Nurses Holding Each Other Accountable: The Effects of Using a Communication Intervention on Staff Engagement

Purpose:
The purpose of this study was to determine if a specific type of communication as an educational intervention would improve staff engagement and accountability and reduce violent behavior.

Significance:
Lateral violence is a barrier to effective communication. This cycle of incivility results in lower productivity, lower level of teamwork, and decreased quality clinical outcomes. Ineffective communication patterns influences a lack of accountability. Nurses need effective communication skills.

Strategy and Implementation:
This experimental research design compared the effects of exposing a treatment group to the communication techniques based on, Crucial Conversations® to a control group who continued their usual communication patterns. Participants were selected using a purposive sampling with random assignment from two units who have consistently scored below the mean on the National Database of Nursing Quality Indicators survey for RN-RN Interactions for two years. Participants completed a pre- and a postintervention survey with similar questions that measured the effectiveness of the intervention and crossover effect on the control group.The postintervention survey measurement was given to both groups one week after completion of the intervention class. The independent variable was the educational intervention of communication and conflict resolution skills. The dependent variable was the nursing interaction scores, which was measured from a subset of questions in the postintervention survey.

Evaluation:
The postintervention survey,nurse interaction statements,revealed an increase in positive responses.The combined mean for the nursing quality interaction type questions were preintervention(M=22.76,SD=.78)and postintervention(M=23.03,SD=.78)resulting in an increase in the nursing interactions.

Implications for Practice:
The crossover effect was highly positive.This communication intervention class should be required for all staff annually. Additional research is needed however, to measure the long-term effectiveness of a communication intervention, increased nurse accountability, and measure the cultural changes.