Document Type

Report

Publication Date

Spring 2024

Date of Final Presentation

4-4-2024

Committee Chair

Cara Gallegos, PhD, RN

Committee Member

Rosanna Moreno, DNP, RN, MNBA, CPPS, FACHE

Coordinator/ Chair of DNP Program

April Howell, DNP, RN

Abstract/ Executive Summary

Problem Description: In 2020, the coronavirus (COVID-19) impacted the world, changing the landscape of the nursing profession. The pandemic changed societal norms to reduce transmission and death rates by instituting social distancing requirements, stay-at-home policies, and mask mandates. Hospitals enacted crisis standards of care, changed orientation and training practices, and restricted family visitation policies. In addition, nursing programs temporarily halted in-person clinical training experiences and transitioned to online learning. These were challenging times to enter the nursing profession. The pandemic worsened the nursing shortage, contributing to burnout, turnover, and increased use of agency or travel nurses, resulting in a loss of institutional knowledge, and changing the landscape of nursing team culture. The departure of experienced nurses with exceptional clinical expertise and interpersonal skills is detrimental to the quality of care. Managing difficult situations with empathy and compassion is critical to patient care. Retaining skilled nurses is essential to maintaining high standards of care and ensuring positive patient outcomes. Communication skills are paramount in any care environment. Effective communication skills are essential for nurses to build rapport and partnerships with patients and families while navigating competing priorities in a high-stakes environment. Communication breakdowns can lead to errors and significant patient harm, impacting patient outcomes, quality of care, and patient and family experience.

Setting: At a pediatric hospital on the west coast.

Rationale: The Relationship-Based Care ® (RBC) model is the theoretical framework that puts the patient and family in the center of care while prioritizing the uniqueness of each patient and family's needs. This model emphasizes the importance of compassion and kindness when developing authentic connections or therapeutic relationships with patients and families because the relationship impacts trust and shared decision-making. Nurses are pivotal in cultivating a therapeutic relationship when families experience physiological and psychosocial challenges during hospitalization or management of chronic illness. Families notice a variation of nurse skill and experience levels; each encounter between a family and a nurse can swing the pendulum into a good or bad experience. Often, this is related to communication. A poor interaction for families, for instance, when a family does not feel heard or thinks a nurse is rude, can lead to mistrust and significantly affect the quality of care and patient outcomes. The art of pediatric nursing is building rapport and having exceptional communication skills to cultivate therapeutic patient and family-centered care partnerships.

Specific Aims: This quality improvement (QI) project examines the impact of providing evidence-based communication training and best practices of patient and family-centered care (PFCC) to increase nurses’ knowledge and confidence, building rapport and collaborative patient and family partnerships.

Project Outcomes: Develop and facilitate a one-hour training using an evidence-based communication framework and best practices of PFCC and develop PFCC guidelines of care.

Implementation and Evaluation Plan: An email advertisement recruited nurse participants from an inpatient oncology unit, nurses working in direct patient care, and by word of mouth. Participants attended a virtual one-hour continuing education and completed a pre- and post-survey. Demographic characteristics and survey responses were collected anonymously and summarized using descriptive statistics.

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