Medical Errors: Nursing Issue and Evidence Search

Clinical Nursing Practice Problem

The problem selected for this evaluation is connected to medical errors and adverse events, which is patient communication. This practice problem is essential for enhancing nursing work because, through communication, medical professionals receive valuable information about a patient’s state and well-being. Hence, this allows them to monitor the patient’s condition and change the treatment strategies when necessary. Also, communication is vital when explaining a diagnosis, treatment, or procedure because patients have to be aware of these factors.

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My rationale for choosing this problem is connected to the need for effectively collaborating with patients to improve their health. I recognize the fact that many conditions, for example, chronic diseases, require patients to manage their health state without assistance. Hence, I think that the ability of a health care provider to communicate with the patient has a direct impact on the disease management process.

Clinical Nursing PICOT Question

Do patients with chronic conditions (P) consulted by nurses who undergo communication training (I) compared to not implementing the intervention (C) improve their self-efficacy when managing their condition based on the PROMIS scale (O) over one month (T)?

Define PICOT Elements

P– (patient population/patients of interest): Individuals with chronic conditions

I– (Intervention): nurse training program targeting communication

C– (Comparison): no intervention

O– (Measurable outcome): PROMIS scale (Gruber-Baldini, Velozo, Romero, &Shulman, 2017)

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T– (Time frame in months): One month

Evidence Retrieval Process and Summary

Ross, J. (2018). Effective communication improves patient safety. Journal of Perianesthesia Nursing, 33(2), 223-225. Web.

While communication is identified as a safety hazard that can harm a patient’s health, it is necessary to determine the implications and severity of this issue correctly. Ross (2018) collects evidence suggesting that communication is a crucial element that predetermines patient safety. The author’s research found that only 40% of examined individuals were able to recall the provider’s diagnosis and recommendations. Moreover, Ross (2018) states that only 40% of the sample that was able to remember the information was interpreting it correctly. This article highlights an important issue in the contemporary care continuum – the need to ensure that patients understand what the provider aims to convey. Hence, this article is relevant to the chosen safety problem and the PICOT because it provides quantifiable evidence suggesting that a large number of patients experience miscommunication when being in contact with their health providers.

Gruber-Baldini, A., Velozo, C., Romero, S., & Shulman, L. (2017). Validation of the PROMIS® measures of self-efficacy for managing chronic conditions. Quality Of Life Research, 26(7), 1915-1924. Web.

The current practice does not involve assessing the patient’s readiness to manage the condition, which may result in complications and improper management. Gruber-Baldini, Velozo, Romero, and Shulman (2017) developed a scale that can help measure the efficiency of patient self-management. This is relevant to the practice problem because similar scares allow to accurately assessing whether the patient understands his or her condition, the management issues that are connected to it, the specifics of treatment, and other elements of care. It evaluates the daily activities, medications taken by an individual, social contacts, and emotions associated with a disease. Hence, this scale can be used to measure the before and after results of the PICOT intervention.

Lim, C., Berry, A., Hirsch, T., Hartzler, A., Wagner, E., Ludman, E., & Ralston, J. (2016). “It just seems outside my health.” HHS Author Manuscripts, 1172–1184. Web.

The focus of the PICOT question is the safety problem that arises as a result of miscommunication, making it necessary to evaluate why this miscommunication occurs. Lim et al. (2016) explain the issues that patients with chronic conditions experience when communicating with their providers. The authors argue that a large number of individuals choose to withhold information when talking to their health provider upon home visits. The primary motivation for this is a patient’s perception of what is essential and relevant to his or her condition. This study is proper because it helps one understand that miscommunication may arise because patients are unaware of certain health-related factors that can affect their condition. This article also highlights the need for providing additional training to nurses, which will help them uncover the missing information.

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Implications of the Evidence

The evidence provides an understanding of the value and impact that proper communication with the patient has in terms of safety and adequate care delivery. According to Ross (2018), in a healthcare setting, the interaction between the sender and the receiver has to be clear in order to achieve the set goals. This is especially relevant since, in a healthcare setting, the specifics of the environment and a need to account for multiple factors that can have an impact on a patient’s health. The measurement scale developed by Gruber-Baldini, Velozo, Romero, and Shulman (2017) allows illuminating one issue from the nursing practice, which is determining whether the patient will be able to follow the recommendations. However, more attention should be dedicated to teaching nurses how to speak with their patients, clarify some aspects, and ensure that the latter do not withhold information they view as irrelevant (Lim et al., 2016). This will help enhance the treatment process and minimize the number of complications and admissions.

The nursing committee should focus their research on this problem since, as suggested by Ross (2018), only a small percentage of individuals, more specifically less than 20%, can correctly interpret the provider’s recommendations. Additionally, the author states that 32% of the nursing malpractice claims were filed due to communication problems that, in some cases, led to patient death. This affects their ability to follow treatment and management plans, which is especially crucial for people with chronic conditions, who can experience complications or acute symptoms as a result of this issue.

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