Copyright 2023
A Dissertation Presented in Partial Fulfillment
of the Requirements for the Degree
Doctor of Health Administration
University of Phoenix
Chapter 1
Effective communication between health care providers and patients’ families is a vital element of health management. In the care setting, nurses are a crucial component in clinical care delivery and provide a close link between the family and the treatment team. Because they are the most accessible asset in the clinical setting, nurses offer a bridge for communication with patients’ families (Anderson et al., 2020). Nurses are frequently tasked with the responsibility of helping family members and coping with their concerns and anxiety. Thus, an ICU nurse’s relationships with patients and their families are exceptionally demanding and intensive, serving as confidante, educator, advocate, cultural liaison, and interpreter (Anderson et al., 2020). Family members assess their satisfaction with their loved one’s ICU hospitalization depending on the communication quality they experienced, as opposed to the quality of care provided (Achury et al., 2015). While family members expressed high levels of satisfaction with the ICU’s treatment and confidence in the health care team, studies have shown they expressed dissatisfaction with the communication, information exchange, and emotional support they received (Carlson et al., 2015).
In the hospital setting, communication faces several obstacles, including the necessity to deliver devastating news. Communicating information about care can be distressing for family members and professional personnel (Edward et al., 2020). However, the transactional model of communication in the ICU environment offers a model for communication that includes a two-way interaction between the patient and family, which will be discussed in detail in a conceptual framework.
Background of the Problem
Healthcare practitioners recognize that efficient communication with the relatives of terminally ill patients is a critical component of intensive care delivery (Norouzadeh, 2020). In such contexts, nurses’ strategies, views, and sentiments in end-of-life circumstances are tied to their perspective on bereavement and their interactions with others and their surroundings (Norouzadeh, 2020). Effective communication is a critical component of nurses’ responsibilities when giving great care to patients’ families. Effective collaborative care requires communication with the family to offer expressive and divine sustenance as well as facilitate effective family-centered decision-making (Norouzadeh, 2020). Nelson et al. (2010) proposed that attempts to enhance palliative care quality should prioritize the procedures and areas that are most useful to the family. One way is communicating with the family regarding the client’s health, interventions, and prediction in an apt, continuous, clear, comprehensive, and empathetic way.
Effectively communicating and informing a dying patient’s family on the treatment course can boost the satisfaction level and prepares them for quality bereavement and make appropriate decisions (Norouzadeh, 2020). By utilizing excellent communication, nurses may alleviate the family’s psychological stress. Ineffective communication, on the other hand, contributes to family conflict, pain, anxiety, sadness, and difficult bereavement among critical patients’ families (Jo et al., 2019). According to Johannesdottir and Hjorleifsdottir (2018), family encounters with appropriate communication and proper interaction during end-of-life care are essential elements for effective interpersonal contact with health professionals.
Problem Statement
The problem is with the progressive increase in end-of-life (EOL) care in nursing homes, interprofessional collaboration in EOL care in nursing homes is becoming increasingly vital (Nishiguchi, 2021). However, there is no defined way of quantifying interprofessional collaboration (Nishiguchi, 2021). Research has demonstrated that effective communication between patients and nurses is essential for patient recovery and smooth daily operations within departments in hospital settings (Kwame & Petruka, 2021). To be successful with these efforts, effective communication from leadership in nursing staffing is crucial. According to Madula et al. (2018), in a study of maternal health care in Malawi, patients rated themselves as very happy when nurses communicated well with them and treated them with warmth, empathy, and respect. In contrast, some patients reported poor communication by nurses, including verbal abuse, disrespect, or a refusal to answer their questions.
The COVID-19 pandemic-related healthcare protocols and visiting restrictions have caused tremendous changes in the ability to establish communication among healthcare stakeholders, including patients, their families, and medical professionals. Emerging research on communication between families and healthcare providers concerning the end of life because of COVID-19 highlights the significance of effective communication. During the pandemic, the number of visitors and the time spent in hospitals were restricted, depriving relatives of ample time with their patients. A common outcome of strained communication among caregivers is profound stress, which affects the quality of grief. Thus, the issue at hand about strained communication between families and healthcare providers (HCP) compounded by the visiting restrictions is worth investigating to understand how communication and collaboration with healthcare workers influences outcomes and interactions with families of patients in ICU with COVID-19.
Purpose of the Study
The purpose of the qualitative narrative inquiry research is to explore effective communication between five nurses, COVID-19 patients, and families in the Eastern New York region. Research studies have shown that ineffective communication between healthcare professionals, patients, and caregivers affects care outcomes and perceptions of care quality (Amoah et al., 2019). There is a persistent barrier to effective communication between nurses and their patients which frequently leads to transpersonal miscommunication among patients, caregivers, and nurses (Yoo et al., 2020).
Other communication-related barriers may include inadequate communication skills, and patients’ unable to convey messages owing to their health status, particularly in intensive care units and hospices (Madula et al., 2020). Madula et al. (2020) demonstrated in a study of maternity care that linguistic blockades impeded smooth communication between healthcare workers and expecting parents. According to a research participant, although some nurses are empathetic and communicate with patients well, others encountered difficulties using the Chitumbuka language to communicate with patients. These communication challenges significantly affected the interaction between nurses and service users (Madula et al., 2020).
Population and Sample
Within a research study, the population refers to the entire collection of individuals to be studied, or, more accurately, about which conclusions are sought (Majid, 2018). A sample in a research study is used to represent the entire population from which the sample was drawn (Majid, 2018). For this research, a sample of five nurses and 13 family members of patients hospitalized due to COVID-19 will be field-tested to explore strategies for effective communication.
Significance of the Study
By effectively communicating, nurses can provide new information, understand patients’ reactions to wellness concerns, evaluate care opportunities, support decision making, and facilitate the welfare of their patients (Yoo et al., 2020). In addition, among the most critical aspects of improving patient safety and quality of care is effective communication with clients and their treatment partners (Yoo et al., 2020).
An international study identified unexpected difficulties that influenced the interaction of healthcare professionals and families of patients in intensive care settings (Yoo et al., 2020).  Patients in critical units and support devices require constant monitoring and nurses maintain their health and well-being. The nurses working in such environments must communicate with the patients’ families and caregivers and make timely decisions based on their expertise, including communicating effectively within a healthcare system to determine the patient’s needs and their families (Kwame & Petruka, 2021). Patient-centered care and effective communication may be affected by a nurse manager’s management style. Several management styles have been identified among nursing managers, which may facilitate or hinder the delivery of patient-centered care (Kwame & Petruka, 2021). In addition, if nurses’ managers fail to take care of the mental health needs of their employees, this may harm the way nurses attend to their patients’ care needs (Yoo et al., 2020). Observations have shown that nurses’ communication with patients is adversely affected if their nurse manager is not present on-site and is unsupportive or insensitive to their needs.  
Nature of the Study
This study uses qualitative narrative inquiry to explore nursing communication experiences from participants’ perspectives (Clandinin & Connelly, 2000). The narrative inquiry seeks to understand the experience of individuals by retaining an orientation to the stories that are being told (Clandinin & Connelly, 2000). Narrative investigations allow a better understanding of the continuity and wholeness of nursing professionalization from the perspective of nurse participants by examining their accounts of their experience of effective communication from nursing leadership.
Research Questions
The following research questions guided this narrative inquiry
R1: Share your experience of how the hospital has reacted to COVID-associated communication and collaboration complexities?
R2: Is there anything else your institution could have done to enhance communication with families?
R3: What were some communication methods used between nurses and COVID-19 patients’ families?
R4: What challenges did nurses have to communicate with COVID-19 families?
Conceptual Framework
This study is an exploration of strategies to improve effective communication between nurses and COVID-19 patients and families. By using the transactional model of communication, three communication theories provided a conceptual framework, for this narrative inquiry: Intrapersonal, interpersonal, and transactional. While nurses intend to treat patients and their families empathetically, when time is limited in the intensive care unit, for example, they frequently conduct one-way conversations (Farshad et al., 2021). Additionally, the typical mode of communication, including language and inflection, can occasionally be misinterpreted and seem offensive (Farshad et al., 2021). As a result, participants struggled to express their sincerity to patients and their families.
Gaining critical insights into the themes surrounding communication implores the adoption of sociological and philosophical standpoints. As detailed in Scambler’s communicative action theory, Habermas’s proposal is a concept of system and lifeworld, which implies a compliment to the system and related policy. The lifeworld and system elements are critical in a contemporary setting, although we must be keen on the likelihood of systems dominating the lifeworld resulting in reification (Bernild, Missel, & Berg, 2021. This theory’s appropriateness to evaluate communication between families and healthcare providers during the pandemic is subject to numerous standardization and operational guidelines such as visiting restrictions and family members who are stakeholders in the patient’s lifeworld, where they interact in everyday lives.
Since this review dwells on communication, the specific element of Habermas’s speech act applies. Here the proponent suggests a normative idea of effective communication void of asymmetrical power relations amid the criticism for being naïve, unrealistic, and to some level, simplified, although it is worth pursuing. When applied in this review, it specifies what families of COVID-19 hospitalized patients are seeking concerning communication with medical professionals and highlights the conditions for such (Bernild, Missel, & Berg, 2021). The application of this conceptual communication framework enables us to critically analyze and understand how families experience communication and collaboration with healthcare employees in inpatient management during the COVID-19 pandemic.
Definition of Terms
Therapeutic communication (Yoo et al., 2020), a critical component of nursing, entails the use of specific strategies to elicit and convey patients’ feelings and ideas, as well as to demonstrate acceptance and respect.
Empathy is the ability to understand and share another person’s emotions (Yoo et al., 2020).
Interpersonal communication is defined as the process by which information is transferred and understood, and it is a critical factor in determining an organization’s success (Farooqi et al., 2020).
The transactional model of communication is defined as an interaction between two persons.
Assumptions, Limitations, and Delimitations
Assuming this study will be conducted in the ICU unit of a community hospital, the results of the study cannot be applied to the general context of nurses working in other medical disciplines such as the out-patient setting or other institutions that provide end-of-life care (EOL).
Limitations may erode the study’s credibility. Biased results are possible because the researcher works for a local healthcare organization. Research participants must be able to express their thoughts and experiences honestly and without fear of bias. There is a possibility that information will be misreported during the interview process. The narrative inquiry method evaluates participants’ stories but does not identify any causal relationships.
The delimitations of this study pertain to the inclusion and exclusion criteria for participation in the research. This review’s sample was selected from one community local hospital in the Eastern New York region. The researcher limited participants to individuals who were in the ICU unit and receiving EOL care. Because of the tiny sample size used in the community hospital, the researcher did not generalize the findings to other regions.
Chapter 1 Summary
This section includes the overview, context of the issue, a statement of the problem, and the importance of the research. Chapter 1 also includes the conceptual framework, four questions, nature of the study, meanings of terms, and a summary of the chapter. Because the disease is more than an individual concern, families play a critical role in healthcare delivery, especially with the ravaging pandemic. This part explores the compounding issues and profound concerns about the prognosis and course of the illness including visiting restrictions to contain the spread thus setting new frames of interaction and collaboration during in-facility care. Chapter 2 includes an in-depth review of the transactional model of communication in connection to strategies used between nurses, COVID-19 patients, and families.  Additionally, chapter 2 identifies a gap in the literature, historical content, current content, the conceptual framework, methodology literature, research design, summary, and conclusion. This part focuses on the experiences of families of COVID-19 admitted patients regarding communication and interaction with medical professionals.
Chapter 2
Literature Review
The purpose of the qualitative narrative inquiry research is to explore effective communication between five nurses, COVID-19 patients, and families in the Eastern New York region. Research studies have shown that poor communication between healthcare professionals, patients, and caregivers affects care outcomes and perceptions of care quality (Amoah et al., 2019). A study of the literature revealed the existence of communication difficulties and their correlations with patients’ experiences of fear, anger, anguish, and frustration (Happ, M. B. (2021). There has been a pilot-scale, randomized controlled study using communication boards reported. Although attention to this issue has increased over the last two decades, authors of multiple literature reviews and syntheses continue to identify primarily qualitative studies, case reports of misinterpretation and/or individualized augmentative and alternative communication support, and small, single-arm feasibility or pilot studies for interventions (Happ, M. B. (2021). The literature, in general, affirms the need for (1) evidence-based communication tools, (2) professional training, and (3) unit-based support to enable patient communication.
In Chapter 2 a review of the literature pertinent to the background of the problem,statement of the problem, the study purpose, and the significance of the problem ispresented. The review of literature includes lists of peer-reviewed journals, researchstudies, previous dissertations, books, and other related reports that support the need forthe study. The focus of this chapter is on the conceptual development related to nursing communication strategies between COVID-19 patients and families. This chapter discusses appropriate search techniques, historical views on quality and safety, and how these ideas are viewed and experienced by nurses, who have been the primary providers of care in clinical and hospital settings since 2001.
A literature review is a critical component of research since it summarizes intriguing study ideas. A literature review is frequently conducted to contextualize a research topic (Denzin & Lincoln, 2011). This procedure entails a thorough examination of the works of scholars to have a better understanding of the idea of interest (Norwood, 2010). Academic materials, such as articles, books, and other sources such as dissertations, and conference proceedings, are analyzed in this review, with a description, summary, and critical assessment of these works provided. The objective of this chapter is to synthesize key published material on the specified issue of patient safety and quality.
Title Searches and Documentation
The literature review drew upon a variety of peer-reviewed sources to inform the research. The University of Phoenix library was used to conduct searches in multiple databases using a variety of search phrases. For example, a search with the phase communication and nursing and covid-19 patients yield 376,000 results from google scholar. Communication and nursing and families yield 6,894 results in EBSCOhost. The researcher selected the articles that mainly reflected the study gap and used them for the review. From ProQuest, the critical phrase was nursing communication, families, and patients and yielded 3,140 search results.
Communication in East Asia
When it comes to healthcare communication, East Asia has seen a lot of growth in the last few years (Pun et al., 2018). There have been a lot of changes in the way healthcare is done in the region to meet the growing need for better healthcare services (Pun et al., 2018). According to Pun et al. (2018), one of the biggest issues that clinicians, researchers, and policymakers must deal with as they work to meet reform goals is whether the patient-centered healthcare philosophies that have been widely used in English-dominant countries (Canada, the USA, the UK, and Australia) can be used in the East Asian setting.
A good example is a way that pre-and post-qualification clinicians are trained (Pun et al., 2018). It’s common for people who speak English to use established models and texts like the Calgary-Cambridge Guides when they teach people how to communicate with people in the health care setting (Pun et al., 2018). However, there aren’t any models for non-English-dominant contexts, and very little work has been done to adapt Western communication models for health professionals who work in non-Western contexts (Pun et al., 2018). Preliminarily, only a few articles have talked about the ’Ifferences in how people communicate about health care in English and non-English settings, which shows that it’s not a good idea to just follow the Western model in East Asia (Pun et al., 2018).
Telecommunication Strategies
It was declared a global pandemic by the World Health Organization on March 11, 2020. This started a lot of people around the world to work together to keep the new coronavirus, called SARS-CoV-2, from spreading (White et al., 2021). In the first wave of the COVID-19 pandemic, healthcare professionals had to make sure patients and their families were able to talk to each other effectively (White et al., 2021). Social isolation and hospital visit restrictions were necessary to stop the spread of the virus. This made it hard for doctors to give family-centered care (White et al., 2021). Literature has said this is important for preparing family members to make decisions and take care of their loved ones (White et al., 2021). It also helps to reduce family member anxiety and allows nominated caregivers to advocate for patients and keep the family together (White et al., 2021).
According to White et al., Junior doctors working on a medical floor during the first wave of COVID-19 didn’t have any advice on how to start a good communication plan (2021). Because of this, we started a project to improve the communication experience of patients and their families by using video and telecommunication strategies (White et al., 2021). The project took place in May 2020, when the first wave of the pandemic began. It is more important than ever to use this data to help plan future communication strategies and learn from past mistakes (White et al., 2021).
Methodology Literature
First, 22 relatives of patients who will be in a COVID-19 ward at the University Hospital Llandough in May 2020, were called and asked about their plans (White et al., 2021). Callers were told why they were being called. Each one agreed to let their responses be recorded and kept anonymous (White et al., 2021). Standard questions (S1) were used to record their answers and the results were then analyzed (White et al., 2021). Finally, relatives were given the chance to get 20-minute video call updates from a doctor, with the permission of the person who was having surgery (White et al., 2021).
When relatives called the ward, they were told to make an appointment for a video call with a doctor to get an update on their loved ones (White et al., 2021). During the right situations, video calling was the most appropriate to tell people bad news and to set up video calls between patients and their families, sometimes when the patients were nearing the end of their lives (White et al., 2021). Qualitative feedback from family members was kept after these sessions. These video calls were made on Accurx, which is approved by the NHS for video calls (White et al., 2021). The head of quality and safety at Cardiff and Vale University Health Board gave the project the go-ahead (White et al., 2021).
In their first survey, 63% of people said they didn’t know enough about their relatives’ admission (White et al., 2021). Qualitative feedback led to finding important themes. Relatives’ most common complaint was that there were not enough or not enough medical updates (White et al., 2021). Relatives said they couldn’t get a response when they called the ward, didn’t get enough medical information from updates from other members of the multidisciplinary team (MDT), and couldn’t figure out how their relative was doing based on only verbal updates (White et al., 2021).
After video calls started, relatives said they were more satisfied with the communication they had received (White et al., 2021). During the visit, they had a better understanding of what was going on in medical terms and how their relative was being cared for (White et al., 2021). They also felt more confident about the care their relative was getting. When video calls were used to break bad news, technology made it possible for a family member to be part of the conversation, get information at the same time as the patient, and help them feel better (White et al., 2021). In end-of-life care, “video visiting” allowed families to say goodbye to their loved ones and come to terms with how their health was going to change (White et al., 2021). One of the relatives said that seeing their loved one sick, but still looking comfortable and cared for, was a good thing (White et al., 2021). According to White et al. (2021), the length of each phone call was set to 20 minutes as an experiment. However, the length of each video call ranged from about 5 to 30 minutes, depending on how much and how much detail there was in the conversation and how interested the relatives were (White et al., 2021).
Having an effective communication platform between the covid patients and the nurses was an important tool for dealing with the menace that was the pandemic. Different articles have been used to analyze the effective frameworks for achieving sound communication in the health care systems. Madula et al. (2018) state that the implementation of effective communication is an important part of healthcare delivery. It ensures that optimal services are offered to the clients while in the hands of the health care professionals. One of the aspects that have been highlighted includes the need for the use of plain English. Suffering covid was a stressful period for everyone, especially when the pandemic had just broken out. Most people were afraid of how this condition would affect their lives. Ideally, there was a need for a good communication platform to ensure that the covid victims understood the condition. Additionally, this was also a chance to identify ways of protecting their family members from contracting the virus.
The author points out that a lack of good communication with the clients usually pushes them to seek health care services in alternative hospitals. This conclusion was made after analyzing how poor communication altered the decisions on health care facilities by pregnant women (Madula et al., 2018). When there is a good communication channel between the two parties, it becomes more possible for them to build a relationship. With a good relationship, it is easier for the patients to ask questions about their condition and what they should do to get better. Based on the research conducted in this article, the authors highlight some of the issues affecting a good communication system between the two parties is a lack of respect.
Essentially, the participants of the research indicated that the midwives that were present to facilitate the delivery process were rude to them. This is detrimental to the patients as they are already suffering pain from the labor (Madula et al., 2018). This is also an issue that may affect the recovery of the patients that suffer from covid. Rudeness from the nurses may cause the patients to become resentful. Some of them may also end up suffering extensive pain but fail to report it as they are afraid of the response they will receive. Another issue that affects the communication between the two parties is the language barrier. Some patients may come from the interior primitive parts of the country. There is a high chance they do not understand any other language apart from their parent language. This was particularly true in multilingual health facilities. It becomes quite hard for the nurses and patients to understand each other if they do not have a common language.
The participants of the research activity stated that the nurses in the facilities they went to were kind and polite to them. However, the main challenge is that they could not understand some of the things they told them. Therefore, they needed to have a third party translate what they were discussing, limiting the respect for the right to privacy. This was also the case in some facilities at the height of the pandemic. The authors also cited concerns when nurses deal with patients who can only communicate through sign language. In this case, a lack of expertise in sign language among healthcare professionals is a challenge in providing healthcare services.
Conceptual Framework Literature
A conceptual analysis by Afriyie (2020) shows that communication is an essential part of the health care service delivery process. A good communication platform has been linked to being important in improving the quality of care the patients receive. First, the author explained the meaning of effective communication. She states that effective is a term that defines something that leads to the achievement of success. She also explains that communication transfers information from one person to the other. Communication is not limited to one aspect. In this case, it can be face-to-face or over the phone. The effectiveness of a communication system depends on whether it achieves the goals that had been set.
The aspect of communication can be explained from two perspectives, the nurses and the patients. Afriyie (2020) states that nurses must respect the patient’s rights. When the pandemic broke out, the patients had a right to health care. Essentially, the nurses were required to be committed to taking care of their patients and ensuring that they were out of danger. This is possible if the patients are in a position to explain the issues that affect them.
The author explains that in terms of respecting the patients, the nurses should be committed to understanding and valuing the patient’s perspectives and background in the communication process (Afriyie, 2020). For instance, the nurses should acknowledge that some patients do not have a medical background. In this case, it can be difficult for them to understand the complex medical terms. The nurses should ensure that they explain such terms to the patients to understand the condition better. This will also help them to understand their medication better. Paying attention to understanding scientific terms contributes to person-centered inpatient care. Under such circumstances, the quality of care delivered to the patient is improved hence more patient satisfaction.
Afriyie, (2020) also cites that although the nurses are required to respect the patient’s rights, it is challenging when the patients are unwilling to communicate issues on their health. This creates a more binding situation for the nurses since they must respect their right to autonomy. It can be difficult to establish if the patients have any further issues, especially if the signs are not physically visible. For the covid patients, it can be challenging to establish a possibility of lung damage when the patients have not cited any pain in their chest that could ring a bell to the medical practitioners.
Despite the challenges, the nurses should ensure that they educate their patients on the need for effective communication between them. This allows the nurses to commit to their ethical requirements and give their patients quality care. Additionally, different methods have been highlighted as part of the approaches that should be implemented to improve communication. First, the nurses should be good listeners. They should take their time to listen to the issues brought forth by the patients without interruption (Farooqi et al., 2020). This allows the patients to be more honest and become more comfortable with their nurses. There also should be the implementation of privacy in communication. All the details shared by the patients should remain private between the two parties. The nurses should only discuss the information with other parties when authorized by the patient. This is in the event when the nurses need to get professional help from their seniors.
Farooqi et al. (2020) explain interpersonal communication and teamwork as beans in the same pod. When the nurses can communicate with their patients, they can work as a team in fighting the virus that the patient suffers from. Interpersonal communication has been defined as the most important factor within an organization. This specifically applies to the health care facilities since they are centered on fighting disease. This article explains the interprofessional aspect of communication. Essentially, the nurses must have a good communication platform with each other. This allows them to develop a more effective way of caring for their patients. Through building an effective communication platform, they are more committed to working as a team in caring for their patients. Teamwork is a salient factor in making meaningful decisions in care delivery
Nurses usually work in shifts. When transitioning to a shift, the nurses need to communicate about their patients. They should discuss their vital signs, medication, and any medical procedures that should be done on the patients. When the pandemic broke out, most health care professionals were affected by the overwhelming number of patients in the wards. At this point, it wasn’t easy to adhere to the recommended staffing ratio. Without a good communication channel, it would be impossible for the nurses to take care of the patients (Farooqi et al., 2020). Teamwork and communication were also necessary for taking care of the patients that did not suffer severe infections. If the patients were not severely ill, it would be unnecessary to hospitalize them.
For this reason, the nurses were supposed to educate the patients on the dos and don’ts of managing the virus. They were also educated on what they should look for as signs of severe infection. When any signs occurred, the nurses would encourage the patients to return to the hospital for close monitoring.
The authors also state that interpersonal communication plays a key role in creating trust between professionals and patients. When the nurses are focused on working on the communication systems, it is possible to create a professional environment for patient recovery. Additionally, it also renews the commitment between the two articles in ensuring that the patient recovers.
Methodology Literature
As explained earlier, some of the covid 19 infections led to severe illness that got the patients admitted to the Intensive care unit. When patients are admitted to the ICU, the nurses are the primary caregivers. What is more, they are the most accessible professionals t the family members. In such cases, there needs to be good communication between the two parties. The nurses must regularly update the patients’ family members on the state of their loved ones (Edward et al., 2020). Most often, the family members rate the quality of care their loved one received based on the communication with the nurses. The nurses should note that they are responsible for managing the fear and anxiety of the family members.
The family members would rate the quality of care poorly if they did not have effective communication with the nurses. Ideally, information sharing is important for the patients’ family members. It usually helps them get mentally prepared for what happens to their loved ones. Additionally, there often is a lot of shared decision-making when the patient is in the ICU. The nurses must communicate with the family members to settle on the care practices that need to be implemented for the patients.
Under such circumstances, the nurses can implement a specific model to guide the communication with the patients’ family members. The shared decision-making model is used to determine what information should be given to the family members to influence better service delivery to the patients. This model is important in improving family satisfaction in the care given to their patients.
This article also conducted a detailed analysis of the patients’ family members’ needs in ICU care. A few respondents stated that they were not satisfied with the quality of care when the medical practitioners did not talk to them the right way. The primary issue affecting the family members is feeling looked down upon by the nurses (Lord et al., 2020). Essentially, it is important to note that the family members are quite sensitive when their loved one is in the ICU. For this reason, the nurses should ensure that the patients do not feel like they were rude to them. They should consult with the patients’ family members better by informing them about the state of their loved ones.
The literature analysis also shows that good communication is key, especially for the nurses that work in the ICU unit. Additionally, the analysis also indicates that the nurses’ knowledge about the virus influenced the quality of care that the patients got. In this case, the nurses needed to invest in getting a sufficient understanding of the virus. This is especially because the virus was still new, and for this reason, there wasn’t an accurate treatment plan. By conducting enough research, they could have information to share with their patients about disease management. At the same time, it was also important for them to ensure that they collected accurate information. Any form of misinformation on the virus would have led to more anxiety about covid 19. This would also influence people’s willingness to take the vaccine, which was a preventative measure for the virus.
Lord et al. (2020) explain that a nurse’s willingness to take care of covid 19 patients was highly influenced by the information they had collected about the risk of exposure. The nurses were at the front line of the fight against the virus. For this reason, they needed to have enough information on the measures they should take to prevent the spread of the virus. In addition, since they were at high risk of exposure to the virus, they needed to put on personal protective equipment to ensure they did not get it.
The nurses were required to be highly committed to educating the patients about the methods of preventing the infection of the virus. Since they were most connected to the patients, they were obliged to encourage the patients to take the vaccine as part of the preventative methods. The nurses also played a key role in educating the family members on how to take care of the family members (Lord et al., 2020). They also needed to inform the patients’ loved ones about the progress made toward the patient’s recovery. This helped rid the anxiety that the family members suffered due to the infection. The family members also needed to be educated on how to deal with the patients after discharge. Some patients would still be asymptomatic and, in this case, could transmit the virus to their family members.
This analysis shows a need for inter-professional collaboration and communication in dealing with the outbreak of the virus. Good communication should also be embraced among the nurses to ensure that they provide the best quality care to the patients. Improvement of the quality of life and professional care is highly dependent on whether the major stakeholders communicate with each other. Even as the risk for covid infections continues to ease and the nurses are less overwhelmed, it is important to ensure that communication and teamwork are still upheld in the management and care of other conditions.
Research Design Literature
In Chapter 1 you briefly described your selected research design. This section should expand on that discussion and include support from several design methodologists including the germinal methodologists associated with the design.
It is important to recognize that this section is not the chapter “conclusion”; it is “conclusions”, meaning what did you conclude from the literature? Focus on what you derived from the literature you reviewed and remember to cite each assertion.
Chapter Summary
The discussion should summarize key points presented in Chapter 2. Information should be presented in a discussion context. Supporting citations should be provided for key points. The chapter summary should end with a transition to next chapter such as “Chapter 3 will…” or “In Chapter 3…”.
Please note that Chapter 2 should be expanded to 30 to 50 pages prior to submitting the complete proposal for review.
Achury Saldaña DM, Pinilla Alarcón M, Alvarado Romero H. Aspects that facilitate or interfere in the communication process between nursing professionals and patients in a critical state. Invest Educ Enferm. 2015;33(1):102-111
Afriyie, D. (2020). Effective communication between nurses and patients: an evolutionary concept analysis. British Journal of Community Nursing, 25(9), 438-445.
Amshuda Sonday, Elelwani Ramugondo, & Harsha Kathard. (2020). Case Study and Narrative Inquiry as Merged Methodologies: A Critical Narrative Perspective. International Journal of Qualitative Methods, 19.
Anderson WG, Puntillo K, Boyle D, et al. ICU bedside nurses’ involvement in palliative care communication: a multicenter survey. J Pain Symptom Manage. 2016;51(3):589-596.e2.
Bernild, C., Missel, M., & Berg, S. (2021). COVID-19: Lessons learned about communication between family members and healthcare professionals—A qualitative study on how close family members of patients hospitalized in intensive care unit with COVID-19 experienced communication and collaboration with healthcare professionals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 58, 004695802110600. doi:10.1177/00469580211060005
Carlson EB, Spain DA, Muhtadie L, McDade-Montez L, Macia KS. Care and caring in the intensive care unit: family members’ distress and perceptions about staff skills, communication, and emotional support. J Crit Care. 2015;30(3):557-561.
Clandinin, D. J., & Connelly, F. M. (2000). Narrative inquiry: Experience and Story in Qualitative Research. San Francisco, CA: Jossey‐Bass Publishers.
Denzin, N. K., & Lincoln, Y. S. (2011). The SAGE handbook of qualitative research (4th ed.). SAGE Publications, Inc.
Edward, K., Galletti, A., & Huynh, M. (2020). Enhancing Communication with Family Members in the Intensive Care Unit: A Mixed-Methods Study. Critical Care Nurse, 40(6), 23–32.
Farooqi, R., Ashraf, F., & Nazeer, I. (2020). Interpersonal Communication, Teamwork Effectiveness, and Organizational Commitment in Pakistani Nurses. Pakistan Journal of Psychological Research, 35(4), 675.
Farshad, A.-A., Mirkazemi, R., Rostamigooran, N., Ayazi, S. M. H., & Motalebi, M. (2021). A conceptual framework for socializing the Iranian health system. Eastern Mediterranean Health Journal, 27(6), 629–637.
Happ, M. B. (2021). Giving Voice: Nurse-Patient Communication in the Intensive Care Unit. American Journal of Critical Care, 30(4), 256–265.
Hicks, J. M. (2020). Leader Communication Styles and Organizational Health. Health Care Manager, 39(4), 175–180.
Hollnagel, E., Sujan, M., & Braithwaite, J. (2019). Resilient Health Care – Making steady progress. Safety Science, 120, 781–782.
Jo, M., Song, M. K., Knafl, G. J., Beeber, L., Yoo, Y. S., & Van Riper, M. (2019). Family-clinician communication in the ICU and its relationship to psychological distress of family members: A cross-sectional study. International Journal of Nursing Studies, 95, 34–39.
Johannesdottir, S., & Hjorleifsdottir, E. (2018). Communication is more than just a conversation: Family members’ satisfaction with end-of-life care. International Journal of Palliative Nursing, 24(10), 483–491.
Kennedy-Shaffer, L., Qiu, X., & Hanage, W. P. (2021). Snowball Sampling Study Design for Serosurveys Early in Disease Outbreaks. American Journal of Epidemiology, 190(9), 1918–1927.
Kwame, A., & Petrucka, P. M. (2020). Communication in nurse-patient interaction in healthcare settings in sub-Saharan Africa: A scoping review. International Journal of Africa Nursing Sciences, 12.
Lord, H., Loveday, C., Moxham, L., & Fernandez, R. (2021). Effective communication is key to intensive care nurses’ willingness to provide nursing care amidst the COVID-19 pandemic. Intensive and Critical Care Nursing, 62, 102946.
Madula, P., Kalembo, F. W., Yu, H., & Kaminga, A. C. (2018). Healthcare provider-patient communication: a qualitative study of women’s perceptions during childbirth. Reproductive Health, 15(1).
Majid, U. (2018, January 10). Research fundamentals: Study design, population, and sample size.
Manzano García, G., & Ayala Calvo, J. C. (2021). The threat of COVID‐19 and its influence on nursing staff burnout. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 77(2), 832–844.
Nishiguchi, S., Sugaya, N., Saigusa, Y., & Inamori, M. (2021). Effect of interprofessional collaboration among nursing home professionals on end-of-life care in nursing homes. Drug Discoveries & Therapeutics, 15(2), 93–100.
Norouzadeh, R., Anoosheh, M., & Ahmadi, F. (2020). Nurses’ Communication with the Families of Patients at the End-of-Life. Omega, 30222820959933.
Norwood, S. L. (2010). Research essentials: Foundations for evidence-based practice. Pearson
Pun, J. K., Chan, E. A., Wang, S., & Slade, D. (2018). Health professional-patient communication practices in East Asia: An integrative review of an emerging field of research and practice in Hong Kong, South Korea, Japan, Taiwan, and Mainland China. Patient Education and Counseling, 101(7), 1193-1206.
Saleh, U., Connor, T. O., Subhi, H. A., Alkattan, R., Harbi, S. A., & Patton, D. (2018). The impact of nurse managers’ leadership styles on ward staff. British Journal of Nursing, 27(4), 197-203.
Vida Maame Kissiwaa Amoah, Reindolf Anokye, Dorothy Serwaa Boakye, Enoch Acheampong, Amy Budu-Ainooson, Emelia Okyere, Gifty Kumi-Boateng, Cynthia Yeboah, & Jennifer Owusu Afriyie. (2019). A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients. BMC Nursing, 18(1), 1–8.
West, K., Purcell, K., Haynes, A., Taylor, J., Hassett, L., & Sherrington, C. (2021). “People Associate Us with Movement so It’s an Awesome Opportunity”: Perspectives from Physiotherapists on Promoting Physical Activity, Exercise and Sport. International Journal of Environmental Research and Public Health, 18(6).
White, H. L., Tuck, A. A., Pyrke, B. C., Murphy, E., Figg, K., Cartwright, G. J., Abdalla, B. A., & Reynolds, M. A. (2021). ‘Face time’ for the first time: Video communication between relatives and junior doctors in the COVID-19 pandemic. Clinical Medicine, 21(3), 211-214.
Yoo, H. J., Lim, O. B., & Shim, J. L. (2020). Critical care nurses’ communication experiences with patients and families in an intensive care unit: A qualitative study. PloS One, 15(7), e0235694.
January 2010