Communication in Nursing: Rubric. Prepared by

Communication in Nursing: Rubric.
Prepared by;

Helen Forbes, RN, PhD (UniSyd)

Director of Teaching and Learning

School of Nursing and Midwifery

Deakin University
Email: [e-mail]


Verbal communication between Registered nurses, nursing students and patients:

Involve patients and carers as partners in health care

Communicate risk

Communicate honestly with patients after an adverse event (open disclosure)

Obtain consent

Interprofessional communication: Participation in teamwork

Providing continuity of care Acknowledgement: The  National Patient Safety Education Framework was developed in 2006 by the Safety and Quality Council which then became the  Australian Commission on Safety and Quality in Health Care. Permission to use the framework was granted by  Bill Lawrence (CEO) on November 10, 2011. The  National Patient Safety Education Framework was developed by the Centre for Innovation in Professional Health Education (CIPHER), Faculty of Medicine, University of Sydney on behalf on the Safety and Quality Council .

Verbal communication between Registered nurses, nursing students and patients:

Novice to Expert categories	Category 4 Expert (5 years post grad) Clinical and administrative nurses with responsibilities for health care workers (Categories 2 & 3) and nursing students (Category 1)	Category 3 Proficient (2 years post grad) Nurses with managerial, team leader and/or advanced clinical responsibilities	Category 2 Competent New Graduate Nurses who provide direct clinical care to patients and work under supervision	Category 1 Novice Mid year 2 BN Nursing students who provide direct patient care under supervision	Beginner Year 1 BN Entry level to nursing
Communicating effectively requires nurses and nursing students to have the knowledge to; Involve patients and carers as partners in health care	Capability: Graduates as experienced professionals have the knowledge, skills and attitudes that enable the development of strategies for staff and students to; include patients and carers in planning and delivering health care services. ^1.	Capabilities: Graduates as new professionals have the knowledge, skills and attitudes that enable them to maximise opportunities for staff to; involve patients and carers in their care and treatment. ^2, 3, 4-6 (Categories 3-4)	Capability: Graduates of BN courses have the knowledge, skills and attitudes that enable the m to use; use good communication and know its role in effective health care relationships ^7-9 (Categories 2-4)	Capability: Nursing students have the knowledge, skills and attitudes that enable them to; provide patients and carers with the information they need when they need it ^10-12 (Categories 1-4)	Capability: Entry to nursing studies students can; treat people with respect listen attentively to others ensure person understands provided information. actively encourage the person to share information.
Communicate risk	disseminate risk information and provide support mechanisms for staff and students required to provide risk information to patients and carers. ^13, 14	implement strategies to ensure patients and carers are provided with quality risk information and assistance to make informed decisions.^14,15	communicate risk information to patients and carers in an appropriate way and assist them to make informed decisions.^14	tell patients and carers if there are any risks in the choices they make. ^15-17	acknowledge the other person’s perspective. speak clearly show empathy to others communicate with people from a variety of backgrounds
Communicate honestly with patients after an adverse event (open disclosure)	develop open disclosure guidelines based on the National Open Disclosure Standard and ensure that staff know and apply the guidelines when patients suffer adverse events or near misses. ^18	establish support systems for disclosing adverse events near misses to patients and carers based on open disclosure principles. ^18	know the processes and their role in fully informing patients or carers after an adverse event or near miss. ^18,19	show understanding for patients suffering as a result of adverse events or near misses. ^18	be honest with people be sensitive to other people’s views. be courteous and respectful of people from various backgrounds
Obtain consent	publish guidelines outlining the key ethical and legal requirements for obtaining consent from patients and carers	ensure that patients and carers are fully informed about proposed services, treatments, alternative treatments and the health care providers.^20	know and apply the legal and ethical requirements for obtaining consent from patients and carers.^20	communicate with patients and carers about their choices and ask if they agree or not. ^21-24	avoid stereotyping people recognise own personal biases and reactions to people from different cultural, ethnic and socioeconomic backgrounds.
Be culturally respectful and knowledgeable	develop and implement a culturally oriented management plan for the organisation. ^25	deliver health care services in a culturally optimising manner. ^25, 26	ensure that people from various backgrounds are treated with respect and honour. ^12, 25, 26, 28	be courteous and respectful when working with patients and families from various backgrounds. ^25, 28

1. VIC Department of Health. “Doing it with us, not for us” Strategic Direction 2010 – 2013. VIC Department of Health, August 2009 http://www.health.vic.gov.au/consumer/downloads/strategic_direction_2010-13.pdf
2. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academy Press, 2001.
3. Institute of Medicine. Health professions education: a bridge to quality. Washington DC: National Academies Press, 2003.

4. National Patient Safety Agency. Seven steps to patient safety - Your guide to safer patient care. London:NPSA www.npsa.nhs.uk, 2004.

5. Ritter P. Lee J, Lorig KR, Moderators of chronic disease self-management programs: who benefits? Chronic Illness, 2011, 7( 2), 162- 172 .

6. Benbassat J, Pilpel D, Tidhar M. Patients’ preferences for participation in clinical decision making: a review of published surveys. Behavioral Medicine 1998; 24(2): 81–8.

7. Chassin M. Patient safety, thy name is quality. Trustee 2000; 53:13–5.

8 Maguire P, Pitceathly C. Key communication skills and how to acquire them. British Medical Journal 2002; 325: 697–700.

9 Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Millbank Quarterly 1996; 74(4): 511–44.

10. Tataw DB Individual, Organizational, and Community Interprofessional Competencies for Education, Training, and Practice in Health and Social Care. Journal of Human Behavior in the Social Environment, 2011, 21(1), 1-24.

11 Benbassat J, Pilpel D, Tidhar M. Patients’ preferences for participation in clinical decision making: a review of published surveys. Behavioral Medicine 1998; 24(2): 81–8.

12. Stein_Parbury, J. Patient and person, 2009, 4^th Ed. Sydney:Elsevier

13. O’Connor AM, Legare F, Stacey D. Risk communication in practice: the contribution of decision aids. British Medical Journal 2003; 327: 736–40.

14. Edwards A, Elwyn G, Mulley AL. Explaining risks: turning numerical data into meaningful pictures. British Medical Journal 2002; 324:827–30.

15. Edwards A, Elwyn G. Understanding risk and lessons from clinical risk communication about treatment preferences. Quality in Health Care 2001; 10: i9–i13.

16. Godolphin W. The role of risk communication in shared decision making. British Medical Journal 2003; 327: 692–3.

17. Paling J. Strategies to help patients understand risks. British Medical Journal 2003; 327: 745–8.

18. Australian Council for Safety and Quality in Health Care. Open Disclosure Standard: a national standard for open communication in public and private hospitals following an adverse event in health care. Canberra: Commonwealth Department of Health and Ageing http://www.safetyandquality.org/articles/Publications/OpenDisclosure_web.pdf, 2003 (accessed November 2004).

19. Kenney LK, van Pelt FA. To err is human; the need for trauma support is too. Patient Safety and Quality Healthcare 2005; 1(3): [pending publication]

20. Beauchamp, T. (2011). Informed Consent: Its history, meaning, and present challenges Cambridge Quarterly of Healthcare Ethics, 20(4), 515-523

21. Beauchamp TL, Childress JF. Principles of biomedical ethics. 6th ed. Oxford: Oxford University Press, 2009.

22. Salladay, SA. Ethical problems. Informed consent: making difficult choices. Nursing, 2006, 36(1): 26-7

23. Kerridge I, Lowe M, McPhee J. Ethics and the law for the health professions. 2^nd ed. Sydney:Federation Press, 2005.

24. Australian Commission on Safety and Quality in Health Care. Open disclosure standard: a national standard for open communication in public and private hospitals following an adverse event in health care. Canberra: Commonwealth Department of Health and Ageing , 2003. http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/3D5F114646CEF93DCA2571D5000BFEB7/$File/OpenDisclosure_web.pdf

25. Like, RC Educating clinicians about cultural competence and disparities in health and health care. Education in the Health Professions. 31(3) 196-206, 2011

26. Engrebretson, J Mahoney, J & Carlson, E. Cultural competence in the era of evidence-based practice. Journal of Professional Nursing, 24(3 ), 172–178, 2008.

27. Calvillo, E., Clark, L., Ballantyne, JE., Pacquiao, D. Purnell, LD Villarruel, AM. Cultural competency in baccalaureate nursing education Journal of Transcultural Nursing, 20 (2), pp. 137-145, 2009.

Interprofessional communication: Teamwork

Novice to Expert categories	Category 4 Expert (5 years post grad) Clinical and administrative nurses with responsibilities for health care workers (Categories 2 & 3) and nursing students (Category 1)	Category 3 Proficient (2 years post grad) Nurses with managerial, team leader and/or advanced clinical responsibilities	Category 2 Competent New Graduate Nurses who provide direct clinical care to patients and work under supervision	Category 1 Novice Mid year 2 BN Nursing students who provide direct patient care under supervision	Beginner Year 1 BN Entry level to nursing
Effective interprofessional communication requires nurses and nursing students to; Participate in teamwork	Capability: Graduates as experienced professionals have the knowledge, skills and attitudes that enable them to facilitate effective teamwork and leadership development appropriate to the needs of the organisation. 1, -4, 12	Capability: Graduates as new professionals have the knowledge, skills and attitudes that enable them to provide training and support for all staff in effective teamwork. 2-4, 12 (Categories 3-4­)	Capability: Graduates of BN courses have the knowledge, skills and attitudes that enable them to use; teamwork to deliver effective health care and know how to include patients as members of the team. 5, 6, 7, 10, 11 (Categories 2-4)	Capability: Nursing students have the knowledge, skills and attitudes that enable them to; communicate with patients, carers and staff and work as part of a team. 5, 6, 7, 8, 9, 10 (Categories 1-4)	Capability: Entry to nursing studies students can communicate with people and work as part of a team by being able to; demonstrate basic group skills including communication, negotiation, and time management listenattentively to others provide information using clear explanations ensure person understands the information you have given to them. actively encourage person to share information
Provide continuity of care	Capability: Design patient services and staff training taking into account the importance of continuity of care for all patients.^13-15	Capability: Introduce staff protocols that promote continuity of care for all patients.^10, 11, 14, 15	Capability: Provide continuity of care for all patients through good teamwork and communication.^5-7, 10, 11, 19	Capability: Provide accurate and sufficient information to the correct people at the right time so patients are provided with the best care.^1^6-19	acknowledge the other person’s perspective. speak clearly show empathy to others communicate with people from a variety of backgrounds record information clearly and legibly give and receive feedback on how well a task was done demonstrate caring and respectful behaviour to others obtain information by asking the correct questions.record information clearly and legibly have respect for people avoid stereotyping people recognise own personal biases and reactions to people from different cultural, ethnic and socioeconomic backgrounds. be honest with people be sensitive to other people’s views.

References

1. Mu, K., Chao, C.C., Jensen, G.M., Royeen, C.B. Effects of interprofessional rural training on students' perceptions of interprofessional health care services Journal of Allied Health 33 (2), 125-131, 2004

2. Chang, W.-Y., Ma, J.-C., Chiu, H.-T., Lin, K.-C., Lee, P.-H. Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals Journal of Advanced Nursing 65 (9), 1946-1955, 2009.

3. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academy Press, 2001.

4. Kavanagh, S. & Cowan, J. (2004). "Reducing risk in health-care teams: an overview", Clinical Governance: An International Journal, 93, 200 - 204

5. Leonard, MW. Role of effective teamwork and communication in delivering safe, high-quality care. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 78( 6), 820–826, 2011.

6. Firth-Cozens J. Teams, culture and managing risk. In: Vincent C, editor. Clinical risk management: enhancing patient safety. London: BMJ Books, 2001.

7. Croker, A., Higgs, J. & Trede, F. What Do We Mean by 'Collaboration' and When is a 'Team' Not a 'Team'? Qualitative Research Journal, 9(1), 28-42, 2009,

8. Jefferies, D. Nursing documentation: How meaning is obscured by fragmentary language Nursing Outlook , 59( 6),  e6- e12, 2011.

9. Wang , N. Quality of nursing documentation and approaches to its evaluation: a mixed-method systematic review Journal of Advanced Nursing 67 (9), 1858- 1875, 2011 .

10. Australian Commission on Safety and Quality in Health Care. Clinical handover and patient safety: Literature review report. Canberra: Commonwealth Department of health and Ageing, 2005

http://www.health.gov.au/internet/safety/publishing.nsf/Content/AA1369AD4AC5FC2ACA2571BF0081CD95/$File/clinhovrlitrev.pdf.

11. Porteous, JM., Stewart-Wynne, EG., Connolly, M. & Crommelin, PF. “.iSoBAR--a concept and handover checklist: the National Clinical Handover Initiative. The Medical Journal of Australia, 190(11) Suppl, 1 June, S152-156, 2009.

12. Deering, S. Multidisciplinary teamwork and communication training. Seminars in Perinatology 35( 2), 89- 96, 2011 .  

13. St-Louis, L. A clinical nurse specialist intervention to facilitate safe transfer from ICU. Clinical Nurse Specialist, 25(6),  321- 326, 2011 .

14. Marshall, S., Harrison, J. & Flanagan, B. The teaching of a structured tool improves the clarity and content of interprofessional clinical communication
Quality and Safety in Health Care, 18 (2), 137- 140, 2009.

15. Nutt, M., Hungerford, C.L. Nurse care coordinators: Definitions and scope of practice. Contemporary Nurse 36 (12),  71- 81, 2010.

16. Edwards, A. & Elwyn G. Understanding risk and lessons from clinical risk communication about treatment preferences. Quality in Health Care 2001; 10: i9–i13.

17. Godolphin W. The role of risk communication in shared decision making. British Medical Journal; 327: 692–3, 2003.

18. Paling J. Strategies to help patients understand risks. British Medical Journal 2003; 327: 745–8, 2003.

19. Schwarz, M & Wyskiel, R. Medication reconciliation: Developing and implementing a program. Critical Care Nursing Clinics of North America,18(4), 503-507, 2006.

Helen Forbes, Deakin University: Rubric: Communication in Nursing. December 2012