| Primary Author: | Anne Marie Kotzer |
| Co-Principal Investigators/Collaborators: | Maree Burke, ADN, RNC-NIC, Sharon Sables-Baus, PhD, RN |
| Organization | Children’s Hospital Colorado |
Abstract
Purpose
- Evaluate communication self-efficacy among clinicians in the NICU;
- Determine whether clinicians’ communication self-efficacy differs based on role.
Background
Direct care nurses in the Neonatal Intensive Care Unit (NICU) identified inconsistencies in practice related to measuring and treating pain/sedation in infants. The question also arose as to the nurse’s confidence level in approaching the physician or neonatal nurse practitioner (NNP) about their concerns. It was suggested that nurses’ confidence with their communication skills may be lacking and may differ based on provider (MD vs. NNP)
Materials & Methods
RNs, therapists, pharmacists, dieticians, etc. in the NICU were invited to complete a Communication Self-Efficacy Scale (CSES) to assess clinician/physician and clinician/NNP communication. The CSES measures communication confidence on two subscales, “assertiveness” and “systematic”.
Results
104 clinicians completed the CSES with the largest groups being nurses (N=73), NNPs (N=12), and therapists (N=8); 79% reported providing direct patient care ≥ 75% of the time. Mean age was 38.26 ± 10.71 yrs and 62.1% held a baccalaureate degree and 22.1% a master’s degree.
Mean “assertiveness” score when communicating with an MD was 36.15 ± 6.20 and the mean “systematic” score was 37.98 ± 5.96. Communication with an NNP was significantly higher (assertive: 37.14 ± 5.52; systematic: 38.8 ± 5.15) than with the MD (p < .0001). Significant differences were seen between MD and NNP communication for RNs alone (p < .0001), with greater confidence when communicating with the NNP. Therapists’ subscale scores were statistically higher when communicating with the NNP than MD.
Conclusion
Much is written about nurse-physician communication and its impact on patient safety and outcomes, yet little information exists about other disciplines’ communication self-efficacy. This study revealed differences across all clinicians and provider groups, demonstrating less confidence when communicating with physicians. While staff education on specific clinical practice issues is needed, the impact will be optimized if education and training are provided around assertive/systematic communication, with dedicated content on communication self-efficacy.
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© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).