Speaking up, being heard: registered nurses’ perceptions of workplace communication

Garon, Maryanne

doi:10.1111/j.1365-2834.2011.01296.x

Cited by 107 publications

(124 citation statements)

References 29 publications

(36 reference statements)

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“…[37] Nurses should be allowed to speak up, and they have a need to be heard. [38] Also, a certain modesty as a culturally typical feature, which regards self-praise as boasting, may play a role here to explain nurses' lower competence scores compared with those of their managers.…”

Section: Discussion Of the Findingsmentioning

confidence: 99%

Congruence between nurse managers’ and nurses’ competence assessments: A correlation study

Numminen¹,

Leino‐Kilpi

Isoaho

et al. 2014

JNEP

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Background/objective: Nurse managers have an important impact on nurses' competence. However, research on managers' and nurses' competence assessments using the same criteria is scarce. For quality care it is important that these assessments align. This study compared nurses' and their managers' competence assessments. Methods:A cross-sectional, descriptive, comparative correlation design was applied. Participants were 1656 manager-nurse pairs conducting self-assessments and manager assessments respectively in a university hospital in Finland. The Nurse Competence Scale which measures nurses' generic level professional competence was used to collect the data. Means, range, frequencies, and standard deviations, and Mixed Models with Repeated Measures were used in data analysis.Results: Both managers and nurses assessed the competence level as good, but managers assessed the level significantly higher than nurses themselves. However, the overall competence profiles between the groups aligned. Higher competence level and smaller Visual Analogy Scale (VAS) score differences between the groups were related to individualized patient care, and ethically committed and flexible action in care situations. Lower competence level and bigger VAS score differences between groups concerned consultation, guiding, and evaluation activities within care team, developmental tasks, and use of research knowledge.Conclusions: Although the difference between managers' and nurses' competence assessments was significant in favour of managers, there is a strong congruence between the groups concerning core tasks of nursing. Competences with low scores, differences between groups, management's support, and factors influencing competence need further research for planning interventions to enhance competence development. Use of multiple assessment methods is recommended to add validity and reliability of the measurements.

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Section: Discussion Of the Findingsmentioning

confidence: 99%

Congruence between nurse managers’ and nurses’ competence assessments: A correlation study

Numminen¹,

Leino‐Kilpi

Isoaho

et al. 2014

JNEP

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“…Facilitating factors are teamwork, staff engagement and communication, as well as organisational characteristics such as openness and transparency. 164,168,169,172,173 These results suggest that there is scope for modification of the survey to reflect these newly identified subdimensions -incorporating two subsections to evaluate perceptions of feedback effectiveness, and three subsections to assess departmental climate. Other amendments may include increasing the number of reverse scored items to maintain consistency and assess reliability of responses as well as reordering components of the questionnaire to limit clustering of similar items.…”

Section: Exploratory Factor Analysismentioning

confidence: 99%

“…Frankel's intervention, Patient Safety Leadership Walkrounds, has been widely adopted. 165,172 There is consensus that local ownership is needed. Facilitating factors are teamwork, staff engagement and communication, as well as organisational characteristics such as openness and transparency.…”

Section: Exploratory Factor Analysismentioning

confidence: 99%

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Evaluation of a continuous monitoring and feedback initiative to improve quality of anaesthetic care: a mixed-methods quasi-experimental study

Benn

Arnold

D’Lima

et al. 2015

Health Serv Deliv Res

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BackgroundThis study evaluated the impact of a continuous quality monitoring and feedback initiative in anaesthesia.ObjectivesTo conduct a quasi-experimental evaluation of the feedback initiative and its effect on quality of anaesthetic care and perioperative efficiency. To understand the longitudinal effects of passive and active feedback and investigate the mechanisms and interactions underpinning those effects.DesignMixed-methods evaluation with analysis and synthesis of data from longitudinal qualitative interviews, longitudinal evaluative surveys and an interrupted time series study.InterventionContinuous measurement of a range of anaesthetic quality indicators was undertaken in a London teaching hospital alongside monthly personal feedback from case summary data to a cohort of anaesthetists, with follow-up roll-out to the whole NHS trust. Basic feedback consisted of the provision of passive monthly personalised feedback reports containing summary case data. In the enhanced phase, data feedback consisted of more sophisticated statistical breakdown of data, comparative and longitudinal views, and was paired with an active programme of dissemination and professional engagement.MethodsBaseline data collection began in March 2010. Implementation of basic feedback took place in October 2010, followed by implementation of the enhanced feedback protocol in July 2012. Weekly aggregated quality indicator data, coupled with surgical site infection and mortality rates, was modelled using interrupted time series analyses. The study anaesthetist cohort comprised 50,235 cases, performed by 44 anaesthetists over the course of the study, with 22,670 cases performed at the primary site. Anaesthetist responses to the surveys were collected pre and post implementation of feedback at all three sites in parallel with qualitative investigation. Seventy anaesthetists completed the survey at one or more time points and 35 health-care professionals, including 24 anaesthetists, were interviewed across two time points.ResultsResults from the time series analysis of longitudinal variation in perioperative indicators did not support the hypothesis that implementation of basic feedback improved quality of anaesthetic care. The implementation of enhanced feedback was found to have a significant positive impact on two postoperative pain measures, nurse-recorded freedom from nausea, mean patient temperature on arrival in recovery and Quality of Recovery Scale scores. Analysis of survey data demonstrated that anaesthetists value perceived credibility of data and local relevance of quality indicators above other criteria when assessing utility of feedback. A significant improvement in the perceived value of quality indicators, feedback, data use and overall effectiveness was observed between baseline and implementation of feedback at the primary site, a finding replicated at the two secondary sites. Findings from the qualitative research elucidated processes of interaction between context, intervention and user, demonstrating a positive response by clinicians to this type of initiative and willingness to interact with a sustained and comprehensive feedback protocol to understand variations in care.ConclusionsThe results support the potential of quality monitoring and feedback interventions as quality improvement mechanisms and provide insight into the positive response of clinicians to this type of initiative, including documentation of the experiences of anaesthetists that participated as users and codesigners of the feedback. Future work in this area might usefully investigate how this type of intervention may be transferred to other areas of clinical practice and further explore interactions between local context and the successful implementation of quality monitoring and feedback systems.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…Research shows that some nurses hesitate to approach nurse managers with their ethical concerns. [1][2][3] Structural problems such as challenging work environments and insufficient communication result in ethical conflicts and mounting moral distress, 4 which threaten patient safety and care quality. 5 Because ethically difficult situations persist, nurse leaders must be ethically sensitive to staff concerns.…”

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confidence: 99%

Avenues of Action in Ethically Complex Situations

Pavlish

Brown-Saltzman

et al. 2015

JONA: The Journal of Nursing Administration

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Speaking up, being heard: registered nurses’ perceptions of workplace communication

Cited by 107 publications

References 29 publications

Congruence between nurse managers’ and nurses’ competence assessments: A correlation study

Congruence between nurse managers’ and nurses’ competence assessments: A correlation study

Evaluation of a continuous monitoring and feedback initiative to improve quality of anaesthetic care: a mixed-methods quasi-experimental study

Avenues of Action in Ethically Complex Situations

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