COMRADE: COMmunicating Resident ADverse Events
Background: Each year, at least 8 million events and errors occur across the 16,000 nursing homes in the U.S. Licensed nurses are often the primary contact to inform residents and family members when there is a patient safety event such as medication error or fall, for example. Nurses surveyed feel that they lack training in this communication process that frequently feels incomplete, challenging, and uncomfortable.
Methods: This is a Phase 1 trial. In Phase 1.0 we tested the intervention training workshops in three Northern California nursing homes. Phase 1.1 we implemented the revised training sessions in a rural Central California nursing home to explore the quality of the communication following training. In Phase 1.2 we are in the process of audiotaping nurses (goal: n=20) before and after the Phase 1.0 version training session to evaluate changes in how the nurse communicates a simulated event via telephone to a standardized graduate research assistant “family member” using a structured tool provided in the training sessions.
Results: Thus far, 30 nurses have completed the training. Of these, 40% were staff nurses and 30% managers, with the remainder support staff (e.g., staff development nurse; treatment nurse). Using a hypothetical serious event scenario, only 60% of the time would nurses apologize and communicate full details of the event. A similar percentage worried they would be reprimanded due to their involvement. We found that nurse participants benefited from the training, with managers and directors of nursing especially reporting increased comfort in event communication.
Implications: We aim to continually refine the training program components and outcome measures with the goal of conducting a future randomized trial to explore the impact this training has on communication processes and outcomes. This study has great potential at improving how licensed nurses communicate with family members after a patient safety event as well as improving nurses’ comfort levels in this process, as well as how family members respond to open and transparent communication. The implications for education include adding patient safety competencies regarding communication of patient safety events in both Baccalaureate and Graduate Nursing curriculums.