Objective: The results of three studies investigating the role of nurse communication in team literacy and patient safety are presented.
Design: The three studies employed longitudinal (studies 1 and 3) and cross-sectional designs (study 2). Sample: The first study involved 372 patients and 254 nurses from one hospital. The second involved 289 nurses and 74 physicians from four hospitals. The third involved 835 patients and 1085 nurses from 19 hospitals.
Variables: The study variables included staff mix, nurse education, work design, and the timeliness and accuracy of communication. The outcome variables included patients’ independence in mobility and self-care (studies 1 and 3) and the team’s ability to meet treatment goals, respond to emergency situations, and achieve good outcomes (study 2).
Methods: In studies 1 and 3, nurses completed an instrument measuring communication quality; both nurses and physicians completed the instrument in study 2. Data on patients’ mobility and self-care were collected at discharge in study 1, and at admission and discharge in study 3. Data on team effectiveness were collected from nurses and physicians (study 2).
Findings: The results of the first study indicated that the quality of communication was higher on units where nurses had more education and autonomy, less experience and role tension. Communication was related to the patients’ therapeutic self-care and functional status at discharge. In the second study, fewer unit beds, patient centered care, and baccalaureate preparation predicted communication quality, which was associated with unit effectiveness. In the third study, the proportion of registered nurses predicted communication quality, which was positively related to improvements in patients’ mobility and self-care at hospital discharge.
Conclusion/Implications: While there is good evidence that effective communication among members of the health care is important to ensuring safe care, we need to investigate how teams build effective communication patterns and team literacy.
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