As the medical industry continues to emphasize patient satisfaction and positive care experiences, organization leaders must understand the role different clinicians play in achieving that end. For the amount of time they spend at the patient bedside, nurses are essential in the journey to better care quality and experiences.
Between delivering care, communicating with patients and family caregivers, and taking care of patient needs that are not directly tied to treatment such as hygiene or toileting, nurses spend about two hours and 25 minutes with their patients per each nine-hour shift, some reports show.
During that time, nurses have a heavy influence on the patient experience. Between nurse communication skills and efforts to drive patient safety and quality care, the patient encounter can hinge entirely on nursing skill.
Below, PatientEngagementHIT.com explores nursing care and the various elements that can have an impact on the patient experience of care.
USING COMMUNICATION SKILLS TO DRIVE PATIENT SATISFACTION
Nurses’ greatest power in improving the patient experience lay in their ability to effectively and empathically communicate with patients. Nurses, who of all clinicians spend the most time with patients, are key to delivering quality patient education while assuaging patient concerns and keeping their fears at bay.
READ MORE: How Nurse Working Conditions Impact the Patient Experience
This begins with rapport-building, nursing experts agree. Nurses who get to know their patients on a personal level are more successful at improving patient satisfaction.
But making that connection is much easier said than done, experts acknowledge. Nurses are in charge of much more than just patient interactions, making it challenging for them to also forge personal relationships with everyone they treat.
“When I talk about making a connection with patients and the six themes of compassionate, connected care, nobody ever argues against it,” said Christy Dempsey, MSN, CNOR, CENP, and the chief nursing officer at Press Ganey said in an interview with PatientEngagementHIT.com. “Everybody wants to do that. The pushback is always not having the time. Nurses say, ‘you must be joking if you think I can spend 15 to 20 minutes with every patient.’”
Building personal relationships with patients doesn’t need to take that long, Dempsey contended. Making a deep connection with a patient usually takes her about one or two minutes, she said, outlining her strategy for communicating with patients.
“In truth, there aren’t even six degrees of separation between us,” she said.
READ MORE: How Digitized Nurse Leader Rounding Can Improve HCAHPS Scores
Dempsey leans on those commonalities to make the patient connection. Perhaps a patient has a shared love of running, or has children the same age as hers. Dempsey uses this information to relate to the patient, making the patient feel more comfortable during the care encounter.
“We can always find something in common that will make a personal interaction. And when I’m ready to wrap up that interaction, I always conclude with that connection.”
Nurse communication is about more than connecting with patients. Nurses are also largely charged with patient education, ensuring that the patient understands her health as well as her care management protocol.
Nurses can lean on patient teach-back, educational technologies, or handout materials to enhance their educational efforts.
UNDERSCORING THE NURSE ROLE IN PATIENT SAFETY, CARE QUALITY
Nurses are also instrumental in protecting patient safety, which is a critical component of patient satisfaction.
“Of all the members of the health care team, nurses therefore play a critically important role in ensuring patient safety by monitoring patients for clinical deterioration, detecting errors and near misses, understanding care processes and weaknesses inherent in some systems, and performing countless other tasks to ensure patients receive high-quality care,” the Agency for Healthcare Research and Quality (AHRQ) says on its website.
Attentive nurses who conduct regular rounding have a positive impact on patient satisfaction scores, data and anecdotal evidence show.
A 2016 study published in the JBI Database of Systematic Reviews and Implementation Reports noted that a timely nurse rounding protocol can improve patient safety outcomes. A rounding protocol reduced patient falls by 50 percent, while patient reports of pain management improved by 11 percent.
Nurse rounding is successful because it gives patients a chance to ask for help when they otherwise may not have. In the above-mentioned study, patient fall rates may have fallen because nurses were able to accompany patients to the bathroom or retrieve an item from across the room, when the patient may have otherwise gone without help.
“Patients don't always know how to get help for some of these things that the nurse leaders can take care of immediately and triage to the right place to get things fixed,” according to Kelly Johnson, PhD, RN, NEA-BC, chief nursing officer at Stanford Children’s Health, which has a comprehensive patient rounding system.
“It gives them, the patients, permission to note things that aren’t exactly like they’d like them and makes them feel better if they can get things the way that they want them delivered,” Johnson said in an interview.
TYING TOGETHER NURSE AND PATIENT EXPERIENCES
In order for nurses to deliver on these key care quality roles, they must have the proper supports.
Data has confirmed that positive working environments has an impact on patient experience scores.
A 2019 study from Penn Nursing revealed that nurse satisfaction and working conditions can impact patient care quality, including safety and satisfaction.
A literature review of 17 journal articles with 16 years’ worth of data about nurse working conditions revealed a link between four key care quality outcomes. Investigators looked at nurse job outcomes, nurse assessments of quality and safety, patient health outcomes, and patient satisfaction.
Data from over 2,600 hospitals, 165,000 nurses, and 1.3 million patients revealed that poor working conditions can have a negative impact on all four of those domains.
“Our quantitative synthesis of the results of many studies revealed that better work environments were associated with lower odds of negative outcomes ranging from patient and nurse job dissatisfaction to patient mortality,” said lead-investigator Eileen T. Lake, PhD, MSN, FAAN, the Jessie M. Scott Endowed Term Chair in Nursing and Health Policy.
“Our results support the unique status of the nurse work environment as a foundation for both patient and provider well-being that warrants the resources and attention of health care administrators,” said Lake, who is also the Jessie M. Scott Endowed Term Chair in Nursing and Health Policy at Penn Nursing.
Studies indicate that nurses need more autonomy and support from other qualified clinicians when working.
A 2018 study published in the British Medical Journal noted that nurses who have the support of clinically competent colleagues, autonomous nursing practice, adequate staffing support, and who work in a patient-centered culture tend to be more satisfied with their jobs, ultimately improving patient care quality.
Dempsey corroborated those findings, stating that nurse autonomy is the key for positive outcomes and nursing satisfaction.
“We have seen good outcomes when nurse practitioners are able to be autonomous,” Dempsey said in a previous PatientEngagementHIT.com interview. “There is also broad understanding that when we are educated and trained as nurses, we understand the value of an interprofessional team and that none of us can do this by ourselves. Because interprofessional teamwork it is so ingrained in nurses and then therefore nurse practitioners, autonomy does not mean that we won’t work without interprofessional colleagues to take care of patients.”
Understanding the roles of various members of an interdisciplinary care team will be essential to driving positive patient experiences in value-based care. To that end, acknowledging the role that nurses play in delivering on that positive experience will be key for healthcare organizations looking to succeed in the changing industry landscape.
By Sara Heath
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