Award Date

5-1-2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Committee Member

Catherine Dingley

Second Committee Member

Rebecca Benfield

Third Committee Member

Lori Candela

Fourth Committee Member

Jennifer Guthrie

Number of Pages

128

Abstract

Introduction Nurse handoff reporting is a crucial time for communication exchange in healthcare settings. During the handoff report, patient information is exchanged between senders and receivers transferring responsibility for care with the main purpose of providing accurate and timely information about the patient. The Joint Commission reports that shortcomings related to communication can be directly related to an increase in patient care errors, with approximately 80% of medical errors resulting from miscommunication during the handoff process. Numerous intervention studies focus on standardizing information, developing physical locations and environments for ideal handoffs, and creating tools for structured information exchange between different types of healthcare professionals. Despite the implementation of a variety of interventions, errors related to handoff communication remain high. In addition, though communication quality and competence are key elements of effective work processes in complex settings such as acute care hospitals, there is a paucity of research focused on nurses’ information exchange and socioemotional behaviors related to the quality of handoff communications. The purpose of this descriptive correlational study was to explore nurse perspectives of the same handoff event using the nurse communication competence model which includes both information exchange and socioemotional behaviors.

Methods Using a cross-sectional descriptive correlational design employing dyadic perspective, 57 nursing handoffs (N = 114) on general medical surgical units was examined from the real time perspective of the incoming and outgoing nurse. Using the Nurse Communication Competence Scale, each nurse rated themselves and the other nurse involved in the handoff event on information giving, receiving, verifying and socioemotional communication behaviors. This study examined the relationship between communication competence, quality of handoff reporting, nursing role (incoming versus outgoing) and type of rating (self versus counterpart).

Results Mean differences existed between incoming and outgoing nurse ratings of information exchange and socioemotional behaviors. Outgoing nurses rated their own information giving behaviors higher, opposed to the rating they received from the incoming nurse (p = 0.00). Outgoing nurses rated information seeking behaviors of the incoming nurse higher than the self-rating from the incoming nurse (p = 0.04). In addition, outgoing nurses also rated their own information seeking behaviors as higher than the rating given to them by the incoming nurse (p = 0.01). Furthermore, outgoing nurses rated their own socioemotional behaviors higher than the rating given to them by the incoming nurse (p = 0.02). The outgoing nurses also provided higher ratings of incoming nurses’ socioemotional behaviors versus the self-rating provided by the incoming nurse (p = 0.01). Outgoing nurses also found the overall quality of the handoff report was higher than the rating provided by the incoming nurse (p = 0.01). Finally, we determined a positive relationship exists between the incoming nurse’s perception of the overall quality of handoff report and the degree of information giving behaviors of the outgoing nurse (p = 0.00) as well as the incoming nurse’s perception of the overall handoff quality and their own socioemotional behaviors (p = 0.02).

Discussion Different perceptions of communication competence associated with high quality handoff reporting exists between incoming and outgoing nurses. The findings of this study have considerable implications for nursing practice, research and education. Our study used a complete model of communication competence including information exchange and socioemotional behaviors, which revealed the need to further study handoff communication beyond standardization. Including relational components of communication and focusing on the needs of each nursing role (incoming versus outgoing) increases the quality of handoff reporting lending to communication that supports patient safety.

Keywords

Communication competence; Handoff reporting; Information exchange; Interpersonal communication; Nurse; Socioemotional behaviors

Disciplines

Communication | Nursing

Language

English

Available for download on Friday, May 15, 2020


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