Meuter et al., 2015). Nursing students are
empowered to develop clinical competencies and socialize in the nursing profession through
clinical learning objectives. Clinical environments, also known as clinical pathways, are
complex and dynamic learning environments (Lancaster, G., Kolakowsky‐Hayner, S.,
Kovacich, J., & Greer‐Williams, N. (2015).

Miscommunication in the healthcare sector can be life-threatening, according to Meuter et al.

(2015). Healthcare practitioners and patients who speak a second language are more likely to
make communication errors when one or both are migrant patients and foreign-trained staff.
There is, however, a need for a more comprehensive study on this topic. This protocol
describes the rules of a hospital-based study that looks at the interactions between medical
professionals and patients who don't speak the same language as them. According to the
report, doctors, nurses, and UAPs often work independently as healthcare professionals who
hardly communicate with one another. Doctors consider themselves the main decision-makers
when it comes to patient care. A significant number of doctors recognize the value of nurses'
skills and knowledge (Lancaster et al., 2015b).

Additionally, according to Van Bogaert et al. (2015), nurse managers were discovered to be
mindful of and to have positive sentiments toward the hospital's structural empowerment of
clinical nurses. They attested to the beneficial effects of empowerment on their staff nurses, as
demonstrated by their increased accountability, independence, capacity for critical thought,
and improved communication abilities, all of which raised the standard and safety of patient
care. At the unit and hospital levels, several transformation efforts were supporting structural
empowerment.

Thus, it is essential to comprehend language in the context of a medical interaction to

comprehend potential issues that may arise when patients and healthcare professionals do not
speak the same first language. The purpose of this study is to investigate these possible
obstacles in a variety of hospital in-patient and out-patient departments within an authentic
healthcare communication context (Meuter et al., 2015b). A preliminary conclusion that
simulation-based learning using SPs may help with information acquisition, communication
skills, self-efficacy, learning motivation, and clinical skill development may be drawn despite
several limitations in the study (Oh et al., 2015).

A patient's care is delivered in part by nurses, physicians, and UAPs; thus, coordination
between the different treatments and interventions is essential to avoiding mistakes and care
fragmentation. Divergent viewpoints and interests can give rise to tensions,
miscommunications, and conflicts that might inhibit successful multidisciplinary
communication and cooperation. Enhancing hospital patient safety necessitates tackling the
existing hierarchical professional structure that is a fundamental feature of healthcare
provision. According to Lancaster et al. (2015c), a hospital patient care model based on the
conductorless orchestra model will reduce hierarchy, acknowledge the contributions of
doctors, nurses, and UAP to care, encourage better communication and teamwork, and
increase patient safety.

Accurately conveying the possibility of the related risk factors is essential when discussing
the specifics of a diagnosis or therapy. Negative outcomes may result from improperly
communicating the severity of the risk, such as patients disobeying orders or refusing
potentially life-saving therapy. While a great deal of literature has been written about risk
communication in healthcare settings between patients and medical professionals, the
majority of this study has concentrated on language-congruent scenarios (Meuter et al.,
2015d).

Patient outcomes are significantly impacted by the nurses' and patients' communication
quality during contact. A thorough grasp of the components of effective communication is
beneficial to assist the development of effective nurse communication in clinical practice
(O'Hagan et al., 2015). Effective nursing communication skills are essential to patient care
because nurses play a crucial role in satisfying patients' communication requirements
(Candlin & Candlin 2015). A solid understanding of nurse-patient communication is
necessary to assist in the development of good communication skills in nurses. From the
viewpoints of nurse educators and clinicians, this paper explores what constitutes good
communication (O'Hagan et al., 2015).

Patient perspectives are a necessary component of measures of communicative effectiveness,

particularly concerning interpersonal aspects of interaction (O’Hagan et al., 2015). Patients
may be worried about their treatment outcomes and their experience of having a medical or
surgical condition requiring hospitalization can mean that patients are not fully attuned to how
health professionals communicate with them. The nurse perspective on effective
communication has not been observed to be subject to the same kinds of limitations as the
patient perspective (including the influence of patients' particular health circumstances)
(’Hagan et al., 2015b).

The nursing profession emphasizes the importance of communication skills, as highlighted in

a study by Nikmanesh et al. (2018). This study aimed to examine the impact of
communication skills training for nurses on patients' satisfaction with nursing staff in teaching
hospitals. Effective communication with patients is crucial for providing quality care.
However, research has shown that nurses often struggle in this area. Recognizing this issue,
Heidari et al. (2015) conducted a study to enhance communication skills in nursing care
education programs.

According to Boykins (2019), effective communication in healthcare requires a dynamic

dialogue between patients and caregivers. This involves active participation from both parties,
including speaking, listening without interruption, asking questions for clarification,
expressing individual perspectives, sharing relevant information, and striving to understand
each other's intentions. Furthermore, Henly (2016) emphasized the importance of effective
communication in clinical settings. He highlighted the significance of health communication
due to its impact on quality of life. Henly noted that discussing health concerns with
healthcare providers can be difficult given the sensitive nature of these issues. He also
stressed the essential role of patient-centered communication in promoting optimal health
outcomes, aligning with nursing principles that emphasize personalized and empathetic care
for patients.
The importance of effective communication in nurse-patient interactions cannot be overstated.
Research has shown that communication plays a vital role in ensuring accurate patient
information and openness. When nurses communicate respectfully with patients, it can reduce
confusion, increase patient involvement in decision-making, improve adherence to treatment
plans, and enhance overall satisfaction with care. Therefore, strong communication between
nurses and patients is essential for providing patient-centered care.(Kwame & Petrucka,
2021).

According to Burgener (2020), healthcare organizations must prioritize enhancing effective

communication to mitigate the escalating occurrence of sentinel and adverse events. This will
not only enhance patient safety and experience but also improve the organization's financial
performance. The article explores different communication protocols that can be employed to
promote consistent and efficient communication within healthcare organizations, leading to
better patient care and satisfaction. The Centers for Medicare and Medicaid Services'
emphasis on patient satisfaction and Hospital Consumer Assessment of Healthcare Providers
and Systems ratings is driving hospitals to reevaluate and manage their healthcare
organizations differently.

National

International students have been enrolling in more programs in the Philippines, particularly in
the medical and nursing fields. Students enrolled in this program were required to complete a
clinical rotation during which they were expected to communicate well with patients. The
purpose of this study is to investigate how nursing students who do not speak Tagalog interact
with Filipino patients as nurses. In this study, a qualitative approach was used. Thirteen
respondents who were chosen using the purposive sample approach were asked three
questions in a semi-structured interview. Six general informants, or the perspectives of
Filipino nursing students, and seven primary informants, or non-Tagalog speaking nursing
students, were included in this study. (Yunita et al., 2019).

In the study of Yunita et al., (2019). For patients to experience receiving or providing care,
interactions between them and nurses are essential (Seiger, Ertyl-Schmuck, & Harking, 2010).
It is well known that effective communication is essential for creating a therapeutic
patient-nurse connection (Nordby, 2007). To acquire more clinical skills, foreign nursing
students must be linguistically and culturally competent if adequate communication and
engagement can positively impact students' learning in a clinical setting, particularly when the
trainee is a foreign student (Komaratat & Oumtanee, 2009).

Effective patient communication during practical learning is one anticipated difficulty that
foreign nursing students in the Philippines encounter (Wa-mbaleka & Appiah, 2015). This
indicates to us that communication is essential in all relationships, and the nurse-patient
connection is no exception. This study aims to investigate how foreign nursing students
engage and communicate with patients who speak Filipino as their first language (Yunita et
al., 2019).
This study assessed the therapeutic communication abilities of the medical and surgical nurses
at the Philippine Public Hospital, according to Publishers (2020). A targeted and descriptive
research approach was adopted in this investigation. It made use of observational and survey
techniques. To characterize the respondent's profile and the degree of therapeutic
communication abilities, the researcher employed a questionnaire that she had created.
Frequency counts, means, weighted means, and ranks were used. It demonstrates the
hospital's nurses' proficiency in therapeutic communication techniques, including the
Acting-Response Technique and Active Listening Response technique. showed that the acting
response and acting listening-response approaches addressing the stand, open, lean forward,
make eye contact, and relax were not substantially connected with age, gender, ethnic group,
the original language spoken, religion, or level of education.

To support the client's recovery from disease, the nurse focuses on the client's unique
requirements during therapeutic communication, which is a type of interpersonal connection.
It includes sharing ideas and expressing sentiments, emotions, and attitudes as well as
successfully focusing and following, asking insightful questions, reflecting on thoughts and
material, and organizing conversation to get information and take action. Publishers, (n.d).
Three reaction kinds are crucial to therapeutic communication: sharing, acting, and listening.
Every kind of answer consists of many spoken strategies. For instance, nurses often employ
five listening strategies under the listening-type response category: paraphrasing, reflection,
clarification, primary-level empathy, and summarizing to assist in constructively influencing
the discussion (Balzer, 2000).

According to research by Delicanova et al. (2016), one of a person's essential requirements is

communication. There is little question that effective nursing practice necessitates ongoing
communication between the nurse and the patient. The study's objective was to ascertain
post-mechanical ventilation patients' communication experiences, preferences, and levels of
satisfaction.

Regardless of their medical condition or the length of their mechanical ventilator therapy,
participants experienced physical, spiritual, and emotional issues as well as communication
difficulties between nurses and patients while on mechanical ventilation. The majority of
nurse-patient communication was brief, direct, and nurse-initiated. Nurse-patient
communication was primarily focused on patient health evaluation, need identification, and
health education. Depending on their goals, each participant created a unique nonverbal
communication style (Delicana et al., 2016).

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