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Background: Effective communication is essential in critical care settings. Use of the SBAR (Situation, Background, Assessment, Recommendation) tool has been shown to standardize and improve communication among health care providers., Local Problem: This quality improvement project was designed to improve communication in an intensive care unit that lacked a standardized communication protocol. Communication practices differed greatly between nurses and advanced practice providers. As a result, patient safety was put at risk owing to incomplete, inaccurate, or delayed information when clinical concerns were reported or escalated., Methods: This project used a pre-post design in which surveys were used to gather information on staff perceptions of communication and collaboration between nurses and advanced practice providers before and after an educational intervention. The 2 groups received identical education on SBAR guidelines adapted for use in the intensive care unit setting and patient safety., Results: Results showed improvement in all areas of communication. Significant improvements were found on the General Perceptions subscale among advanced practice providers (P = .04) and among nurses (P = .007). In the combined study population, improvements were observed on all subscales, with significant results for the Open Communication (P = .03) and General Perceptions (P = .002) subscales. A significant increase was found in the percentage of nurses using the SBAR tool after the intervention (95%) compared with before the intervention (66%; P < .001)., Conclusion: Implementation of the SBAR communication tool significantly improved general perceptions of communication in this intensive care unit., (©2022 American Association of Critical-Care Nurses.)

Despite the frequency, complexity, and intensity of communication that occurs between nurses, patients, and families, palliative care nurses often struggle with end-of-life communication. The primary goal of this quality improvement project was to increase nurse confidence and satisfaction engaging in end-of-life communication following the implementation of the COMFORT model; the secondary goal was to improve patient-family satisfaction with care provided in the palliative care unit. Fourteen palliative care nurses attended a 4-hour course to learn the tenets of the COMFORT model and practice through role-play exercises. A repeated-measures design was used to measure nurse confidence and satisfaction precourse, postcourse, and 3 months postcourse. A between-subjects pre-post design was used to compare family satisfaction survey scores in the 3-month period before versus the 3 months after implementation. Analysis revealed a statistically significant increase in all measures of nurse confidence and satisfaction from precourse to postcourse and from precourse to 3 months postcourse. There was no statistical difference between the family satisfaction survey scores before versus after training, although survey results were generally high at baseline and most respondents rated palliative services with the best possible response. This project demonstrates that COMFORT model training increased confidence and satisfaction of palliative care nurses engaged in end-of-life communication and demonstrates potential for use in other clinical areas that do not specialize in end-of-life nursing (eg, critical care) but find themselves in need of the communications skills to address end-of-life care.

Objective: To review the legal issues concerning family members' access to information when patients are in the ICU., Data Sources: U.S. Code, U.S. Code of Federal Regulations, and state legislative codes., Data Extraction: Relevant legal statutes and regulations were identified and reviewed by the two attorney authors (L. F., M. A. V.)., Study Selection: Not applicable., Data Synthesis: Review by all coauthors., Conclusions: The Health Insurance Portability and Accountability Act and related laws should not be viewed as barriers to clinicians sharing information with ICU patients and their loved ones. Generally, under Health Insurance Portability and Accountability Act, personal representatives have the same authority to receive information that patients would otherwise have. Persons involved in the patient's care also may be given information relevant to the episode of care unless the patient objects. ICUs should develop policies for handling the issues we identify about such information sharing, including policies for responding to telephone inquiries and methods for giving patients the opportunity to object to sharing information with individuals involved in their care. ICU clinicians also should be knowledgeable of their state's laws about how to identify patients' personal representatives and the authority of those representatives. Finally, ICU clinicians should be aware of any special restrictions their state places on medical information. In aggregate, these strategies should help ICU managers and clinicians facilitate robust communication with patients and their loved ones.

Context: Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses., Objectives: To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication., Methods: A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via e-mail in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, U.S., Results: The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%)., Conclusion: ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions., (Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

An aging population with underlying health conditions, such as heart disease and diabetes, is at high risk for infections, including pneumonia, influenza, and coronavirus disease 2019 (COVID-19). In particular, the number of individuals in skilled nursing and long-term care facilities is increasing and older adults are at greatest risk. Research reveals these infections can lead to sepsis, septic shock, and death unless detected early through a sepsis screening process. The current quality improvement project demonstrates the capabilities of an early sepsis recognition screening tool in a skilled nursing facility and explores process changes required to operate facilities with high quality care. [Journal of Gerontological Nursing, 47(8), 37–44.] [ABSTRACT FROM AUTHOR]

Background Integrating palliative care into intensive care requires active involvement of bedside nurses in discussions of patients' prognosis and goals of care. Objective To improve critical care nurses' skills and confidence to engage in discussions with patients' families and physicians about prognosis and goals of care by using a focused educational intervention. Methods An 8-hour-long workshop was developed for critical care nurses. Key roles and skills of nurses in communication about prognosis and goals of care were defined. Participants practiced skills during facilitated role-plays. A reflection session addressed burnout, distress, and self-care. Participants completed surveys before, immediately after, and 3 months after their workshop, rating their confidence and skill in performing key tasks. Use of a participant focus group and open-response items in the surveys further elucidated the impact of the workshop. Results Between March 2011 and April 2013, a total of 82 critical care nurses completed a workshop. Compared with before the workshop, after the workshop, nurses reported greater skill and confidence for 14 survey items (P < .001), including assessing families' understanding of prognosis and goals of care, addressing families' emotional needs, and contributing to family meetings. Increases were sustained 3 months after the workshop. Conclusion Defining roles and providing opportunities for skills practice and reflection can enhance nurses' confidence to engage in discussions about prognosis and goals of care. [ABSTRACT FROM AUTHOR]

The Care Journal is a tool developed by the Josie King Foundation to promote interactive exchange among providers and patients/families. The Care Journal was implemented in a pediatric intensive care unit, and surveys were administered to assess perceptions about use. Parents who used the Care Journal and nursing staff found it to be a useful tool that improved communication, made parents feel more knowledgeable and empowered, and improved parents' overall perception of the hospital stay. [ABSTRACT FROM AUTHOR]

The article explores the relationship between the social movements of the 1960s and the media of mass communication. Because of ways in which mass media present images, protesting groups were dismayed with media images that presented their members in ways that ignored and damaged their egos. In 1966, the National Organization for Women created the Image of Women Task Force to reflect the concern of other groups within the movement by opposing to what they perceived as misrepresentation.

Using content-analytic procedures, the authors investigate how American religion has been defined, described, and given "social reality" via mass communication. Six hundred and forty-eight religion sections appearing in Time magazine between 1947 and 1976 were analyzed in several ways. Statistical treatment of the data revealed that (1) religion is depicted as a conflict-ridden human enterprise, (2) denominational stereotypes and geographical biases affect media coverage of religion, and (3) media-based portrayals of religion differ sharply from demographic and sociological facts. Five conventional explanations of these data are discussed, but a sixth--a rhetorical understanding of mass communication activities--is preferred. [ABSTRACT FROM AUTHOR]